Self-prescribed Use Research Articles

Self-prescribing of antibiotics by patients seeking care in Indian emergency departments.

Study objectiveAntibiotic resistance is a global health threat. India has one of the highest rates of antibiotic use in the world. The objective of this study was to evaluate the prevalence of self‐prescribed antibiotic use of patients presenting with febrile and infectious disease‐related complaints to Indian emergency departments.MethodsThis was a prospective observational study conducted at 6 Indian emergency departments (EDs) between January 1, 2019 and December 31, 2019. Adult patients who presented with a chief complaint of febrile illness or infectious disease complaints were included. Our principal outcomes of interest were self‐prescribed use of antibiotics within the prior 6 months or for the presenting complaint. We queried respondents about source of antibiotics as well as about demographic characteristics that influenced use.ResultsA total of 1421 patients were enrolled. Sixty percent (n = 856) of respondents reported using antibiotics in the prior 6 months or for their current complaint. Those who reported self‐prescribing antibiotics either in the past or currently had at least some college education (P < 0.001), tended to use the pharmacy (P < 0.001) or the ED (P = 0.001) for their care when sick, and were more likely to have some comorbid conditions (P = 0.014) as compared to the group that did not self‐prescribe antibiotics. The most common reason respondents reported self‐prescribing antibiotics was because they did not want to wait to see their doctor (n = 278, 33%). Thirty‐five percent of patients who were self‐prescribed antibiotics before presentation did not receive and were not prescribed antibiotics in the ED, at discharge, or both.ConclusionsSelf‐prescribing of antibiotics occurs commonly in India. This use increases the risk for resistance due to inappropriate or unnecessary use. Promotion of antibiotic stewardship is needed to curtail such use.

Cautions and Opportunities for Botanicals in COVID-19 Patients: A Comment on the Position of the French Agency for Food, Environmental and Occupational Health & Safety.

Cautions and Opportunities for Botanicals in COVID-19 Patients: A Comment on the Position of the French Agency for Food, Environmental and Occupational Health & Safety.

P011 HIGH TIME: INCREASED INQUIRY ABOUT MARIJUANA USE IN IBD PATIENTS IS NECESSARY

Abstract Background Marijuana use in the United States continues to increase with recreational sales legal in 11 states and the District of Columbia and medicinal approval expanded to include over two thirds of states. It is estimated that cannabinoid products are used by 15–40% of individuals with inflammatory bowel disease (IBD). However, the efficacy and safety have not been well-established. It is important that providers are aware of the extent of marijuana use in IBD patients. There is limited information about the frequency that providers inquire about recreational and medicinal use of marijuana. This study evaluated the frequency that providers screen for cannabinoid product use in individuals with IBD. Methods A chart review of all IBD patients seen at a university GI clinic over a 5-year period was performed. A confidential database using Microsoft Excel of patient age, gender, race, IBD diagnosis and recreational drug use was created. Charts were specifically queried for documentation of recreational or medicinal marijuana / cannabinoid (CBD) product use. Statistical analysis was performed using Fisher’s exact test with significance set at p&amp;lt;0.05. The study was approved by the institutional IRB. Results 381 records were analyzed. 284 patients had UC, 95 CD, and 2 indeterminate colitis. There were 172 men and 209 women (mean age 44.1 years; range 20–82). 195 patients were white, 97 African American, 11 Asian, 38 other/unknown, and 40 declined. Providers screened for recreational drug use, including marijuana, in 182 patients (47.8%). Marijuana / CBD use (medicinal or recreational) was noted in 19 (4.9%) charts (4 for IBD symptoms, 3 recreational, 12 no reason documented; 2 had prescriptions). There was no significant difference in the rate of screening for drug or marijuana / CBD use based on gender (p=0.627), race (p=0.447), or IBD type (p=0.169). Discussion The efficacy and safety of marijuana use in IBD remains unestablished despite that up to 40% of patients endorse cannabinoid use. It is important that providers are aware of the frequency of marijuana / CBD use by IBD patients. Identification of self-prescribed use may prompt further evaluation and modification of medication regimen. This study revealed that providers inconsistently inquire specifically about marijuana / CBD use. The growing prevalence of recreational and medicinal marijuana use should prompt increased screening and appropriate incorporation of this information into optimizing care. References

Knowledge, Attitude, and Practice of Diabetic Patients toward Herbal Products in Iran: A Cross-sectional Study

