Consult Health Care Professionals Research Articles

Health Information Seeking Behaviour in University Students Sri Lanka

Health Information Seeking Behaviour (HISB) refers to the action individuals take to fulfil their health-related information needs. In today's information-rich world, understanding HISB has become crucial for developing effective strategies in information-seeking and health management. For university students, efficient HISB can alleviate health-related anxiety, enhance risk management, promote self-care, and empower informed decision-making, all of which can positively impact academic performance. The findings unveiled intriguing patterns in information source preferences, with 46.2% of students turning to the Internet as their primary source, 41% relying on interpersonal networks, and 13% consulting healthcare professionals. Notably, no students reported using mass media platforms for health information. Gender, year of study, degree program, physical activity, health literacy, self-efficacy, and perceived severity of health problems exhibited significant associations with the choice of information sources. For instance, male students preferred the Internet, while female students leaned towards consulting healthcare professionals and interpersonal networks. Second-year students primarily used the internet, while final-year students sought advice from family and friends. Those who work-activity turned to healthcare professionals, whereas sports-activity favoured the internet. Furthermore, students with low work activity showed reduced odds of using the internet. Interestingly, sports activity had a significant impact only among internet information seekers. Students with moderate health literacy were more inclined to consult family and friends. This comprehensive study provides valuable insights into the factors affecting HISB among university students, offering a nuanced understanding of their information-seeking behaviour. These findings have implications for health education and interventions promoting informed and responsible health-related decision-making among young adults.

Epidemiological characteristics of a population visiting a patient-centered informative website about irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a chronic disorder characterized by abdominal pain and an altered bowel habit. The aim of this study was to evaluate the characteristics of a population visiting a patient-centered informative website about IBS. Five digital surveys were used to assess the Rome IV criteria, red flag symptoms, healthcare use, psychological comorbidities, quality of life, symptom severity, diet, physical activity. Patients were divided into a Rome positive and negative population with the Rome positive population being further subtyped based on dominant stool pattern. Red flag symptoms (42%) and comorbid psychological disorders (65% anxiety and 39% depression) were common. Despite consulting health care professionals and therapy, most patients (96%) still experienced moderate to severe symptoms with an average impact on quality of life. 73% performed regular physical exercise and 25% of the Rome positive population followed the FODMAP diet. Almost all participants consulted a health care professional at one point in time and used some form of therapy. 54% of the patients believed there is generally sufficient information available and 57% thinks that their physician takes IBS seriously. However, only 41% thinks that their physician has sufficient knowledge about IBS. This study underlines the importance of a thorough characterization of IBS patients. Furthermore, patients expressed an urgent need for high quality information and education for both health care professionals and patients.

Children's nutrition and the risk of developing neoplasms in childhood and adolescence.

Background: The effect of children's eating habits on the development of cancers in childhood and adolescence has been of great concern to researchers in recent years. This literature review aims to present the foods that may be related to the prevention or the incidence of cancer at the children between 0-18 years of age. Methods: A research on nutrition and the appearance of tumors in children and adolescents between the ages of 0-18 years old was done regardless of gender, educational level and nationality. A literature review was conducted using online databases and words, such as “Nutritional Habit”, “Nutritional Status”, “Diet’’, “Adolescence’’, “Childhood’’, “Pediatric Cancer’’, “Neoplasm’’, “Carcinoma’’, “Lymphoma’’ and “Leukemia’’. We collected and analyzed a total of 34 surveys, including three meta-analyses, ten case-control studies, one cross-sectional study and two research articles. Results: Worldwide the results showed a protective interrelation between breastfeeding, and the consumption of fruits, vegetables and dairy products in the development of childhood cancer. In contrast, the consumption of meat, cured meats, smoked fish, vegetable oils, soft drinks such as cola, junk food, but also the exposure to heavy metals, stand as the risk factors for childhood cancer cases. Conclusion: The Disease’s prevention is associated with intrauterine life and the mother's diet during pregnancy. The nutrition of the child is crucial in the first years of life and eating habits then affect food choices at an older age. A Balanced children’s nutrition is important and depends on the parents who should consult health care professionals. Finally, due to the constant appearance of new data, it is considered necessary to further study this field in Greece and cross-culturally.

