Over-the-counter Drug Use Research Articles

Drug-drug interactions in pediatric oncology patients.

Drug-drug interactions (DDIs) can negatively affect pharmacotherapy. However, pediatric DDI studies are scarce. We undertook an exploratory study to investigate prevalence and clinical relevance of DDIs between cytostatic and noncytostatic drugs in outpatient pediatric oncology patients. After informed consent and inclusion, the following information was collected: currently prescribed noncytostatic and cytostatic drugs, comorbidities, and use of over-the-counter (OTC) drugs, complementary and alternative medicines (CAMs), and dietary supplements. All medication was screened for DDIs according to two databases: Micromedex® Solutions and the Dutch drug database G-Standard. The researcher presented DDIs with an associated potential for adverse outcome and a proposal for intervention to three independent experts. If the experts considered a DDI to be potentially clinically relevant and requiring intervention, the physician was notified. Seventy-three patients were included (median age 8.9 years). A total of 67 different DDIs were counted (66 in Micromedex® Solutions, 14 in G-Standard, and 13 DDIs in both databases). The medication reviews resulted in 35 interventions related to 11 different DDIs. The majority of DDIs concerned noncytostatic drugs (25/35) and one third occurred between cytostatic and noncytostatic drugs (10/35). The use of QTc-interval-prolonging drugs resulted in one intervention. The use of OTC drugs, CAM, or dietary supplements did not lead to DDIs. This study resulted in a selection of 11 potentially clinically relevant DDIs for 73 outpatients in our pediatric oncology department. Interventions were formulated in close collaboration between physicians and clinical pharmacists. Future research should focus on assessing DDIs concerning QTc-interval prolongation.

Knowledge and Prevalence regarding use of Over the counter drugs (OTC) Drugs to Overcome Dysmenorrhea among Undergraduate Girls

Primary dysmenorrhea is an idiopathic condition thought to be related to the release of inflammatory mediators that are associated with uterine vasoconstriction and pain during menstruation. Dysmenorrhea is generally treatable with analgesics including NSAID's, acetaminophen, antispasmodics etc. Nowadays women use over the counter (OTC) medication frequently for the management of dysmenorrhea. This study was aimed to assess the prevalence and knowledge about the use of OTC drugs to overcome dysmenorrhea among undergraduate student girls. Quantitative study approach was selected and the research design was non experimental descriptive study. Non probability purposive sampling was used to select hundred under graduate girls from selected colleges within the age group of 18-21 years as samples. A self prepared questionnaire with 38 questions was used to collect the data and collected data were analyzed using descriptive and inferential statistics. Among total 100 samples, Seventy nine samples experienced dysmenorrhea and out that 32 uses drug. Among 32, nine were using OTC drugs. Among the 100 samples, none of them had good knowledge, 55% had moderate knowledge and 45% were poor in knowledge about the use of OTC medications. There was a significant association between knowledge level and age of menarche at the level of significance 0.05.

Investigation of advantages and disadvantages of OTC drug group

Over The Counter (OTC) drug group, which is known as over-the-counter drug, is simply defined as an over-the-counter drug. This group of medicines are medicines that the individual can provide without prescription from the pharmacy in order to provide self-treatment according to his / her own needs without physician control. In this context, the widespread use, use, advantages and disadvantages of OTC drugs, one of the most important factors affecting rational drug use in the study, are emphasized. In recent years, governments have been encouraged to put OTC forms of prescription drugs on the market because of various reasons, such as saving money on health spending, and various legal regulations are being made for this purpose. In addition to the advantages such as the widespread use of OTC products, the increased convenience of transportation and the increase in the level of disease awareness indirectly caused by the increase of OTC market, drug abuse, masking of serious symptoms, and increased cost of treatment for the patient. In summary, it is thought that drugs converted from prescription status to OTC product status will contribute to health spending, which seems to cause more health expenditure. Therefore, the implementation of a number of legal regulations to prevent the use of unreasonable drugs is thought to require pharmacists to play a more collaborative and enforcing role in the treatment process.

