Minor Ailments Research Articles

Erratum to: Alternative Treatments for Minor GI Ailments.

[This retracts the article DOI: 10.24926/iip.v10i3.1659.].

Beyond medicines provision: community pharmacists roles in meeting patient needs through value-added pharmacy services

Abstract Objectives Pharmacy practice now requires more patient-centred and outcome-oriented approach, hence the need for a more value-based model. In developing countries like Nigeria, out-of-pocket spending for health care is high and patients usually visit the community pharmacy first to attend to their health needs. Since patients need to get value for their money, assessing their perception on services provided and their need for value-added pharmacy services is imperative. Thus, this study aims at assessing the perception of patients on services provided by community pharmacies in Nigeria and to ascertain their needs for value-added pharmacy services. Methods A 15-item questionnaire was administered to randomly sampled respondents who routinely visit their community pharmacy. The questionnaire addressed demographics, satisfaction with community pharmacy practice, accessibility of healthcare professionals and need for value-added pharmacy services. The respondents gave oral informed consent prior to administration of the questionnaires. Descriptive statistics were applied in data analysis. Key Findings A total of 384 questionnaires were distributed, and 300 were duly filled and returned. The survey lasted for 3 months, and the questionnaires were self-completed. All respondents agreed that pharmacy practice is important in healthcare delivery in Nigeria. Seventy-one per cent stated that the community pharmacy was their first port of call for treating minor ailments and seeking advice on medicines and health. Furthermore, 61% indicated that they trust pharmacists more than other health professionals in the area of medicines provision and advice. All respondents agreed that they require provision of more services other than medication dispensing and advice from their pharmacists. Conclusions Results suggest that patients have a positive perception towards community pharmacists as the most accessible and trusted health professionals for minor ailments and medicines provision. However, in addition to medicines provision, these patients require more services from pharmacists that add value in meeting their various health and medicines needs.

Community pharmacists' perceptions, attitudes and barriers towards pharmacist-led minor ailment services in Malaysia.

Background Community pharmacists are increasingly recognized to have an important role in providing a convenient and accessible alternative support for patients with minor ailments. In view of the abilities of community pharmacists in managing minor ailments, some countries have started the pharmacy-based minor ailment schemes that offers public access to treatment and advice of minor ailments from their local pharmacist. Nevertheless, there is limited study in Malaysia that explore the current practice of community pharmacists in managing minor ailment. Objective This study aims to evaluate community pharmacists' perceptions, attitudes and barriers of pharmacist-led minor ailment services. Setting Community pharmacists inMalaysia. Methods A cross-sectional survey among community pharmacists practicing in Malaysia was conducted between December 2017 until March 2018. The self-administered survey was distributed online via email, Facebook and WhatsApp's group. Main outcome measure Community pharmacists' perceptions, attitude and barriers towards minor-ailment service in community pharmacy settings. Results A total of 305 community pharmacists had completed the survey. The majority of community pharmacists in Malaysia had positive perceptions and attitudes towards pharmacist-led minor ailment services. The most common perceived barriers were lack of patient's medical information, absence of dispensing separation and lack of support from other healthcare professionals. Ethnicity, position and years of working experience were found to have significant associations with community pharmacists' score of attitudes and barriers related to minor ailment treatment in community pharmacy settings. Conclusion Community pharmacists in Malaysia have positive perceptions and attitudes over benefits of minor ailment services to public, however the barriers towards the service must be overcome to ensure service is sustainable for public's benefits.

Self-medication among pregnant women in two municipalities in the Central Region of Ghana

Self-medication in pregnancy is a concern in Ghana. We assessed the practice among 136 pregnant women in Effutu and Agona West Municipalities using facility-based, cross-sectional design and mixed method approach of data collection. Our findings show that pregnant women of varying backgrounds self-medicate for sociocultural and economic reasons, with 69% prevalence, motivated by cheaper treatment cost (17%), minor ailments (29%) and positive outcomes (33%). Commonly used medications include antibiotics (23%), pain killers (20%) and herbal preparations (19%). We recommend further studies on pharmacological compositions of the medications used and effects on pregnancy outcomes to inform policy and programs decisions.

