On Over-the-counter Research Articles

LINGUISTICS-BASED PHARMACEUTICAL PRODUCT NAMING METHODS: A MORPHOLOGICAL STUDY ON OTC MEDICINE PRODUCTS IN INDONESIA

Objective: Objective of the study was to assess the linguistics-based product naming methods of some over the counter (OTC) medicine in Indonesia and their impacts to companies and consumers.Methods: The study uses qualitative descriptive method carried out among 57 data randomly taken from the lists of OTC medicine issued by some pharmaceutical companies in Indonesia. The data were classified into the morphological theory regarding the word formation methods which discusses the process of forming the words, product naming strategy and theory of OTC products taken from FDA.Results: This study shows that a proper and precise OTC medicine naming method can employ the linguistics aspect especially word formation theory to describe the kinds, characteristics, and the usage of the products. The word formation methods found in this study are blending 59.6% (34 products), clipping 1.7% (1 product), compounding 3.5% (2 products), and unknown method 35% (20 products). In the context of product naming strategies, 65% of the data employs superiority and product advantage emphasizes, usability or ability conducted by the product, and showing what can be obtained using the product. While the remains 35% does not employ the product naming strategies properly except easy to pronounce. The unknown OTC medicine naming method is not on target with the OTC medicine consumers in Indonesia since the meaning of the product names are not easily recognized from their namings.Conclusion: From the results, it can be underlined that the product naming processes should be in line with the product naming strategies to have effective and understandable names of OTC medicine. There are 59.6% using blending naming, 1.7% using clipping, 3.5% using compounding, and 35% using unknown method. In the context of product naming strategies, 65% employs superiority and product advantage emphasizes, usability or ability conducted by the product, showing what can be obtained using the product; 35% does not employ the product naming strategies properly except easy to pronounce. The ineffective and not understandable names of OTC could lead to disadvantages for both companies and consumers.

Lack of pregnancy warnings on over-the-counter dermatologic products containing potentially harmful hydroquinone.

To determine the presence of pregnancy warnings on over-the-counter (OTC) dermatologic products with hydroquinone, a potentially harmful ingredient. Data were obtained from the Food and Drug Administration National Drug Code Directory and Label Repository to identify OTC dermatologic products containing hydroquinone. Products were stratified based on pregnancy or general warning presence (WP) or absence (WA). Product characteristics were compared between groups: hydroquinone concentration, presence of external packaging, indication and warning statements. Of the 112 products studied, 21 had a pregnancy warning and 3 included a general warning against use: WP (n=24) and WA (n=88) group. External packaging was more prevalent in the WP group compared to WA (62.5% vs 29.5%, P=0.004). Majority of OTC dermatologic products containing hydroquinone did not have a pregnancy warning. This highlights the need for improved labeling and informs providers caring for pregnant women of OTC labeling limitations.

Market Liquidity, Closeout Procedures and Initial Margin for CCPs

Closeout procedures enable central counterparties (CCPs) to respond to events that challenge the continuity of their normal operations, most frequently triggered by the default of one or more clearing members. The procedures ensure the regularity of the settlement process through the prudent and orderly closeout of the defaulter’s portfolio. Traditional approaches to CCPs’ margin requirements typically assume a simple closeout profile, and do not account for the ‘real-life’ constraints embedded on the management of a default. The paper proposes an approach of evaluating how distinct closeout strategies may expose a CCP to different sets of risk and costs, and consequently could impact the sufficiency of financial resources to cover its risk exposure to a default. The approach is based on a counterfactual simulation, and evaluates a full spectrum of hedging strategies in an exploratory and model-free manner, deriving endogenous and market-dependent risk metrics. Using the trade repository data available to the Bank (as a result of EMIR reporting) on over-the-counter (OTC) interest rate swaps (IRS) and ten years (ie 2005 to 2015) of information on related market risk factors, the paper derives empirically an efficient hedging strategy that minimizes the CCP’s risk exposure to a defaulting clearing member. Endogenous trade-off structures between total risk (market risk plus funding needs) and transaction costs are also established, with marginal sensitivities to individual components of the hedging strategy determined.