Medicine reclassification processes and regulations for proper use of over-the-counter self-care medicines in Japan.

ObjectivesJapan has actively reclassified substances ranging from prescription drugs to over-the-counter (OTC) drugs in recent years. The sale of most OTC drugs was deregulated several times and pharmacists’ supervision was deemed no longer mandatory. Japan established a new OTC evaluation system in 2015 to hear opinions from various stakeholders regarding medicine types to be reclassified. This study aimed to examine the new framework to identify candidate substances for reclassification. Moreover, we examined how to manage the safe, self-care use of OTC drugs in Japan.MethodsThe necessary regulatory information on OTC approvals as of January 2015 was collected using an Internet search and relevant databases. To highlight the characteristics of OTC drugs in Japan, the UK was selected as a comparison country because it too was actively promoting the reclassification of medicines from prescription to nonprescription status, and because of economic similarity.ResultsJapan and the UK have a risk-based classification for nonprescription medicines. Japan has made OTC drugs available with mandatory pharmacists’ supervision, face-to-face with pharmacists, or online instruction, which is similar to the “pharmacy medicine” practiced in the UK. Japan recently reformed the reclassification process to involve physicians and the public in the process; some interactions were back to “prescription-only medicine” in the UK.ConclusionIt is expected that the opinion of marketers, medical professionals, and the public will improve the discussion that will greatly contribute to the safe use of drugs. Monitoring the new system will be noteworthy to ensure that OTC drug users are managing their self-care properly and visiting a doctor only when necessary. The supply methods are similar in Japan and the UK; however, the expected growth in the Japanese OTC market by the Cabinet and the industry is still uncertain.

Placental inflammatory response to metformin treatment in obese pregnant mice

Following a large regulatory reform in 2009, which ended the state's pharmacy monopoly, non-pharmacy retailers in Sweden today sell certain over-the-counter (OTC) drugs. The aim of this study was to investigate consumer preferences regarding OTC drug retailers and the reasons for choosing a pharmacy versus non-pharmacy retailer. We conducted a web survey aimed at Swedish adults. Out of a stratified sample of 4058 persons, 2594 agreed to take part (48% women; mean age: 50.3 years). Questions related to OTC drug use, retailer choice and factors affecting the participants’ preferences for OTC drug retailers. Logistic regression was conducted to analyse OTC drug use and reasons for retailer choice in relation to sex, age and education. Nine in ten participants reported OTC drug use in the 6 months prior to the study. For their last OTC purchase, 76% had gone to a pharmacy, 20% to a grocery shop and 4% to a convenience store, gas station or online. Geographic proximity, opening hours and product range were reported as the most important factors in retailer choice. Counselling by trained staff was important to 57% of participants. The end of the state's pharmacy monopoly and the increase in number of pharmacies seem to have impacted more on Swedish consumers’ purchase behaviours compared with the deregulation of OTC drug sales.

Consumer preferences for over-the-counter drug retailers in the reregulated Swedish pharmacy market

Following a large regulatory reform in 2009, which ended the state's pharmacy monopoly, non-pharmacy retailers in Sweden today sell certain over-the-counter (OTC) drugs. The aim of this study was to investigate consumer preferences regarding OTC drug retailers and the reasons for choosing a pharmacy versus non-pharmacy retailer. We conducted a web survey aimed at Swedish adults. Out of a stratified sample of 4058 persons, 2594 agreed to take part (48% women; mean age: 50.3 years). Questions related to OTC drug use, retailer choice and factors affecting the participants’ preferences for OTC drug retailers. Logistic regression was conducted to analyse OTC drug use and reasons for retailer choice in relation to sex, age and education. Nine in ten participants reported OTC drug use in the 6 months prior to the study. For their last OTC purchase, 76% had gone to a pharmacy, 20% to a grocery shop and 4% to a convenience store, gas station or online. Geographic proximity, opening hours and product range were reported as the most important factors in retailer choice. Counselling by trained staff was important to 57% of participants. The end of the state's pharmacy monopoly and the increase in number of pharmacies seem to have impacted more on Swedish consumers’ purchase behaviours compared with the deregulation of OTC drug sales.