Disempowering women—a mixed methods study exploring informational support about pain persisting after childbirth and its consequences

BackgroundAccess to information is essential to achieving individual empowerment; meaning the ability to exercise control, manage one’s own condition and make informed decisions. However, studies have shown that information provided to women regarding physiological changes during the postpartum period and postpartum health was inadequate, incorrect, or inconsistent.MethodsThe aim of this study was to explore informational support about pain persisting after childbirth and its consequences. A sequential explanatory mixed methods design was used. In the first, quantitative phase, 1,171 women, who gave birth eight months earlier, completed a self-administered questionnaire. In the second, qualitative phase, 20 women who experienced chronic pain were interviewed. Descriptive statistics and qualitative content analysis were used to analyse the data.ResultsThe majority of the women did not receive information about pain persisting after childbirth, or the information was insufficient or incorrect. They did not know when and where to seek help and did not consult health care professionals. In addition, the lack of information had a negative impact on women’s psychological well-being. All women expressed the need to be informed by health care professionals, irrespective of the individual risk of developing chronic pain.ConclusionsHealth services should ensure availability of information to give the women opportunity to achieve empowerment to make good health decisions, increase control over their health and well-being as well as to enhance their self-efficacy. We propose that a booklet or leaflet with relevant information about the risk of developing chronic pain, symptoms and treatment, along with advice about appropriate health care settings should be provided as part of antenatal or postnatal care.

Patient-reported experience of dry eye management: An international multicentre survey

PurposeTo explore the journey taken by patients in a range of different countries to manage their dry eye symptoms. MethodMembers of the general public who responded positively to the question “Do your eyes ever feel dry?” completed a questionnaire describing their demographics, the impact of their symptomology, the advice they have received and the management options they have tried. The Ocular Surface Disease Index (OSDI) questionnaire was also completed. ResultsA total of 916 individuals (Canada = 235, Mexico = 127, New Zealand = 157, Taiwan = 246, UK = 151) of similar age distribution (median 38 years, IQR: 27–50) completed the survey. The reported duration of symptoms was longest in Canada (median 4 years, range 2–10) and least in Taiwan (2 years, range 1–3; p < 0.001), and similar trends were observed for symptom severity (p = 0.001). However, there was no statistically significant difference between countries with respect to the impact of symptoms on quality of life (median 3/10; p = 0.08). Less than half of the individuals in any country had consulted with a health professional. About half had tried a treatment for their dry eye symptoms, with artificial tears being the most common treatment, followed by warm compresses, and both therapies were rated as reasonably effective (median 5−7/10). ConclusionMany people with dry eye symptoms are not consulting health care professionals who can confirm the diagnosis, exclude differential diagnoses, and offer a wide range of treatments targeted at the dry eye subtype.

Why Do Some Spanish Nursing Students with Menstrual Pain Fail to Consult Healthcare Professionals?

Dysmenorrhea is a problem that affects a large percentage of young women worldwide. Alarmingly, the majority of these women choose to self-medicate rather than consult a healthcare professional, despite the risks involved. The present study aimed to explore the reasons why undergraduate nursing students do not consult health care professionals regarding their menstrual pain. A qualitative study was conducted using an open question: “Why didn’t you consult a healthcare professional?” within the context of a research project on primary dysmenorrhea among nursing students at the University of Huelva, Spain. The responses of 202 women were analyzed using content analysis. Three categories were identified: assessment of the pain experienced, expectations, and experiences of professional care and selfcare. We found a striking normalization of the problem; notably, students downplayed the importance of the problem, considering that it was not worth consulting a physician. Furthermore, there was a notable degree of self-medication using non-steroidal anti-inflammatories (NSAIDs). These results may be useful for orienting policies to raise social awareness of this problem and for designing health education strategies aimed at women with primary dysmenorrhea.

Youtube as a Source of Patients' and Specialists' Information on Hemorrhoids and Hemorrhoid Surgery.