Regulatory power, post-crisis transatlantic disputes, and the network structure of the financial industry

AbstractThe international financial crisis was followed by waves of domestic regulatory reforms, first and foremost, in the United States and the European Union. Post-crisis financial regulation was sometimes different across jurisdictions. Moreover, the United States and the European Union sought in various ways to (re)assert their regulatory power not only vis-à-vis the market, but also with regard to other jurisdictions, which often resisted the projection of regulatory power beyond national borders. Consequently, a handful of important post-crisis transatlantic regulatory disputes emerged concerning E.U. rules on hedge funds, U.S. rules on bank structure and E.U. and U.S. rules on over-the-counter (OTC) derivatives. These disputes mainly involved the terms of access to each other's markets, the equivalence between domestic rules, and the extraterritorial effects of those rules. Some of these disputes were also intra-E.U. disagreements, whenever the preferences of the United Kingdom were different from those of Continental countries and similar to those of the United States. The network structure of the financial industry and the patterns of financial interdependence across the Atlantic amplified the extra territorial effects of domestic reforms, but at the same time triggered an active involvement of the transnational financial industry in the management and, eventually, the settlement of these disputes.

Socioeconomic Determinants of Antibiotic Consumption in the State of São Paulo, Brazil: The Effect of Restricting Over-The-Counter Sales.

BackgroundImproper antibiotic use is one of the main drivers of bacterial resistance to antibiotics, increasing infectious diseases morbidity and mortality and raising costs of healthcare. The level of antibiotic consumption has been shown to vary according to socioeconomic determinants (SED) such as income and access to education. In many Latin American countries, antibiotics could be easily purchased without a medical prescription in private pharmacies before enforcement of restrictions on over-the-counter (OTC) sales in recent years. Brazil issued a law abolishing OTC sales in October 2010. This study seeks to find SED of antibiotic consumption in the Brazilian state of São Paulo (SSP) and to estimate the impact of the 2010 law.MethodsData on all oral antibiotic sales having occurred in the private sector in SSP from 2008 to 2012 were pooled into the 645 municipalities of SSP. Linear regression was performed to estimate consumption levels that would have occurred in 2011 and 2012 if no law regulating OTC sales had been issued in 2010. These values were compared to actual observed levels, estimating the effect of this law. Linear regression was performed to find association of antibiotic consumption levels and of a greater effect of the law with municipality level data on SED obtained from a nationwide census.ResultsOral antibiotic consumption in SSP rose from 8.44 defined daily doses per 1,000 inhabitants per day (DID) in 2008 to 9.95 in 2010, and fell to 8.06 DID in 2012. Determinants of a higher consumption were higher human development index, percentage of urban population, density of private health establishments, life expectancy and percentage of females; lower illiteracy levels and lower percentage of population between 5 and 15 years old. A higher percentage of females was associated with a stronger effect of the law.ConclusionsSSP had similar antibiotic consumption levels as the whole country of Brazil, and they were effectively reduced by the policy.

Interest in over-the-counter access to a progestin-only pill among women in the United States

Abstract Background A progestin-only pill may be the first pill formulation to become available over the counter in the United States; however, no research on over-the-counter (OTC) pill interest has focused on progestin-only pills or a representative sample of teens. The objective of this study was to assess U.S. women and teens’ interest in OTC progestin-only pill use. Methods In October 2015, we conducted a nationally representative, cross-sectional, online survey with 2,026 sexually active adult women aged 18 to 44 not currently desiring pregnancy, and 513 female teens aged 15 to 17. Logistic regression was used to identify characteristics associated with likely OTC progestin-only pill use. We also assessed reasons for use or nonuse, duration of use, and willingness to pay. Results Thirty-nine percent of adults and 29% of teens reported likely use, with a greater likelihood if covered by insurance. Adults were willing to pay $15 per month and teens $10 per month on average. Among adults, women who were never married or living alone (vs. married), uninsured (vs. privately insured), current pill or less effective method users (vs. ring, patch, injectable, or intrauterine device), tried to get a birth control prescription in the past year, or ever used an oral contraceptive pill or progestin-only pill had higher odds of likely use. Among teens, Spanish speakers and those who ever had sex had higher odds of likely use; Black teens (vs. White) had lower odds. Conclusions Teens and adults are interested in using an OTC progestin-only pill. These findings indicate a large pool of interested users and the potential for improved contraceptive access by making an OTC progestin-only pill available.