Medication information and supply behaviours in elite and developing athletes

ObjectivesTo investigate the behaviours of elite and developing athletes in obtaining medications and medication information, and to identify the role of pharmacists in athlete care. DesignCross-sectional survey. MethodsAn electronic, 39-item questionnaire was developed, piloted and distributed to elite and developing athletes aged 18 years and above at a state-based sporting institute. Quantitative data was analysed using descriptive statistics and free text comments were analysed using an inductive reasoning approach. ResultsA total of 98 responses were analysed. Ninety (n=90/98, 91.84%) participants obtained medications in the six months prior to survey completion. Pharmacies were the most common source of both prescription (n=67/69, 97.10%) and non-prescription medications (n=64/75, 85.33%). Forty-five (n=45/98, 45.92%) participants also attended pharmacies when they had a minor ailment. Sixty-two (n=62/98, 63.27%) participants ‘sometimes’ consulted pharmacists for medication information. Only 11 (n=11/98, 11.22%) knew, according to their sporting institute medication policy, that athletes were required to consult a medical practitioner before taking anti-inflammatory, pain-relieving or sleep-inducing medications. Forty (n=40/98, 40.82%) participants believed pharmacists could play a role in their medication management. ConclusionsMany elite and developing athletes visited pharmacies for medication supply and treatment of minor ailments. Doping regulatory agency websites were the most commonly used and trusted sources for medication information, although some athletes believed pharmacists could also contribute to their medication management. Future research should consider whether pharmacists are ready for a role in sports pharmacy.

Quality variation and standardization of black pepper (Piper nigrum): A comparative geographical evaluation based on instrumental and metabolomics analysis

Black pepper (Piper nigrum; BP), known as the 'king of spices', imported from various countries is widely available in Saudi Arabian markets, as its demand as a food as well as a medicine for minor ailments is increasing in the country. However, there is a lack of appropriate information regarding these samples in terms of quality variation and standardization. We thus aimed to evaluate the quality and standardize the BP sample with respect to its physicochemical characters, active principle variation [i.e. piperine (PPN)], toxicity, and biological activity. The main focus is to validate whether any difference exists in the quality and quantity of active principle in these samples. For this purpose, physicochemical (chemical tests and ash values) and instrumental analyses [accelerated solvent extraction (ASE), ultra-high-pressure liquid chromatography (UHPLC)-diode array detector, infrared (IR), nuclear magnetic resonance (NMR), and inductively coupled plasma-MS (ICP-MS)] and biological evaluation {in vitro antioxidant activity [2,2-diphenyl-1-picrylhydrazyl and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)] and cytotoxicity assay} were performed. An extract yield (g) with %recovery of 2.26 ± 4.24 (11.3) was obtained for the Vietnamese sample, using a fast and rapid method of extraction (ASE). These values were 1.22 ± 2.64 (6.1) and 0.75 ± 1.69 (3.75) for the Pakistani and Indian samples. Physicochemical tests revealed the presence of flavonoids and phenolic compounds in all samples; however, in the Vietnamese sample a low amount of total, acid-insoluble, and high water-soluble ash value was noted. IR and NMR was applied to further standardize the samples. Results of ICP-MS analysis showed a high amount of macronutrients and micronutrients in the samples tested while UHPLC analysis revealed a high amount of PPN (ng/mL) in the Pakistani sample (1,362,614.09); these values were 1,051,848.04 and 768,512.81 for the Vietnamese and Indian samples, respectively. In vitro antioxidant and cytotoxicity activities revealed higher potential for the Vietnamese sample. The samples were properly standardized and effectively differentiated in terms of quality and biological activities using a fast and reliable method, however it certainly does not mean that a particular geographical region is more better or productive in terms of herbal products.