In the past, most people sought medical information by consulting health care professionals. Nowadays, many people started to use online resources to access medical information. The study aims to investigate whether YouTube videos on hemorrhoids and hemorrhoid surgery can be a useful e-learning source for the general population, surgical trainees and specialists. A YouTube search was performed in October 2019 using the keywords "hemorrhoids" and "hemorrhoid surgery", and the videos were divided into 2 groups according to the keywords. Three independent researchers assessed the metadata and classified them according to the level of accuracy (hemorrhoid group) and the level of usefulness (hemorrhoid surgery group). Cohen's test and Kappa (K) value were used to evaluate the inter-investigators agreement. A total of 200 videos were analyzed, 100 for each keyword. Regarding the hemorrhoid group, 43 videos (48.3%) were misleading, 9 were accurate (10.1%), 18 were approximate (20.2%), and 19 were considered a personal experience (21.4%). Regarding the hemorrhoid surgery group, around 60% of the videos were lacking a clear explanation, while about 16% were inaccurate. Only the remaining 24% were considered useful for teaching. Around half of the YouTube videos regarding hemorrhoids topic were found to be misleading or inaccurate and present a risk of harmful consequences. Credible videos with accurate information need to be uploaded by medical professionals and medical institutions and some sort of filtering, using categories by the staff of YouTube, appears to be necessary. Care must be taken to produce clear, high-quality operative clips with proper scientific commentary.

Understanding parental concerns related to their child's development and factors influencing their decisions to seek help from health care professionals: Results of a qualitative study.

Early identification of children at risk of developmental delay is crucial to promote healthy development. Assessing parental concerns about development is often part of identification processes. However, we currently do not understand well how and why parents become concerned and how and why they access early identification and intervention services. The purpose of this study was to explore parental perceptions about their child's development and the factors influencing their reported professional help-seeking behaviours. This exploratory study was part of a larger study describing child development in children aged 2-5 in a small Canadian city. We conducted semistructured interviews with 16 parents whose children were at risk of developmental delay to examine their perceptions of their child's development, their use of community services promoting development, and their recommendations to optimize those services. Four themes were identified: (a) Vision of child development influencing help-seeking behaviours: Natural or Supported?, (b) Internal and external sources contributing to parents' level of developmental concern, (c) Using internal resources and struggling to access external resources, and (d) Satisfaction with services accessed and recommendations to access more support. Parents' vision of child development along with sources of parental concern appeared to influence the level of concern, enhancing our understanding of how parents become concerned. The level of concern and parents' knowledge and perceived access to resources seemed to influence their decision whether or not to consult health care professionals. Parents provided many suggestions to improve services to promote child development and support families. Results highlight the importance of supporting parents in recognizing if their child is at risk of delay and increasing awareness of available resources. It appears particularly important to ensure that health care professionals and community-based support services are accessible to provide parents with the support they need, especially when they have concerns.

Complementary and Alternative Medicine Methods Used Among Turkish Pediatric Oncology Patients

PurposeComplementary and alternative medicine (CAM) methods are gradually becoming common in pediatric oncology. The aim of this study was to determine the current use of CAM methods by Turkish mothers for their children with cancer. Design and methodsThe sample for this descriptive and cross-sectional study consisted of the mothers (n = 110) of children with cancer undergoing treatment in a hematology-oncology clinic and outpatient clinic. The data were collected using a questionnaire that included the CAM methods used by mothers for their children with cancer. ResultsOf 110 children, 65 (59.1%) were diagnosed with leukemia and 107 (97.3%) underwent chemotherapy. More than half of the mothers (53.6%) were using CAM methods. The most common CAM method was the use of natural products (93.2%), of which the most frequently used were carob, mulberry, and grape molasses. Mothers used CAM to support the treatment of their children with cancer and alleviate the side effects of chemotherapy and, in most cases, without previously consulting healthcare professionals about their use. ConclusionsThis study revealed that most mothers used CAM methods for their children. Practice implicationsIt is important that healthcare professionals are aware about the use of CAM methods in children with cancer to prevent any possible negative interaction between conventional (i.e., chemotherapy) and alternative treatments.

Cutaneous neurofibromas: patients\u2019 medical burden, current management and therapeutic expectations: results from an online European patient community survey