Pharmacy students’ use and views on over-the-counter (OTC) medicines: a questionnaire study

IntroductionThe role of the pharmacist centers on ensuring the safe and effective use of medicines, including over-the-counter (OTC) medicines. It is important to ascertain pharmacy students׳ use and opinions on OTC medicines, given that they are the pharmacists of the future and that this market continues to expand. This study aimed to investigate Queen׳s University Belfast (QUB) final-year pharmacy students׳ use and views on OTC medicines. Scarce work has been conducted in this area to date. MethodsFollowing ethical approval and a pilot study, all students (n = 155) were invited to participate in a self-completed questionnaire (n = 20 questions), distributed at a mandatory class. Descriptive statistics and non-parametric tests (Chi-squared and Mann–Whitney U test) were used for data analyses. ResultsThe response rate was 99.4% (154/155). The majority (153/155) reported using OTC medicines; the key consideration during personal product selection was effectiveness. Most [96.1% (147/153)] were in agreement that safety was the over-riding concern during OTC consultations. While 96.1% (149/155) considered that using an evidence-based approach improved the quality-of-patient care, 68.0% (104/153) would be prepared to sell a product that lacks evidence of effectiveness, provided it would not cause harm. ConclusionsThe importance of evidence of effectiveness was acknowledged, yet many students in this study were prepared to recommend unproven products. Further strategies are required at QUB to ensure this routine consideration alongside safety in practice.

Testing of Candidate Icons to Identify Acetaminophen-Containing Medicines.

Adding icons on labels of acetaminophen-containing medicines could help users identify the active ingredient and avoid concomitant use of multiple medicines containing acetaminophen. We evaluated five icons for communication effectiveness. Adults (n = 300) were randomized to view a prescription container label or over-the-counter labels with either one or two icons. Participants saw two icon candidates, and reported their interpretation; experts judged whether these reflected critical confusions that might cause harm. Participants rated how effectively each icon communicated key messages. Icons based on abbreviations of “acetaminophen” (“Ac”, “Ace”, “Acm”) were rated less confusing and more effective in communicating the active ingredient than icons based on “APAP” or an abstract symbol. Icons did not result in critical confusion when seen on a readable medicine label. Icon implementation on prescription labels was more effective at communicating the warning against concomitant use than implementation on over-the-counter (OTC) labels. Adding an icon to a second location on OTC labels did not consistently enhance this communication, but reduced rated effectiveness of acetaminophen ingredient communication among participants with limited health literacy. The abbreviation-based icons seem most suitable for labeling acetaminophen-containing medications to enable users to identify acetaminophen-containing products.

Dependence on Over the Counter (OTC) Codeine Containing Analgesics: Treatment and Recovery with Buprenorphine Naloxone

Misuse and dependence on prescribed and over the counter (OTC) codeine-combination analgesics is an emerging public health concern. We present a clinical case series of four adult patients dependent on OTC codeine combination analgesics in Ireland. Cases (two males/two females, aged 44–57 years) were consuming between 12 and 72 codeine-containing tablets/day. In three cases, consumption was linked to pain, with on-going misuse reflecting dependence on codeine. Cases were initiated on buprenorphine-naloxone (Suboxone®), stabilised on doses of between 4 mg/1 mg and 14 mg/3.5 mg per day and remain on treatment without additional opioid use, as verified by drug screening reports. Although anecdotal, these cases show the potential of effective opioid assisted treatment (OAT) using buprenorphine-naloxone (Suboxone®) to successfully treat this distinct form of opioid dependence disorder. Optimal service provision should recognise unique patient profiles and needs for this form of opioid dependence and incorporate psycho-social supports.