An exploration of the attitudes and perceptions of the UK public towards self-care for minor ailments.

the purpose of this pilot study was to explore the attitudes and perceptions of members of the UK public towards self-care for minor ailments. with an ageing and increasing population, and an NHS under extreme pressure, methods to reduce demand on health services are vital. Increasing the use of self-care for minor ailments is one way in which this pressure could be alleviated. this study used qualitative methods including semi-structured telephone interviews. The data were then evaluated, and key themes drawn out using thematic analysis. the results showed that the public are aware of the notion of self-care, and some are engaging with it. However, for a number of reasons, patients are still likely to want a face-to-face appointment despite the use of online and telephone advice services. the study highlighted that there are multifactorial aspects impacting on a patient's likelihood of engaging in self-care when faced with a minor illness. The results are not generalisable to every member of the public, but interesting questions are raised with regard to the usefulness of current public health messages in various media when there appears to be a lack of desire from the public to use some recommended services.

Australian pharmacists: ready for increased non-prescription medicines reclassification.

Reclassification of medicines from prescription to non-prescription increases timely access to treatment, promotes self-management of minor ailments and relieves healthcare system burden. Previous research identified that Australia lagged behind the United Kingdom and New Zealand in medicines reclassification. This study aimed to identify Australian pharmacists' opinions on the current state of medicines reclassification; the prescription medicines consumers requested without prescription; the medicines pharmacists believed should and should not be considered for reclassification; and perceived barriers to reclassification. A 2016 national online survey that sought pharmacists' opinions on the state of reclassification, perceived barriers to reclassification and readiness of the profession for further reclassification. Pharmacists' comments were invited through open-ended questions. Two hundred and thirty-five valid surveys were completed. Respondents practised in community, hospital, consultant and academic contexts, and the majority were female (58.7%, n=138). More than two thirds (70.66%, n=166) of pharmacists reported receiving daily or weekly requests for non-prescription access to prescription medicines. The majority of pharmacists (71.7%) agreed that the Australian pharmacy profession is ready for further medicines reclassification, guided by patient safety, harm minimisation and medication continuance. The most prominent barrier to further reclassification was opposition from other healthcare professionals. Australian pharmacists believe that their profession has the capacity to safely and effectively manage a wider range of non-prescription medicines through increased reclassification in the contexts of patient safety and risk mitigation. This study has contributed to the global conversation on non-prescription medicines access, providing momentum for practice and policy change.

Bridging the gaps in health service delivery for truck drivers of India through mobile medical units

Background:Truck drivers in India suffer from many lifestyle-related health problems. Providing primary health care services to truck drivers is essential to improve their overall health and well-being. This paper reports the findings of a community-based mobile medical unit program providing nonemergency and basic primary care services to truck drivers along the major highways of India. Piramal Swasthya Management and Research Institute launched this community-based mobile medical unit program, in partnership with Shriram Transport Finance Corporation Limited (STFCL).Materials and Methods:The paper describes the program model, its coverage, the sociodemographic profile, and common health morbidities of the truck drivers availing the program services. 2-year routine program data (April 2017 to March 2019) were accessed and analyzed.Results:A total of 1,167,210 number of unique truck drivers availed the program services during the reference period, of which 61,331 had complete data. The majority of truck drivers were male (99.1%) and just a few women (0.88%) and transgender (0.003%). The mean age was 45.5 years ± 10.91 and nearly half (49%) were in the productive age group (31–45 years). Noncommunicable and other chronic diseases (34.74%), musculoskeletal problems (24.17%), communicable diseases (14.52%), oral cavity-related problems (1.23%), and other minor ailments (17.77%) were the major consultation categories.Conclusion:Truck drivers in India have significant health morbidities. Providing primary health care services to truck drivers through mobile medical units is a step toward achieving universal health coverage.