BackgroundNeurofibromatosis type 1 is an inherited condition with variable phenotypic expression and a high medical and social burden.The objectives of this patient survey were to better understand the real-world experiences of patients living with cutaneous neurofibromas (cNF), to perceive their satisfaction and feelings about cNF current management (only laser and surgery are currently available), and to highlight their expectations of new therapeutic modalities.ResultsOne hundred seventy patients from 4 European countries took part in the study, 65% (n = 110) were women and mean age was 39 years old. 96% (n = 164) of respondents have cNF on visible parts of the body and the survey confirmed that total number of cNF and visibility increase with age.Patients reported that cNF mainly impacts everyday mood, general daily life and social life. The visibility of cNF had a higher impact than their number.92% (n = 156) of patients have a regular and multidisciplinary medical follow-up. The dermatologist is one of the most consulted healthcare professionals.76% (n = 130) of respondents have treated their cNF: 65% (n = 111) had surgery and 38% (n = 64) had multiple laser sessions. Frequency of operations and regrowth of cNF were the two most unsatisfactory aspects with both treatments for patients. Indeed, after removal, new cNF appear in more than 75% (n = 128) of cases.As a future treatment, patients expected a topical (30%, n = 51) or oral medication (29%, n = 50). Around 2 out of 3 patients would agree to take it at least once a day or more for life but they would like a well-tolerated treatment.According to patients, the most important effectiveness criteria of a new treatment are to block cNF growth and reduce their number. 70% (n = 119) of patients would consider a future treatment moderately effective to very effective if it could clear 30% of cNF.ConclusionsThis first cNF European patient community survey confirmed that the visible stigma and unaesthetic aspect of cNF have an important impact on patients’ quality of life. The survey highlighted that patients were not entirely satisfied with the actual surgery and laser treatments and revealed their clear and realistic expectations for future treatment of cNF.

Natural History of Back Pain in Older Adults over Five Years.

Back pain is a prevalent health problem. Research often focuses on adults. Evidence on the long-term course of back pain in older patients is limited. A prospective cohort study (BACE) was conducted in a primary care setting in the Netherlands. We aim to investigate the 5-year course and medical consumption of older adults (>55 years) presenting with back pain in general practice. Patients aged >55 years, consulting their general practitioner with a new back pain episode, were included between 2009 to 2011. Follow-up questionnaires included, for example, pain severity, disability, quality of life, recovery, and medical consumption. A total of 675 patients (mean age ± SD, 66.4 ± 7.6 years) participated, showing a mean (± SD) back pain reduction from 5.2 (± 2.7) to 3.6 (± 2.8) (numeric rating scale, 0 to 10) at 3 months follow-up; disability decreased from 9.8 (± 5.8) to 7.8 (± 6.2) (Roland-Morris Disability Questionnaire, 0 to 24). After 6 months, this remained practically constant over time. Medical consumption was highest in the first months; medication was used by 72% at baseline and approximately one-third (25% to 39%) during follow-up. At 5-year follow-up (response rate 58%; n = 392), 43% had recovered; a majority reported persistent or recurrent back pain. Clinically relevant improvements in back pain intensity and disability were seen in the first 3 to 6 months of follow-up. A majority of patients does not become pain free within 3 months; this does not improve over 5 years. However, most patients stop consulting health care professionals during follow-up. Current medical strategies may not be sufficient in older back pain patients, where back pain becomes a recurrent or chronic condition in the majority of patients.

OS3.6 Prediagnostic symptoms and signs of adult glioma: the patients’ view

Abstract BACKGROUND Little is known about the symptoms and signs glioma patients experience in the year before diagnosis, either or not resulting in health care usage. The objective of this study was to determine the incidence of several symptoms and signs glioma patients experienced in the year prior to diagnosis, as well as visits to a general practitioner (GP) related to these issues. MATERIAL AND METHODS This was a cross-sectional study, including adults diagnosed with a glioma &lt;12 months ago. Patients were asked to complete a 30-item study-specific questionnaire, if possible with input of a proxy, focusing on symptoms and signs they experienced in the 12 months before diagnosis. For each indicated symptom/sign, patients were asked whether they consulted the GP for this issue. In addition, the presence of comorbidity and other chronic complaints were assessed, as well as consulted health care professionals (HCPs) in the year prior to diagnosis. The statistical analyses were corrected for multiple testing. RESULTS Between July 2016 and March 2019, 58 patients completed the questionnaires, 54 (93%) with input of a proxy. Forty-one (72%) patients were men, with a median age of 60 years (range 43–78), and the median time since diagnosis was 4 months (range 1–12). Forty (69%) patients had a comorbidity or chronic complaint, and the median number of consulted HCPs was 2 (range 0–8). The median number of symptoms/signs experienced in the year before diagnosis was 8 (range 2–19) in low-grade and 5 (range 0–24) in high-grade glioma (p=0.258). The five most frequently mentioned problems were fatigue (34/58, 59%), mental tiredness (28/58, 48%), sleeping disorder (23/58, 40%), headache (22/58, 38%) and stress (20/58, 34%), with no differences between low- and high grade glioma. Twenty-five (43%) patients had visited the GP with at least one issue. We found that patients who did consult their GP reported significantly more often muscle weakness (11 vs 3, p=0.002), paralysis in for example a hand or leg (10 vs 3, p=0.006), or a change in consciousness (9 vs 3, p=0.013) compared to those that did not consult the GP. However, they did not differ with respect to the number of symptoms (median 7 vs 5), comorbidities and chronic complaints (median 1 vs 1), or overall health care usage (median 3 vs 2). CONCLUSION Glioma patients experience a range of problems in the year prior to diagnosis, but patients who consult the GP report significantly more often neurological problems.