一般用医薬品およびサプリメントの購入時におけるお薬手帳の利用意識向上を目指した集団指導の効果

Information on ethical drugs is managed by medication notebooks but information on over-the-counter (OTC) drugs and dietary supplements is hardly covered. Therefore, it is important to understand the awareness about medication-notebook use on the purchase of OTC drugs and dietary supplements and to take measures to improve awareness. In our study, in order to understand the awareness and situation of medication-notebook use and clarify the effect of group instructions for improving the awareness, we gave a lecture about medication-notebook use and investigated items such as awareness about medication notebooks before and after the lecture. We conducted a questionnaire survey in 80 participants in a public lecture in Gifu Municipal Hospital on April 19, 2014. The lecture explained about medication notebooks and their usefulness for ethical drugs, OTC drugs and dietary supplements, etc. The items of the questionnaire were, for example, awareness about medication-notebook use for ethical drugs, OTC drugs and dietary supplements (Likert scale, evaluation 1-5). The recovery rate of questionnaires was 80.0％. Regarding the awareness about medication-notebook use for OTC drugs and dietary supplements, the rates of evaluations 4 and 5 before the lecture were low (30-50%) regardless of ways of purchasing them, but the evaluations increased significantly after the lecture (P < 0.05). Our study clarified that awareness about using medication-notebooks for OTC drugs and dietary supplements is insufficient at present and suggested that group instructions about medication-notebook use improve awareness.

AB0844 Detection of low Levels of Vitamin D or Free Testosterone in Patients Receiving Prednisone for A Rheumatic Disease

ObjectivesThe purpose of this cross-sectional study was to determine the prevalence of vitamin D insufficiency in males and females and testosterone deficiency in males, who have an increased risk for...

Safeguarding Older Adults From Inappropriate Over-the-Counter Medications: The Role of Community Pharmacists

To elicit the thought process or mental model that community pharmacists use when making recommendations on over-the-counter (OTC) medications to older adults and to elicit the current practices of community pharmacists in providing information, advice, and counseling to older adults about potentially inappropriate OTC medications. Three separate focus groups with pharmacists were conducted with 5 to 8 pharmacists per group. A vignette about an elderly woman seeking an OTC sleep aid was used to elicit information that pharmacists seek to establish when making a recommendation. Focus groups were recorded, transcribed verbatim, and analyzed for themes using the initial and focused coding methods of grounded theory. Community pharmacists' mental models were characterized by 2 similarities: a similarity in what community pharmacists seek to establish about patients and a similarity in when community pharmacists seek to establish it--the sequence in which they try to learn key details about patients. It was identified that pharmacists gather specific information about the patient's medication profile, health conditions, characteristics of the problem, and past treatments in order to make a recommendation. Community pharmacists recommended behavioral modifications and seeing their physician prior to recommending an OTC sleep aid, primarily due to medication safety concerns. Pharmacists can play a key role in assisting older adults to select and use OTC medications.

Pharmacotherapy and over-the-counter drug use among elderly in Belgrade, Serbia

From November 2012 to January 2013, 480 seniors were recruited at the Pubic Health Center in Belgrade, Serbia. The patients' records were validated by four independent investigators. Data on over-the-counter (OTC) drug use were collected through a questionnaire. Polypharmacy, an intake of ≥5 prescribed medications, reported in 10.4% of seniors, was associated with cardiovascular (odds ratio [OR] = 3.07; 95% confidence interval [CI] = 1.12–8.39) and endocrine diseases (OR = 2.25; 95% CI = 1.05–4.84) as well as with the number of treated chronic conditions (OR = 2.45; 95% CI = 1.75–3.44). The most frequently used OTC drugs were analgesics (metamizole, diclofenac and acetaminophen) and vitamins (vitamin C and vitamin B complex). The number of treated chronic conditions was associated with use of OTC drugs (OR = 1.17; 95% CI = 1.01–1.36). Multiple chronic conditions correlated with multiple OTC drug use (ρ = 0.125, p = 0.019). Our analysis indicated that the prevalence of polypharmacy and OTC drug use in the elderly are comparable to those in industrialized countries.

Diclofenac with or without an antiemetic for acute migraine headaches in adults.