Use of over-the-counter (OTC) drugs and perceptions of OTC drug safety among German adults.

In Europe, little empirical evidence is available about over-the-counter (OTC) drug consumption and risk perceptions. The objective of this study was to describe consumers' OTC drug use and perceptions of OTC drug safety in Germany. An online survey based on a quota sample with combined strata for age, gender, and education of 300 adult German participants was conducted in June and July 2013. The survey questionnaire covered the participants' OTC and prescription drug use, risk perceptions of OTC and prescription drugs, package leaflet reading habits, and OTC drug off-label use. Seven day prevalences of OTC drug use were higher in women (52.0%) than in men (40.8%). The risk perception of specific OTC drugs was impacted by the route of administration, the indication, and the drugs' ingredients. Products for dermal application or plant-based products were considered 'rather not risky' by 82.7-96.6 of the participants, depending on the product. Products for oral use or chemically synthesized substances were considered less safe. While 48.0% of consumers reported always reading the package leaflet of OTC drugs, 44.5% reported not reading it if they knew the drug or believed the drug was very safe. People, 60 years and older, reported significantly lower levels of OTC drug off-label use (9.3%) than younger people (22.0%). The 7-day prevalence of OTC drug use in Germany is high, especially among women. Consumers generally have balanced perceptions regarding OTC drug safety. Behaviours and knowledge related to OTC drug use should be considered by health care providers and regulators.

Adverse Event Trends Associated with Over-the-counter Drugs: Data Mining of the Japanese Adverse Drug Event Report Database

Over-the-counter (OTC) drugs play an important role in self-medication. To ensure patient safety, pharmacists should ask patients to pay attention to possible adverse events (AE) associated with OTC drugs and educate patients about the symptoms related to those AEs. The aims of the present study were as follows: (1) to assess the tendency of AEs to occur with OTC drug use in Japan; (2) to detect a safety signal for OTC drugs using the reporting odds ratio (ROR); and (3) to evaluate clustery features, which include suspected drugs and therapeutic classifications, and safety signal indices (number of reports and the ROR), using cluster analysis. The number of reports of AEs following use of combination cold remedy, antipyretic and analgesic remedy, and herbal medicine was 1007, 566, and 221, respectively. We set the cluster number at five; clustery features obtained were as follows: (1) high reporting rate for skin and subcutaneous tissue disorder AEs was the largest group related to combination cold remedy; (2) high reporting rate for nervous system disorder AEs including dizziness was the second largest group. The same medicinal ingredient may demonstrate similar tendencies of the occurrence of AEs and similar clustery features in the Japanese Adverse Drug Event Report database. Our analysis of AEs associated with OTC drugs may be useful for pharmacists and patients alike. Further studies are required to draw better-informed conclusions.

Drug Use and Involvement in a Safety-Critical Event

This study used the Naturalistic Truck Driving Study data set to test the feasibility of applying naturalistic data to evaluation of the relationship between prescription (Rx) and over-the-counter (OTC) drug use and involvement in a safety-critical event (SCE). The risk of drug use was calculated by comparing SCEs and baseline epochs that occurred within a drug's half-life with SCEs and baseline epochs that did not occur within a drug's half-life (for the same half-life period). This research found that nearly 97% of commercial motor vehicle drivers used an OTC drug at least once (mostly caffeine), and 25% used at least one Rx drug. Furthermore, Rx and noncaffeine OTC drug use was not associated with an increased or decreased risk of involvement in an SCE. As caffeine was the only drug classification used multiple times by many drivers, this odds ratio analysis was the only analysis performed. Caffeine use while driving was found to be associated with a decreased risk of SCE involvement in all seven half-lives (half-life odds ratios ranging from 0.44 to 0.66). This project illustrated the feasibility of using a naturalistic driving approach to assess the risk associated with Rx and OTC drug use while driving. It is possible that analyses for specific medications could be performed with a sufficiently large sample of drivers who used each classification of drug.