Knowledge and Practices Regarding Self-Management of Minor Ailments among Pregnant Mothers

Background: During pregnancy, mother faces many minor discomforts due to physiological, ana­tomical, psychological, biochemical and immunological adaptations occurs in their body. The wellbeing of pregnant mothers is threatened due to these minor discomforts and lead to un­neces­sary hospitalization. This study was aimed to assess the knowledge and practices regarding self-management of minor discomforts among preg­nant mothers attending to selected Antenatal Clinics (ANC), Medical Officer of Health (MOH) area, Batticaloa. Subjects and Method: A cross sectional des­crip­tive study was conducted in selected ante­natal clinics among all registered antenatal mot­hers (n=238) attending to these ANCs. A vali­dated and pretested interviewer administered ques­­­­tionnaire was used to collect the data. Know­ledge on self-management of minor dis­orders was dependent variable and independent vari­ables were the sociodemographic status, eco­no­mic status and obstetric details of pregnant mot­hers. Descriptive and inferential statistic was per­form­ed to analyze the relevant data. Results: Nearly half of the participants (54.6%) were in 20–29 years and 62% of them were primiparous mot­hers. Around 93% of them were experienced nausea and vomiting during their pregnancy and among them all were reported nausea and vomit­ing has been occurred during their 1st trimester. About 75% of them mentioned that home reme­dies are the best way to self-manage the minor dis­­­com­forts. The mean know­ledge score on minor discomforts and self-management was 12.16 (SD= 14.64). Majority of participants (94.1%) scored less than 50%. Knowledge score was sig­ni­fi­cantly associated with participant’s ethnicity, reli­gion, monthly income, educational level and their parity. Conclusion: The prevalence of minor dis­com­forts among pregnant mothers was high and preg­nant mothers have expressed that minor dis­comforts can be managed with home remedies. Further, knowledge level regarding minor dis­com­forts and their self-management was in­ade­quate. Keywords: Antenatal mothers, minor discomforts, knowledge, self-management, Sri Lanka Correspondence: Gnanaselvam Kisokanth. Department of Clinical Nursing, Faculty of Nursing, University of Colombo, Sri Lanka. Email: kiso@dcn.cmb.ac.lk Mobile: +94772228330 Journal of Maternal and Child Health (2020), 05(03): 303-312 https://doi.org/10.26911/thejmch.2020.05.03.09

Stunting and associated factors in children of less than five years: A hospital-based study.

Objectives:To estimate frequency of stunting and associated factors in children aged less than five years in a tertiary care hospital of Lahore.Methods:An Analytical cross-sectional study was conducted in Pediatrics Outpatient Department at Akhtar Saeed Trust Teaching Hospital, Lahore from December 2017 to July 2018. Two hundred children of ages under five years coming to outdoor for treatment of minor ailments were included after informed consent from their parents. Non-probability, convenient sampling technique was used to collect sample. Data collected and analyzed on SPSS version 19. To find out association of stunting with multiple qualitative variables, chi-square test was applied and p-value was fixed at ≤ 0.05 to be significant.Results:Out of 200 children screened in OPD, 42 (21.0%) were found to be stunted. The total percentage of stunting in male children was 28 (66.6%) and in female children were 14 (33.3%). Stunting was significantly associate with male gender (p=0.047), joint family system (p=0.049), low literacy level in mothers (p=0.031), unvaccinated status (p=0.003) and history of bottle feeding (p=0.037).Conclusion:The frequency of stunting in children less than five years of age is 42 (21.0%). The significant risk factors associated with stunting were found as male gender (p= 0.047), joint family system (p=0.049), low maternal education (p=0.031), unvaccinated status(p=0.03).

Over-the-counter medicines: Global perspective and Indian scenario.

Patients often approach a pharmacist instead of visiting a doctor for minor ailments such as cough, cold, allergies, pain, fever, acidity, diarrhea, and skin-related conditions. Purchase of specific medicines over the counter is legally recognized in most countries. 'Over-the-Counter (OTC) Medicines' means drugs which are legally allowed to be sold by pharmacists without need for a prescription. The term does not have a legal definition in India. Technically, drugs are OTC unless they are specifically stated as prescription only drugs. OTC drugs allow faster and cheaper access to healthcare; however, their misuse and adverse health effects cause concerns. This article describes concept of OTC medicines and practices in India against the background of globally prevalent regulations and practices. A recognized category of OTC medicines by law, patient awareness programs, and support of pharmacists and pharmaceutical companies are required to optimize the use of OTC medicines in India.