Background: Considering that herbal medicines are commonly used for treatment or management of type 2 diabetes, the aim of this study was to determine the knowledge, attitude, and practice (KAP) of patients with diabetes regarding herbal products. Methods: A cross-sectional study was conducted on 421 patients with diabetes who referred to the Iran Diabetes Association in Tehran, Iran in 2014. The KAP of participants on herbal products were determined by a pre-designed questionnaire containing close ended questions. Results: The participnats' age Mean ± SD was 38.0 ± 20.6 years. Of 421 participants, 163 used some type of herbal products during the past year for controlling diabetes. Of these patients, 40 to 60% did not have knowledge about the possibility and desirability of using herbs along with or instead of the anti-diabetic chemical drugs. However, 71% of patients believed that they could not use herbal products without physician's prescription. Participants had a negative attitude towards using herbal products instead of conventional drugs, especially without the physician's prescription (40–60% of patients). Among users of herbal products, 53.0% believed that these products caused no side effects. One-third of patients used herbal products at least once a month for controlling or treating their disease. Most participnats (64.4%) informed their physiciens about consumingherbal drugs and 15.8% had self-prescribed use of these herbal products. Conclusion: Our findings indicated that nearly a third of patients with diabetes used herbal remedies and most of them considered these products safe. However, more than half of the patients informed their physician about using herbal medicines.

Use of non-steroidal anti-inflammatory drugs and nutritional supplements in Zimbabwean football

Background. The use of medications by football players in many populations is known to be high. Data on African players are scarce. Objective. To determine the magnitude of use of non-steroidal anti-inflammatory drugs (NSAIDs) and nutritional supplements by Zimbabwean football players. Methods. We conducted a cross-sectional study during the 2011/2012 Premier Soccer League football season. A total of 86 players responded to a self-administered questionnaire that assessed self-reported use of NSAIDs and nutritional supplements. Results. All the participants admitted to taking NSAIDs, with 44% self-prescribing. Nutritional supplements were taken by 56% of the respondents. Of these, 21% took them on a daily basis and 40% did so without professional advice. Conclusion. Regular, self-prescribed use of NSAIDs and nutritional supplements is high among Zimbabwean football players.

Use of non-steroidal anti-inflammatory drugs and nutritional supplements in Zimbabwean football

Background. The use of medications by football players in many populations is known to be high. Data on African players are scarce. Objective. To determine the magnitude of use of non-steroidal anti-inflammatory drugs (NSAIDs) and nutritional supplements by Zimbabwean football players. Methods. We conducted a cross-sectional study during the 2011/2012 Premier Soccer League football season. A total of 86 players responded to a self-administered questionnaire that assessed self-reported use of NSAIDs and nutritional supplements. Results. All the participants admitted to taking NSAIDs, with 44% self-prescribing. Nutritional supplements were taken by 56% of the respondents. Of these, 21% took them on a daily basis and 40% did so without professional advice. Conclusion. Regular, self-prescribed use of NSAIDs and nutritional supplements is high among Zimbabwean football players.

The self-prescribed use of aromatherapy oils by pregnant women

While some studies have reported effectiveness of aromatherapy oils use during labour there is no reported evidence of efficacy or risks of aromatherapy oils use for pregnancy-related symptoms or conditions. A number of aromatherapy oils are unsafe for use by pregnant women yet there is currently no research examining the prevalence and characteristics of women who use aromatherapy oils during pregnancy. To conduct an empirical study of the prevalence and characteristics of women who use aromatherapy oils during pregnancy. The research was conducted as part of the Australian Longitudinal Study on Women's Health (ALSWH), focusing on the nationally representative sample of Australian women aged 31-36 years. Data were collected via a cross-sectional questionnaire (n=8200) conducted in 2009. Self-prescribed aromatherapy oils were used by 15.2% of pregnant women. Pregnant women were 1.57 (95% CI: 1.01, 2.43) times more likely to self-prescribe use of aromatherapy oils if they have allergies or hayfever, and 2.26 (95% CI: 1.34, 3.79) times more likely to self-prescribe use of aromatherapy oils if they have a urinary tract infection (UTI). Our study highlights a considerable use of aromatherapy oils by pregnant women. There is a clear need for greater communication between practitioners and patients regarding the use of aromatherapy oils during pregnancy, as well a need for health care practitioners to be mindful that pregnant women in their care may be using aromatherapy oils, some of which may be unsafe.

Group based antenatal care for overweight and obese women

Background: Aromatherapy is a complementary therapy. t uses highly concentrated substances, called essential oils, hich are extracted from plants. Essential oils are commonly sed to relieve a range of pregnancy-related symptoms. owever, some essential oils are unsafe for use in pregnancy ecause of the potential dangers for either the mother or aby. Adverse effects include phototoxicity, dermal toxicity, arcinogenicity and general pharmacological effects. The nternational Aromatherapy and Aromatic Medicine Assocition advise against use of aromatherapy oils by pregnant omen without first consulting a trained professional. Aim: To determine the prevalence, and factors associated ith, self-prescribed use of aromatherapy oils by pregnant omen in Australia. Methods: Cross-sectional analysis of data from the ustralian Longitudinal Study on Women’s Health. The ssociations between self-prescribed use or non-use of romatherapy oils and a range of health symptoms, diagoses and quality of life (SF-36) measures were made using hi-square tests, Student t-tests and logistic regression modlling. Results: There were 897 pregnant women, of which 16% sed aromatherapy oils. The women who used aromatherapy ils had significantly poorer levels of bodily pain (p = 0.026). omen who regularly experience allergies, hayfever or inusitis symptoms were 1.9 (95% CI: 1.1, 3.0) times more ikely to use aromatherapy oils (p = 0.013). Women who reglarly experience severe tiredness were 2.0 (95% CI: 1.1, .7) times more likely to use aromatherapy oils (p = 0.036). Discussion: A considerable proportion of pregnant women elf-prescribe their use of aromatherapy oils. Given the otential risks that aromatherapy oils can have on the omen and/or their unborn baby, this finding has implicaions for both midwifery education and practice.