THE PROBLEM OF USAGE OF DRUGS WITHOUT PRESCRIPTIONS BY THE YOUTH

Introduction. Self-treatment, defined as application of drugs without prescription without consulting your doctor has become a common phenomenon. Easy access to this group of pharmaceutical. advertising campaigns and lack of awareness of adverse effects as a result of incorrect application makes drugs without prescription the medications which have become our first choice. The aim of the study is to assess the problem of the use of over the counter (OTC) drugs by young people living in the Silesian Voivodeship. Material and methods. The study included 180 persons from the Silesian voivodeship at the age of 18-30. The research tool was an author’s, anonymous questionnaire. The questions included within it concerned, among others: frequency, form and side effects of drugs applied without prescription. Results. Despite the fact that the majority of respondents (57%) assess their health state as good, the overwhelming number of people (91%) report applying medications without a prescription. The most popular OTC pharmaceutical products include painkillers and vitamins. One in five respondents (20%) admits that he or she consumes more medication than it is recommended in the package leaflet. Conclusions. Very good and good health state declared by the respondents does not exclude accepting their medication without prescription. In case of treatment of intermittent or mild symptoms, the use of medications without a prescription – saves patient’s time and unburdens health care system. This phenomenon, however, is a challenge for the public health sector. Actions must be undertaken which are aimed at raising consumers-patients’ awareness regarding the dangers posed by improper use of OTC drugs.

Correlates to over-the-counter drug use among college students

Background: Over-the-counter (OTC) drug use is an increasing problem among college students. Purpose: The present study examined correlates to OTC drug use among this population. Methods: After a comprehensive review of the literature, a three-page survey was developed to examine the research questions. Students were surveyed in health, fitness and leisure classes. Results: Results indicated that approximately 16% of students used OTC drugs in their lifetime. No significant differences were found based on sex and grade whereas significant differences were found based on perceived harm and friends’ use of drugs. OTC drug use was also associated with recent use of other substances. Discussion: The present study indicates substantial rates of OTC use among college students. Findings may aid prevention specialists and college health professionals in developing effective prevention and intervention programs.

Parent, Teacher, and School Factors Associated With Over-the-Counter Drug Use Among Multiracial Youth

Background Over-the-counter (OTC) drug use is an increasing health issue among adolescents. Purpose This study investigated OTC drug use among 7th through 12th grade multiracial students in one metropolitan area. Methods A total of 2134 students completed the PRIDE Questionnaire, which examines alcohol and other drug use. Results A total of 8.3% of multiracial students reported using OTC drugs in their lifetime. Students involved in prosocial activities and those reporting positive parent factors were significantly less likely than their counterparts to use OTC drugs. Teacher and school factors were associated with reduced odds of use for males and high school students. Conversely, engaging in risky behaviors and having friends who used alcohol, tobacco, or marijuana significantly increased the odds for OTC drug use among males, females, junior high, and high school students. Discussion Several risk and protective factors for OTC use were identified and, as such, should be addressed in prevention programming. Translation to Health Education Practice Health education professionals should implement OTC drug use initiatives for multiracial youth that aim to reduce risk factors and increase protective factors against use. In addition, parents should be incorporated into prevention efforts because parent factors were important in reducing drug use among youth.

Education and Practice for Pharmacists Being a Connection between Physicians and Persons Having Unawareness of Mental Illness

Pharmacists work in places where they often get in contact with people who may have trouble with their illness, patients and patients' family with prescription, and customers who purchase over-the-counter (OTC) drugs and/or daily goods. Pharmacists can also identify excessive or unsuitable use of OTC drugs resulting from a psychiatric disorder. Moreover, they are in a position in which they can also find the normal-dose addictions and fatigued patient's family resulting from their daily patient's care. Since the consultation to a pharmacist is free of charge, many people often go to the pharmacist to talk about their health concerns. If pharmacists can get in contact with persons who are not aware of their mental illness and send them to the primary care physician, the pharmacists may contribute to prevent suicide and find the unrecognized psychiatric disorder. However, since pharmacists have little knowledge regarding to the psychiatric disorder, they cannot actively contact with this type of people. This article will argue about the methodology and education for pharmacists to connect undiagnosed patients to the appropriate medical care. It is proposed that the pharmacists should encourage the undiagnosed psychiatric patients to contact with the primary care physician. In addition, pharmacists should recommend the change of prescription to the medical doctors who examine the patients expected the addiction to the prescribed drug.