Identifying an effective mobile health application for the self-management of allergic rhinitis and asthma in Australia

Objective: People with allergic rhinitis (AR) often self-manage in the community pharmacy setting without consulting health care professionals and trivialize their comorbidities such as asthma. A mobile health application (mHealth app) with a self-monitoring and medication adherence system can assist with the appropriate self-management of AR and asthma. This study aimed to identify an app effective for the self-management of AR and/or asthma.Methods: MHealth apps retrieved from the Australian Apple App Store and Android Google Play Store were included in this study if they were developed for self-management of AR and/or asthma; in English language; free of charge for the full version; and accessible to users of the mHealth app. The mHealth app quality was evaluated on three domains using a two-stage process. In Stage 1, the apps were ranked along Domain 1 (Accessibility in both app stores). In Stage 2, the apps with Stage 1, maximum score were ranked along Domain 2 (alignment with theoretical principles of the self-management of AR and/or asthma) and Domain 3 (usability of the mHealth app using Mobile App Rating Scale instrument).Results: Of the 418 apps retrieved, 31 were evaluated in Stage 1 and 16 in Stage 2. The MASK-air achieved the highest mean rank and covered all self-management principles except the doctor’s appointment reminder and scored a total MARS mean score of 0.91/1.Conclusions: MASK-air is ranked most highly across the assessment domains for the self-management of both AR and coexisting asthma. This mHealth app covers the majority of the self-management principles and is highly engaging.

Diagnostic delay and suboptimal management in persistent idiopathic facial pain and persistent dentoalveolar pain; a cross-sectional study

The aim of this study was to explore the diagnostic and therapeutic challenges encountered by patients with persistent idiopathic facial pain (PIFP) and to investigate factors influencing its delayed diagnosis. In this cross-sectional study, 34 patients with newly diagnosed PIFP were interviewed. Data about diagnostic delay, number and nature of previous consultations, and previous medical and surgical interventions were recorded. Pearson's correlation and Student t test were used to examine the differences among the variables in relation to diagnostic delay. The average time between the onset of symptoms to correct diagnosis was 19.3 ± 11.1 months. Diagnostic delay was significantly longer in patient with pain localized to intraoral sites (22.6 ± 7.4) compared with patients with extraoral pain (16.1 ± 9.3). The average number of health care professionals consulted before correct diagnosis was 3.7 ± 2.3. General dental practitioners were the most commonly consulted health care professionals (n = 27; 79.4%). On average, patients were given 2.3 ± 0.24 misdiagnoses before the correct diagnosis was determined and were prescribed 3.5 ± 2.4 classes of drugs. Twenty-five patients (73.5%) underwent unnecessary surgical/dental interventions. Patients with PIFP are frequently misdiagnosed, leading to prescription of ineffective medications and unnecessary investigations and surgical interventions. Educational efforts should emphasize on improving knowledge and awareness of this condition.

Quality of life in family caregivers of patients in the intensive care unit: A longitudinal study

BackgroundFamily caregivers of patients in the intensive care unit (ICU) experience impairments in the quality of life. Previous studies report that psychological quality of life improves over time, but there has been limited longitudinal research, and measurement points have differed. Factors such as age, gender, and posttraumatic stress symptoms have been found to be associated with the quality of life, but level of hope and its associations with the quality of life have not been investigated. ObjectivesThe objective of this study was (1) to evaluate changes in the quality of life in family caregivers during the first year after a patient's admission to the ICU and (2) to identify associations between patients' and family caregivers' background characteristics, posttraumatic stress symptoms, hope, and quality of life. MethodsA longitudinal study design with five measurement points was used. Family caregivers completed study questionnaires at enrolment into the study and at 1, 3, 6, and 12 months after the patient's admission to the ICU. The quality of life was measured with the 12-Item Short Form Health Survey. ResultsFamily caregivers (N = 211) reported improved psychological quality of life during the first year after the patient's admission to the ICU, but it was still lower than the psychological quality of life reported in norm-based data. Being on sick leave, consulting healthcare professionals (e.g., general practitioner), and increased level of posttraumatic stress symptoms were significantly associated with psychological quality of life, whereas hope was not. Reported physical quality of life was comparable to norm-based data. ConclusionFamily caregivers of patients in the ICU reported impairments in quality of life during the first year after the patient's admission to the ICU. Being on sick leave, consulting healthcare professionals, and reduced posttraumatic stress symptoms may improve mental quality of life.