London minor ailments scheme to close at end of March 2020

London minor ailments scheme to close at end of March 2020

A Qualitative Study of Nonagenarian Persons in Two Districts of Kerala

Older persons are vulnerable sections in the population from many angles. They are the worst affected when disasters like floods and epidemics strike the society. The proportion of older persons in the age group of 80 years and above in the state of Kerala, 13 percent of the total population is comparatively higher than in other states. Among the elderly, the number of persons in the age group of 90-100, nonagenarians is also increasing . This subgroup of 90 plus in the population needs to be studied in the Kerala context as this is an emerging phenomenon. It is important to document their multi-disciplinary profile as part of the longevity studies. This could throw up a number of clues regarding longevity in a developing country context. The present study is an exploratory exercise with the objective to gather basic information about daily routine, food habits, support systems, overall quality of life and health conditions as well as availability of health services. Two districts were purposively selected for this exercise- Alleppey and Trivandrum. From each district, the 90 plus individuals were also purposively selected using a viva-voce method- based on information supplied by key informants in the community regarding presence of such individuals in the community. A check-list tool was designed for the in-depth interview by including the topics to be covered. A well-structured and carefully followed daily routine is found among most of the respondents that we interviewed. Most people manage their daily routine all alone and they even manage that with their walking sticks. Close family members provided support to many individuals. A few, even those living with their wives have engaged a home nurse mainly to give a bath and for doing some minimum physical exercises. Most respondents reported orthopedic complaints which included knee pains, other joint pains, low back pain etc. One of the salient trends that we observed from the data as evident from the current trends in Kerala, is the higher load of Non Communicable Diseases. A number of respondents have diabetes, CHD, neurological problems etc. Surprisingly, many respondents have better eye sight and hearing although a few suffer from hearing loss. Many use Ayurvedic medicines for many of their problems especially for orthopedic complaints. They resort to oil massage for these complaints. Many manage minor ailments with home remedies because they do not want to disturb their family members. The overall quality of life of the 90 plus individuals is found to be better than that is normally assumed. Some of them are found to be in good physical and mental condition and manage their own life without much support. People with better social and family support can manage their life and cope up with their problems. It appears that the social and family support in addition to a more structured life could have helped in prolonging and sustaining their life. Based on this exploratory study, we would suggest that the existing geriatric policy framework should give due attention to the issues identified here. There should also be special home-based care and support in addition to special hospital-based services.

Commentary: Telemedicine: The unsung corona warrior.

Commentary: Telemedicine: The unsung corona warrior.

A descriptive study to assess the level of knowledge regarding first aid management of minor ailments among GNM students in faculty of nursing s.g.t. university budhera, Gurugram (Haryana)

A descriptive study to assess the level of knowledge regarding first aid management of minor ailments among GNM students in faculty of nursing s.g.t. university budhera, Gurugram (Haryana)

Olfactory neuroblastoma – a rare tumour under the guise of chronic rhinosinusitis

Olfactory neuroblastoma (ONB), also called esthesioneuroblastoma, is a rare tumour that occurs in the nasal cavity and paranasal sinuses. The symptoms that patients report are similar to chronic rhinosinusitis (CRS). The authors present the case of a patient referred to hospital due to nasal obstruction on the left side. The performed endoscopic surgery revealed within the left middle nasal concha a tumour penetrating into the anterior ethmoid and frontal recess. ONB was diagnosed in the histopathological examination. The patient was qualified for complementary radiotherapy. The patient has been under medical supervision for 24 months. There have been no signs of recurrence. It was decided to present the above case due to the lack of deviations in the ENT endoscopy and minor ailments reported by the patient, which in combination with advanced age could lead to discontinuation of surgical treatment.

Assessing insomnia management in community pharmacy setting in Jordan: A simulated patient approach.