The Factors Contributing to Expenditures on Over-the-Counter Drugs in South Korea

ObjectivesTo determine the factors contributing to the use of over-the-counter (OTC) drugs and to examine the relationship between the purchase of OTC drugs and the utilization of health care services in South Korea. MethodsThis study used data from the 2008 Korea Health Panel Survey. The respondents were classified according to the purpose of the OTC drug use. The first group (n = 364) included respondents who had purchased OTC drugs for self-medication, and the second group (n = 955) included respondents who had taken OTC drugs for nutrition for more than 3 months. Logistic regression analyses were conducted to identify the factors contributing to the purchase of OTC drugs. ResultsThe self-medication group was more likely to be older and to have a chronic disease. In addition, the purchase of OTC drugs was related to the utilization of other health care services. The more outpatient services at clinics were used, the more the respondents tended to purchase OTC drugs for self-medication and nutrition. As hospital outpatient visits increased, however, the purchase of OTC drugs for self-medication decreased and the purchase of OTC drugs for nutrition increased. ConclusionsThis study shows that age and chronic disease are the major factors related to using OTC drugs for self-medication for long-term periods. Furthermore, this study suggests that the use of outpatient services is one of the factors associated with purchasing OTC drugs. Considering the potential adverse effects of OTC drugs, communication between physicians and patients should be encouraged at outpatient visits.

Pediatric off‐label drug use in China: risk factors and management strategies

To analyze the risk factors of pediatric off-label drug use, and propose management strategies for policy making of the pediatric off-label drug use in China. (i) We applied stratified random sampling to select recipes of children aged 0 to 18 years in pediatric clinics and wards of the West China Second University Hospital in 2010. (ii) All included prescriptions were categorized as off-label use or on-label use, according to the latest package insert licensed by the State Food and Drug Administration. (iii) Risk factors and the weights were calculated using logistic regression. (iv) The correlation between risk factors and the different kinds of off-label prescriptions was presented using adjusted odds ratio, and the impact of the risk factors was measured using standardized partial regression coefficient. (v) SPSS 16.0 was used for statistic analysis. (vi) From the perspective of the medical institutions, pharmaceutical enterprises, professional institutions, and the public, we combined the results of the Evidence-based research on the policy of the off-label drug use in 15 countries and the results of risk factor analysis, in order to propose management strategies for the policy making of pediatric off-label drug use in China. (i) Using the method of sampling, we received 2640 recipes from outpatients and 14,374 prescriptions from 749 inpatients. (ii) The neonates (0 to 27 days) had higher risk in off-label drug use than the other three children age groups. (iii) The dermatological medicines (D), nervous system medicines (N), traditional Chinese medicines, and respiratory drugs (R) were high-risk off-label medicines whose labels should be updated more frequently. (iv) The great factors of off-label drug use are those influence health status and relate to health services (ICD-10:Z00-Z99) (mainly in the clinic of child care and growth development, and in the ward of chemotherapy). (v) Off-label drug use in the ward was 4.4 times than that in clinic service (P < 0.001), which suggested that off-label drug use in the ward may be a key point of the management of medical institutions. (vi) The risk of off-label essential drug use was 1.67 times than that of non-essential drug use. (vii) The risk of off-label Rx drug use was 3.2% higher than that of OTC (Over-The-Counter) drug use, without a significant difference. (i) A management guideline for off-label drug use is urgently needed, with which we can guide medical institutions to establish the management regulations of off-label drug use. (ii) Pediatric clinical research should be promoted actively, and pharmaceutical enterprises should be encouraged to completely provide pediatric drug information. (iv) Academic organizations should be invited to join in for best professional drug use. (v) Pediatric patients and their families should receive the education on rational drug use.