Overactive bladder symptom severity, bother, help-seeking behavior, and quality of life in patients with type 2 diabetes: a path analysis

BackgroundThis study aimed to investigate the relationships among overactive bladder (OAB) symptom severity, bother, help-seeking behavior, and quality of life (QOL) in patients with type 2 diabetes.MethodsA total of 127 diabetic patients, aged at least 18 years, with overactive bladder from a hospital in Shandong Province, China, were recruited for this study. Symptom severity, bother, and quality of life were assessed using the Overactive Bladder Symptom Score (OABSS), Patient Perception of Bladder Condition (PPBC), and Overactive Bladder Questionnaire Short Form (OAB-q SF), respectively. Help-seeking behavior was assessed by asking patients whether they consulted health care professionals or received treatment for their bladder problems. A two-step path analysis was performed to analyze the data.ResultsOAB symptom severity was directly associated with lower levels of QOL, and the strength of this association was no longer significant when taking bother and help-seeking behavior into account. Bother increased with OAB symptom severity, and patients with bothersome OAB tended to have lower levels of QOL. Moreover, bother increased help-seeking behavior; however, patients who sought help tended to have lower levels of QOL.ConclusionsOur findings highlight the role of bother and help-seeking behavior in the relationship between OAB symptom severity and QOL. To improve a patient’s QOL, health care providers should focus not only on symptom bother but also on dysfunctional help-seeking patterns.

The prevalence of lower urinary tract symptoms in population aged 40 years or over, in South Korea.

PurposeLower urinary tract symptoms (LUTS) can be distressing and socially isolating, and the economic impact can be substantial. Further data to characterize the epidemiology and effects of LUTS in South Korea would be beneficial.Materials and MethodsIn an international, internet-based survey, the prevalence and impact of LUTS was evaluated in adults aged ≥40 years. Questions related to International Continence Society (ICS) symptom definitions and the bother associated with each symptom. The international prostate symptom score (IPSS) and the overactive bladder symptom score (OABSS) were assessed.ResultsOf the 2,080 participants from South Korea, 1,090 (52.4%) were women and 740 (35.6%) were aged ≥60 years. The prevalence of LUTS according to ICS criteria was 68.2% (men, 70.6%; women, 66.0%). LUTS prevalence increased significantly with age (p=0.01 in men and women). Storage symptoms only were reported in 16.2% of men and 30.5% of women, making this the most common ICS symptom group overall. Individual symptoms with the highest prevalence in the overall population were nocturia, frequency, and weak stream (36%, 30%, and 29%, respectively). IPSS results showed that 40.1% of participants had at least moderate symptoms. The prevalence of OABSS-defined overactive bladder was 19.7% (men, 19.5%; women, 19.9%). Fourteen percent of individuals with any LUTS visited healthcare professionals regarding urinary symptoms.ConclusionsLUTS affect the majority of adults aged ≥40 years in South Korea. The low percentage of individuals with LUTS consulting healthcare professionals regarding urinary symptoms indicates a need to improve rates of diagnosis and treatment.

Opioid-induced constipation, use of laxatives, and health-related quality of life