The self-prescribed use of aromatherapy oils by pregnant women: Cause for concern?

The self-prescribed use of aromatherapy oils by pregnant women: Cause for concern?

Use of Self-Prescribed Nonprescription Medications and Dietary Supplements Among Assisted Living Facility Residents

Describe the prevalence of self-prescribed use and misuse as well as users' opinions concerning nonprescription medications and dietary supplements in assisted living facilities. Descriptive cross-sectional study. Two assisted living facilities (ALFs) in Oregon and Washington State. Convenience sample of 45 ALF residents. Chart reviews and face-to-face interviews. Prevalence and types of use of self-prescribed over-the-counter (OTC) medications and dietary supplements; misuse of these products, and participants' opinions concerning use of these products. Among 29 women and 16 men with a mean (+/- SD) age of 84.8 +/- 6.9 years and a mean of 9.9 +/- 6.4 years of education, 84.4% were using selfprescribed OTC medications and dietary supplements at the time of this study. A mean of 3.4 products was used per participant. Nutritional supplements were most frequently used (32% of products), followed by gastrointestinal products (17%), pain relievers (16.3%), herbals (14.4%), topical products (12%), and cold/cough products (8.5%). Potential misuse was identified in 23 (51%) of the participants. Problems in the use of products included duplication (70%), potential drug/disease/food interactions (20.8%), and other inappropriate use (9.1%). The majority (76%) of the participants believed the products were helpful in maintaining health, 56% of them wanted more product information, 49% sought product information from family and friends, 40% turned to their physicians and nurses for information, and 11% asked pharmacists for advice. The use of nonprescription medications and dietary supplements among ALF residents was high, and simultaneous use of multiple products with the same active ingredient was the most prevalent problem. The residents turned to family and friends, physicians, nurses, and ALF staff for information on these products more frequently than they did to pharmacists.

The Red Eye

The patient with a red eye constitutes a very common clinical problem encountered in the Emergency Department setting. Conjunctivitis, the most common cause of the red eye, generally is not associated with disturbance of vision or associated ocular pain. If either of these symptoms is present, a more serious disorder must be suspected. Treatment of infectious conjunctivitis is guided by interpretation of a Gram's stain and subsequent culture of any exudate present. Initial treatment of most cases includes use of topical antibiotic and local comfort measures. Complications of infectious conjunctivitis include more invasive disease such as keratitis or abscess formation, with potential corneal perforation and destruction. All patients should be referred for ophthalmologic followup, both to assess adequacy of treatment and to treat unexpected complications. Remember that allergic conjunctivitis is a common condition that responds to antihistamine decongestant medications given orally or topically. Occasionally these conditions are caused by self-prescribed use of ocular medication, and discontinuation of all eye medication is required. Corticosteroid eye drops are rarely indicated and should be used only at the direction of an ophthalmologist. When the diagnosis is uncertain, treatment is best withheld, as shotgun therapy is seldom beneficial.

The Red Eye

The patient with a red eye constitutes a very common clinical problem encountered in the Emergency Department setting. Conjunctivitis, the most common cause of the red eye, generally is not associated with disturbance of vision or associated ocular pain. If either of these symptoms is present, a more serious disorder must be suspected. Treatment of infectious conjunctivitis is guided by interpretation of a Gram's stain and subsequent culture of any exudate present. Initial treatment of most cases includes use of topical antibiotic and local comfort measures. Complications of infectious conjunctivitis include more invasive disease such as keratitis or abscess formation, with potential corneal perforation and destruction. All patients should be referred for ophthalmologic followup, both to assess adequacy of treatment and to treat unexpected complications. Remember that allergic conjunctivitis is a common condition that responds to antihistamine decongestant medications given orally or topically. Occasionally these conditions are caused by self-prescribed use of ocular medication, and discontinuation of all eye medication is required. Corticosteroid eye drops are rarely indicated and should be used only at the direction of an ophthalmologist. When the diagnosis is uncertain, treatment is best withheld, as "shotgun" therapy is seldom beneficial.