Surveillance Study on Use of Over-the-Counter Drug and Health Food by School Pharmacist for Grade-schooler, Junior High School Student, and High School Students

In recent years, it is necessary to acquire knowledge not only about medicine but also over-the-counter (OTC) drugs and health food for children, because lowering trend in the age of the health hazard by improper use of health food is reported. Therefore, in order to estimate the extent of use of OTC drugs and health food, the school pharmacists administered a questionnaire to students in grade-school (n=123), junior high school (n=303), and high school (n=115) in Fukuyama city. As a result of the questionnaire survey, surprisingly, the usage ratio of OTC drugs and health food showed the most increase in grade-schooler. The trigger of use of health food is "parents' recommendations" in the lower grades, otherwise the ratio of "use by themselves" was increased in the higher grades. Moreover, a remarkable difference was observed by the kinds of use in students with or without exercise. Interestingly, exercise group expected "physical strength" effects than no exercise group. In addition, the ratio of consultation to the pharmacist at the time of purchase of OTC drugs and health food was low in all grade students. In particular, the ratio of consultation to the pharmacist at the time of purchase of health food was very low in high school students. Therefore, to provide accurate information of medicine and health food for students, the school pharmacist should engage not only in routine work but also in positive guidance about OTC drugs and health food in the future.

The Importance of Taking a History of Over-the-Counter Medication Use: A Brief Review and Case Illustration of “PRN” Antihistamine Dependence in a Hospitalized Adolescent

Over-the-counter (OTC) and prescription medication abuse has been rapidly increasing, yet publications on OTC abuse in adolescents are limited. We present a brief literature review and a novel report of antihistamine dependence emerging after admission in an adolescent, subsequently treated with naltrexone. This case highlights the need to take a thorough history of OTC, herbal, and prescription drug use from parents and patients separately and repeatedly, at initial presentation, and again if withdrawal symptoms emerge. General strategies for combating OTC and prescription abuse are given.

A pharmacoepidemiologic study of community-dwelling, disabled older women: Factors associated with medication use

Background: Although disabled older adults may be among the subpopulation of adults with the highest risk for adverse drug events (ADEs), reliable data on their use of medications are limited. Objectives: The aims of this study were to describe the extent and patterns of medication use in community-dwelling, disabled older women, and to identify factors associated with medication use in this population. Methods: Cross-sectional analyses of baseline data on medication use from the Women's Health and Aging Study I (WHAS I) were performed. WHAS I was an observational study of 1002 community-dwelling women aged ≥65 years who self-reported difficulty in at least 2 of 4 domains of physical functioning (ie, upper-extremity functions, mobility, self-care, and higher functioning tasks needed for independent living in the community). After descriptive analyses of their prescription and over-the-counter (OTC) drugs, associations between participants' characteristics and medication utilization were determined, using generalized linear models. Results: Of the 975 participants, 580 (59.5%) used ≥5 medications and 115 (11.8%) used ≥10 medications (prescriptions and OTCs). The mean number of medications used was 3.9 for prescription drugs and 1.9 for OTC drugs. Cardiovascular drugs and analgesics were the most frequently used prescription and OTC drugs, respectively. Participants with complete outcome and covariate data (n = 803) were included in the multivariate analyses. Cancer was associated with a 13% increase in total medication use (95% CI, 1.00–1.27). Multimorbidity (1.08; 95% CI, 1.02–1.15), frailty (1.13; 95% CI, 1.02–1.26), high Mini-Mental State Examination score (1.03; 95% CI, 1.01-1.05), congestive heart failure (CHF) (1.39; 95% CI, 1.23–1.58), angina (1.27; 95% CI, 1.12–1.44), chronic obstructive pulmonary disease (COPD) (1.20; 95% CI, 1.05–1.37), diabetes mellitus (DM) (1.24; 95% CI, 1.07–1.43), difficulty with shopping for personal items such as medicines and toiletries (1.20; 95% CI, 1.06–1.35), and possession of health insurance (1.21; 95% CI, 1.04–1.40) or a prescription plan (1.16; 95% CI, 1.05–1.29) were independently associated with increased use of prescription drugs. A diagnosis of osteoarthritis of the hands (1.29; 95% CI, 1.121.49) and having a spouse (1.19; 95% CI, 1.01–1.40) were associated with increased use of OTC drugs. Participants with DM (0.78; 95% CI, 0.65–0.94), African Americans (0.70; 95% CI, 0.60–0.82), and those who had difficulty shopping (0.85; 95% CI, 0.72–0.99) used fewer OTCs than did participants without these characteristics. Conclusions: Most of the disabled older women in this study took ≥5 medications at baseline, potentially putting them at high risk for ADEs. Those with multimorbidity, frailty, CHF, angina, DM, COPD, cancer, and difficulty with instrumental activities of daily living are target subpopulations for polypharmacy intervention.