Background and aimsReal-life data on laxative use in patients suffering from opioid-induced constipation (OIC) are very limited, and many OIC patients are only using over the counter laxatives to resolve their constipation. Our aim was to describe laxative utilization and quality of life in participants in Norway who ever experienced OIC. MethodsThis was a cross-sectional online survey conducted between 27th of June and 3rd of July 2014 among participants above 18 years with self-reported OIC and who had agreed to receive information from the pharmacy chain (Boots A/S, Norway). The questionnaire comprised a series of multiple choice, close-ended, and free text questions on abdominal symptoms, laxative use and health-related quality of life. ResultsA total of 417 participants met the study eligibility criteria: (1) treated with opioid for a minimum of 4 weeks, (2) actively accepted participation, and (3) confirmed ever experiencing OIC and in addition completed the survey. Among the eligible participants, 86% were females, 85% were younger than 60 years of age, and 57% were currently suffering OIC. More than half of the currently constipated participants were experiencing moderate to very severe abdominal bloating (63%), abdominal pain (55%) and/or pain during bowel movement (50%). Less than every fourth participant (23%) had consulted health care professionals (HCPs) about their constipation. Up to 39% reported that they handled their OIC by self-management, e.g., bought laxative, reduced the dose and/or changed opioid without consulting HCP or pharmacy. Less than half (48%) of the laxative users were satisfied with the laxative they were using to relieve their constipation. The EQ-5D health-related quality of life score was mean (SD): 0.587 (0.272). Although not statistically significant (p=0.067), there was a tendency of lower quality of life among the participants who were currently constipated compared with those not currently constipated (difference of mean EQ-5D: 0.629–0.555=0.074). A significantly lower (p=0.001) quality of life was found among participants who were dissatisfied with their laxative [mean (SD): 0.424 (0.350)] than among those who were satisfied or neither satisfied nor dissatisfied [mean (SD): 0.628 (0.235) and 0.673 (0.155), respectively]. ConclusionsThe results suggest a high degree of moderate to very severe abdominal symptoms, a high degree of self-management of opioid-induced constipation, a low degree of satisfaction with laxative, and low health-related quality of life of patients suffering from chronic pain necessitating long-term opioid treatment, subsequent constipation and laxatives use. ImplicationsPatients suffering from OIC with low quality of life and remaining symptoms despite use of two or more laxatives are a vulnerable patient group in need of optimized healthcare management, who also might benefit from more specific and innovative therapy.

Study on self-medication among 2nd year medical students

Background: Self-medication is use of medicines by individuals to treat self-recognized symptoms and illness. Self-medication is a common type of self-care behavior in the general public, but medical students differ in such practice, as they have knowledge about drugs and diseases. Methods: The present study involved 100 2 nd year final term medical students in “Shivamogga Institute of Medical Sciences,” Shivamogga, Karnataka. Study was questionnaire based, and the results were analyzed by descriptive statistical methods. Results: In our study, 57% were female, and 43% were male. About 60% had knowledge about over the counter (OTC) drugs and considered Ayurveda drugs also OTC drugs. 25% considered self-medication entirely safe, whereas 61% considered self-medication have advantages. Self-medication was preferred by 72% as they felt that there is no need to consult health care professionals for a simple ailment. Self-medication was practiced by 62% students, among which 86% were appropriate, and 48% among them utilized knowledge from previous consultation. In 28% fever was the most common condition and paracetamol was the most commonly used drug. Conclusions: Self-medication was widely practiced among the students. They had good knowledge of OTC drugs. The practice of self-medication was almost appropriate. In general self-medication must be accompanied by appropriate information. Educating benefits and risks of self-medication is very much needed for medical students and the public now a day.

The use of pregabalin in the treatment of hot flashes.

Perimenopausal women often consult health care professionals for help in managing vasomotor symptoms such as hot flashes and night sweats. Similar symptoms are also associated with the use of certain drugs such as tamoxifen and leuprolide.1,2 Various therapies have been studied for the treatment of these symptoms, the most predominant being hormonal therapy (HT). Because of the risks and contraindications associated with HT, however, nonhormonal pharmacologic therapy has been explored for the treatment of hot flashes. Antidepressants (e.g., venlafaxine, paroxetine and fluoxetine), as well as clonidine, Bellergal (belladonna, ergotamine and phenobarbital) and gabapentin are medications that can be prescribed as alternatives to HT, as suggested by the Society of Obstetricians and Gynaecologists of Canada (SOGC).3 While antidepressants affect the release and reuptake of serotonin and/or norepinephrine,4-6 gabapentin and pregabalin are gamma-aminobutyric acid analogues,7,8 and their mechanism of action related to the reduction of hot flashes is currently unclear. Patients using gabapentin for neurologic conditions have been described in the literature as having a reduction in hot flashes.9 Although pregabalin is not listed by the SOGC as one of the options for treating hot flashes, preliminary data supporting its use for this indication are available.10,11 This investigational use of pregabalin stems from past evidence that shows the benefit of gabapentin,12,13 an agent of the same class, for the treatment of hot flashes.