Insomnia is one of the most common minor ailments to which patients seek advice in a community pharmacy setting. Due to the availability of a wide variety of over-the-counter (OTC) products, community pharmacists are in the front line to safe-guard patients looking for self-medication or advice for treatment of insomnia. The purpose of this study was to assess the content of community pharmacists’ interactions with patients seeking advice for insomnia in Jordan. A cross-sectional study using a simulated patient methodology was conducted across a stratified convenience sample of community pharmacies in three major cities in Jordan. The visits were evaluated using pre-defined criteria adapted from published literature relating to content and counseling skills. Visits were audio-recorded using a hidden microphone and the simulated patient completed a data collection form immediately after each visit. A total of 67 community pharmacies (response rate = 93.0%) agreed to participate and were all visited once by the simulated patient. The median duration of the visit was 2 minutes (range: 0.2–4 minutes). The majority (86.6%) of visits resulted in the sale of a drug, most commonly a combination product (paracetamol and diphenhydramine) for 30 recommendations (44.8%). This was followed by a natural plant extract combination product, namely valerian and lemon balm (Melissa officinalis L.) for 23 (34.3%). Pharmacists often did not question medical history or other symptoms prior to product sale. Frequently, the recommended dose (49.3%) and administration time (38.8%) were the only information provided to the patient. No information was provided in relation to potential drug interactions or contraindications. No advice was offered on lifestyle or good sleeping hygiene. This study provided evidence that community pharmacists in Jordan in general did not offer adequate counseling for patients seeking advice for insomnia. Exploration of the reasons and factors contributing to this practice and highlighting professional opportunity and responsibility is recommended.

Patients' Use of the Internet to Find Reliable Medical Information About Minor Ailments: Vignette-Based Experimental Study.

BackgroundLittle is known about the exact process of how patients search for medical information on the internet and what they retrieve. There is especially a paucity of literature on browsing for information on minor ailments, a term used for harmless diseases that are very common in the general population and thus have a significant impact on health care.ObjectiveThis vignette-based experimental study aimed to explore what kind of Web-based search strategies are applied and how search strategies, demographic characteristics, and the quality of the visited websites relate to finding the right diagnosis. Additional goals were to describe how searching on the Web influences one’s perception of the severity of the potential diagnosis and whether or not the participants would discuss the information they found on the internet with their doctors.MethodsOut of 1372 survey participants, 355 were randomly sampled, and 155 of them were recruited and assigned to one of four clinical scenarios. Each search term they used was classified as one of three search strategies: (1) hypothesis testing, (2) narrowing within the general hypothesis area, and (3) symptom exploration. The quality of the websites used was determined by using the DISCERN instrument. To compare the diagnostic accuracy of the participants before and after the internet search, a McNemar test was used. Chi-square tests were used to describe which factors are related to the chosen search strategy. A multivariate binary logistic regression model was constructed to predict which factors are related to finding a sound diagnosis after searching the internet for health information.ResultsMost participants (65.8%, 102/155) used the symptom exploration strategy. However, this depends on the assigned scenario (P<.001) and the self-estimated severity score of the symptoms before the internet search (P=.001). A significant relation was found between choosing an accurate diagnosis and age (odds ratio [OR] 0.94, 95% CI 0.90 to 0.98) and the clinical scenario, as well as the use of high-quality websites (OR 7.49, 95% CI 1.85 to 30.26). Browsing the internet did not lead to a statistically significant change in participants’ beliefs about the severity of the condition (McNemar test, P=.85). Most participants (65%) shared their retrieved information with their physician and most of them (75%) received a positive response.ConclusionsOur findings suggest that most patients use a symptom-based approach; however, if patients expect the potential diagnosis to be severe, they tend to use a hypothesis verification strategy more often and are therefore prone to certain forms of bias. In addition, self-diagnosing accuracy is related to younger age, the symptom scenario, and the use of high-quality websites. We should find ways to guide patients toward search strategies and websites that may more likely lead to accurate decision making.

Applying a whole systems lens to the general practice crisis: cross-sectional survey looking at usage of community pharmacy services in England by patients with long-term respiratory conditions

ObjectiveUK policy initiatives aiming to extend community pharmacy services to moderate patient demands and to reduce general practitioners’ (GPs) workload have had limited success. This study used marketing theory to...