Factors Associated with Multiple Medication Use in Different Age Groups

Multiple medicine use among elderly persons is likely to be the result of treatment regimens developed over a long period of time. By learning more about how multiple medication use develops, the quality of prescribing may be improved across the adult lifespan. To describe patterns of multiple medicine use in the general Swedish population and its association with sociodemographic, lifestyle, and health status factors. Data from a cross-sectional population health survey collected during 2001-2005 from 2816 randomly selected Swedish residents (age 30-75 y; response rate 76%) were analyzed. Multiple medicine use was restricted to prescription drugs and defined as the 75th percentile; that is, the 25% of the study group using the highest number of drugs per individual. Seventy-one percent of the respondents used some kind of drug, 51.5% used one or more prescription drug, 38.4% used one or more over-the-counter (OTC) medication, and 8.3% used one or more herbal preparation. The cutoff amounts defining multiple medicine use were: 2 or more medications for 30- to 49-year-olds, 3 or more for 50- to 64-year-olds, and 5 or more for 65- to 75-year-olds. No association between use of multiple medicines and use of OTC drugs or herbal preparations was found. When drugs were classified into therapeutic subgroups, 76.3% of those aged 30-49 years, 97.9% of those aged 50-64 years, and 100% of those aged 65-75 years were taking a unique combination of drugs. Multivariate analyses showed that diabetes and poor self-rated health were associated with multiple medicine use in all age cohorts. Female sex and hypertension were associated with multiple medicine use among those aged 30-49 and 50-64 years, current smoking among those aged 50-64 years, and obesity among those aged 65-75 years. Multiple medicine use was associated with morbidity and poor self-rated health across all age groups. The vast majority of users of multiple drugs are taking a unique combination of medications.

Predictors of Over-the-Counter Drug and Herbal Therapies Use in Elderly Patients With Heart Failure

Background Over-the-counter (OTC) drug and herbal therapies (HT) may worsen heart failure or interact with prescription medications. Frequency of and predictors for routine OTC drug and HT use are not well studied. Methods and Results We examined routine use of OTC drug and HT in patients at 8 medical centers. Medical conditions independently associated with use of OTC drugs, HT, or both were assessed using multivariable logistic regression models. Of 374 subjects, OTC drug and HT were routinely used by 349 and 43 patients, respectively. Mean age was 69.6 ± 13.1 years, 63% were male, and 81% were Caucasian. Common OTC drugs were antiplatelets (baby-dose aspirin), vitamins, acetaminophen, antacids, laxatives, and calcium. The most common HT used was echinacea. History of hypercholesterolemia was associated with higher OTC drug use (OR 4.36; 95% CI 1.60–11.87; P = .004); renal failure predicted less use (OR 0.09; 95% CI 0.01–0.59; P = .013). History of hypertension was associated with less HT use (OR 0.47, 95% CI 0.24–0.92; P = .028). Conclusions In HF patients, routine use of OTC drugs was common, but HT use was not. OTC drugs were used more often in patients with hypercholesterolemia and were used for a variety of reasons; thus, routine assessment and individualized education are advocated.