This review is an update of a previously published review in Issue 2, 2012 (Derry 2012a). Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter (OTC) analgesics. Diclofenac is an established analgesic, and new formulations using the potassium or epolamine salts, which can be dissolved in water, have been developed for rapid absorption, which may be beneficial in acute migraine. Co-therapy with an antiemetic should help to reduce the nausea and vomiting commonly associated with migraine. To determine the efficacy and tolerability of diclofenac, alone or in combination with an antiemetic, compared to placebo and other active interventions in the treatment of acute migraine headaches in adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Oxford Pain Relief Database, ClinicalTrials.gov, and reference lists for studies through 27 September 2011 for the original review and 15 February 2013 for the update. We included randomised, double-blind, placebo-controlled or active-controlled studies, or both, using self administered diclofenac to treat a migraine headache episode, with at least 10 participants per treatment arm. Two review authors independently assessed trial quality and extracted data. We used numbers of participants achieving each outcome to calculate relative risk (or 'risk ratio') and numbers needed to treat to benefit (NNT) or harm (NNH) compared to placebo or a different active treatment. Five studies (1356 participants, 2711 attacks) compared oral diclofenac with placebo, and one also compared it with sumatriptan; none combined diclofenac with a self administered antiemetic. Four studies treated attacks with single doses of medication, and two allowed an optional second dose for inadequate response. Only two studies, with three active treatment arms, provided data for pooled analysis of primary outcomes. For single doses of diclofenac potassium 50 mg versus placebo (two studies), the NNTs were 6.2, 8.9, and 9.5 for pain-free at two hours, headache relief at two hours, and pain-free responses at 24 hours, respectively.Similar numbers of participants experienced adverse events, which were mostly mild and transient, with diclofenac and placebo.There were insufficient data to evaluate other doses of oral diclofenac, or to compare different formulations or different dosing regimens; only one study compared oral diclofenac with an active comparator (oral sumatriptan 100 mg). Oral diclofenac potassium 50 mg is an effective treatment for acute migraine, providing relief from pain and associated symptoms, although only a minority of patients experience pain-free responses. Adverse events are mostly mild and transient and occur at the same rate as with placebo.

Factors Influencing Consumer Purchasing Patterns of Generic Versus Brand Name Over-the-Counter Drugs

US consumers spend more than $20 billion/year on over-the-counter (OTC) drugs. Although generic and brand name OTC drugs share the same active ingredients and undergo the same rigorous Food and Drug Administration approval process, brand name formulations continue to lead the OTC drug market with a higher market share. There is a limited amount of publicly available information regarding consumer perceptions and awareness about generic and brand name OTC drugs. The main objective of this research was to understand what factors influence US consumers to purchase generic versus brand name OTC drugs. The researchers used a 20-question, self-administered, multiple-choice survey to collect data on the factors influencing consumers' preferences for generic versus brand name OTC drugs. Results revealed that the single most influential factor for participants when purchasing OTC drugs was lower cost. Although economic factors play an important role in influencing consumers to choose generic formulations, a variety of other factors including advertisements, duration of the OTC effectiveness, severity of sickness, preferable form of OTC medication, safety of the OTC, relief of multiple symptoms, and preferred company will persuade others to pay more for brand name drugs. Ultimately, increased awareness and use of generic OTC drugs may result in substantial cost savings for consumers.

Investigation of Consumer Attitudes, Intentions and Brand Loyal Behavior on the OTC Drugs in Bangladesh

Aims: To investigate the consumers’ attitudes and intentions to exhibit brand loyal behavior of Bangladeshi consumer on over the counter (OTC) drugs. Study Design: A cross- sectional survey. Place and Duration of Study: Consumers from the five major hospitals (Dhaka, Bangladesh) had been surveyed between January 2012 and June 2012. Methodology: The study was conducted among 100 OTC consumers in Bangladesh. Data were collected through questionnaire surveys and personal interviews. Results: The experimental data suggest that direct experience with the product, price range and brand reliance are important determinants of repetitive purchase behavior on OTC drugs. Cost sensitivity had a vital effect on intention to further purchase (r = .02, p =0.05). Moreover, earlier experience with the brand was critical in determining trustworthiness, beliefs, price sensitivity and purchase behavior. The behaviors of OTC consumers are influenced by a different set of factors. Previous experience and price sensitivity is dependent (Chi square = 31.603; p = 0.01. Furthermore, medical experience and buying an OTC product is dependent and the result were also found significant (Chi square = 32.292; p = 0.01). Conclusion: Present study shows that branding and prior experience remains the major influences to buy an OTC drug in Bangladesh.

