Senior citizens and over the counter drugs: challenges in rural India

Abstract

The population of elderly is on a rise in India. According to the 2011 census by the government of India, senior citizens constitute 8% of the total population. 1 An analysis of the morbidity and mortality profile of the elderly has shown that they suffer equally from both communicable and non-communicable diseases, many with multiple diseases at the same time which inevitably lead to the use of multiple medications or polypharmacy. 2-4 This also encourages the tendency for self-medication, increase in the use of non-prescription drugs and purchase of medications showing the previous medication cover, especially in India where the health care is becoming expensive, especially for those who are poor. 5,6 Over the counter (OTC) drugs, otherwise known as non-prescription drugs are those medications that are bought without any prescription. It gives the patient, the freedom to self manage the symptoms. A study by United nations international drug control programme has revealed that use of such drugs is on a rise in South Asian countries like India. 7 Many consider it as an economic way of treatment for common self-limiting illnesses especially among the geriatric population. 8-10 The flip side of this practice is that the geriatric populations are more vulnerable to adverse drug events that are ABSTRACT Background: The geriatric population is on a rise in India, which is accompanied by an increase in their health care needs. As they are prone to have multiple diseases simultaneously the tendency for over the counter (OTC) or nonprescription drugs is much higher among the elderly population. A thorough knowledge about the medication practices among elderly is indispensable since the chances for adverse drugs events; drug interactions etc. are higher among them. The primary objective of the present study was to measure the prevalence of over the counter drug usage among those aged 60 years or above residing in a rural block of North Tamilnadu, India. Methods: A community based cross sectional study was conducted among those aged 60 years or above using an interviewer administered questionnaire and data was collected from 100 consenting participants who were selected using multi stage sampling. Results: The prevalence of the usage of over the counter drugs among the elderly population was found to be 51% (95% CI 41.1-60.9). It was shown that the usage of OTC drugs was associated with higher socio economic status (p value 0.015) and literacy (p value 0.003). Conclusions: Further studies need to done to identify whether such high prevalence of OTC drug usage among elderly is a reflection of drug practices among general population and if proven otherwise should explore the various reasons for the same so that necessary measures can be implemented to alleviate the situation.

Adverse Drug Reaction Reporting in Geriatric Oncology in India: An Understudied Topic that Needs Attention

“…51 In studies done in Tamil Nadu and North India, the prevalence of the usage of OTC drugs among the elderly population was found to be 51 and 65.5%, respectively, which is higher compared with an Australian study (17.7-35.5%). [51][52][53] In two other Indian studies, CAM was reported to be used by 23% of oncology patients. 47,54 Sixty-nine percent of those polled said they used CAM in addition to modern medicine.…”

“…51 On the other hand, higher socioeconomic status ( p = 0.015) and literacy rates were associated with OTC drug use ( p = 0.003) in another study that is similar to western studies. 53 55 56…”

“…51 On the other hand, higher socioeconomic status (p ¼ 0.015) and literacy rates were associated with OTC drug use (p ¼ 0.003) in another study that is similar to western studies. 53,55,56 Ayurveda is the most popular CAM (64.8%), followed by homeopathy (62.4%) with many patients using both practices together. 51 Due to a lack of elderly patients reporting their use of CAM, preventing CAM-related side effects and drug interactions is difficult.…”