Management of Common Cold Symptoms with Over-the-Counter Medications: Clearing the Confusion

The common cold, an acute upper respiratory tract infection of viral origin, is among the most widespread ailments in the world. Although the general public usually relies on over–the–counter (OTC) medication(s) to treat cough/cold symptoms, reliable guidance is needed to help select the appropriate OTC medication for each individual. Consumers may be confused by the wide variety of products available, containing ≥ 1 active pharmaceutical ingredient. Health care professionals are in a position to help people identify the most bothersome symptom(s), evaluate underlying medical conditions and medications, and recommend the most appropriate OTC active ingredient(s) for treatment. Patients should be educated about available OTC medications to manage cough/cold symptoms and the importance of learning to read the package labeling for appropriate dosing and administration. In addition, potentially serious causes of cough/cold symptoms (eg, influenza, asthma, bronchitis) or underlying medical conditions that put the individual at increased risk for complications should be ruled out when symptoms do not resolve within a typical cold timeline. This review article discusses the active ingredients found in OTC medications and the clinical evidence supporting their use. The need to educate health care professionals and patients on the safe and effective use of OTC medications is addressed, and we offer a guide for the management of symptoms that appear during the timeline of a typical common cold.

A qualitative interview study: patient accounts of medication use in early rheumatoid arthritis from symptom onset to early postdiagnosis

ObjectiveTo examine accounts of medication use in participants with early rheumatoid arthritis (RA) from symptom onset to early postdiagnosis.DesignQualitative study with in-depth, personal interviews.Participants37 women and one man, aged 30–70s,...

Absence of ‘over‐the‐counter’ medicinal products in on‐line prescription records: a risk factor of overlooking interactions in the elderly

To assess possible origins of harmful interactions in elderly patients arising from the current absence of information on over-the-counter (OTC) medicines in the Danish 'on-line prescription record'. Information on current use of prescription drugs and OTC medicinal products (non-prescription drugs, herbal medicine, dietary supplements, and others) was collected by home visit interviews. The latter OTC products were not listed in an on-line prescription record that covered the previous two years. Information on interactions between OTC medicines and between OTC products and prescription drugs was obtained from the Danish National Drug Interaction Database. Of the 309 patients recruited (median age 75 years, interquartile range (IQR) 70-81), 229 (74%) used 568 OTC medicines not listed in the Danish 'on-line prescription record', amongst which we identified 166 potential interactions - between OTC treatments or between OTC and prescription drugs. Fifty percent of patients taking OTC medicines were exposed to potential interactions, i.e. one to three instances per patient. Twenty-five percent of patients exposed to interactions experienced interaction listed as 'Can be used with certain precautions'. The absence of information on OTC products in an on-line prescription record entails a risk of overlooking interactions in elderly patients. Such products should be included in on-line medication records to prevent adverse effects from interactions. However, online medication records are not available in all countries and as inclusion of data on OTC drugs seem not to be feasible presently. Still, it is highly recommended that the patient's drug list is reviewed on a regular basis.

The impact of media campaigns on smoking cessation activity: a structural vector autoregression analysis

To evaluate the effect of tobacco control media campaigns and pharmaceutical company-funded advertising for nicotine replacement therapy (NRT) on smoking cessation activity. Multiple time series analysis using structural vector autoregression, January 2002-May 2010. England and Wales. Tobacco control campaign data from the Central Office of Information; commercial NRT campaign data; data on calls to the National Health Service (NHS) stop smoking helpline from the Department of Health; point-of-sale data on over-the-counter (OTC) sales of NRT; and prescribing data from The Health Improvement Network (THIN), a database of UK primary care records. Monthly calls to the NHS stop smoking helpline and monthly rates of OTC sales and prescribing of NRT. A 1% increase in tobacco control television ratings (TVRs), a standard measure of advertising exposure, was associated with a statistically significant 0.085% increase in calls in the same month (P = 0.007), and no statistically significant effect in subsequent months. Tobacco control TVRs were not associated with OTC NRT sales or prescribed NRT. NRT advertising TVRs had a significant effect on NRT sales which became non-significant in the seasonally adjusted model, and no significant effect on prescribing or calls. Tobacco control campaigns appear to be more effective at triggering quitting behaviour than pharmaceutical company NRT campaigns. Any effect of such campaigns on quitting behaviour seems to be restricted to the month of the campaign, suggesting that such campaigns need to be sustained over time.