Use Of Non-prescribed Medication Research Articles

Characterizing the impact of the Covid-19 pandemic on adults with autosomal dominant polycystic kidney disease: a cross-sectional study

BackgroundThe Covid-19 pandemic greatly affected those with chronic diseases, impacting healthcare access and healthcare seeking behaviors. The impact of the pandemic on adults with Autosomal Dominant Polycystic Kidney Disease (ADPKD) has not been investigated.MethodsParticipants were recruited from a cohort of 239 ADPKD patients enrolled in a longitudinal study at the University of Maryland. Patients on renal replacement therapy were excluded. N = 66 patients participated in a phone questionnaire from June 2022-December 2022 about ADPKD-related complications, concern about contracting Covid-19, healthcare-seeking behaviors, and telehealth utilization before and after March 2020.ResultsN = 34 (51.5%) of participants reported a positive Covid-19 test result. N = 29 (44%) expressed high concern of contracting Covid-19. Those who avoided medical care at least once (N = 17, 25.8%) had similar demographics and ADPKD severity to those who did not, but reported greater telehealth utilization (88.2% vs. 42.9%, p = 0.002), greater use of non-prescribed medication for Covid-19 treatment or prevention (35.3% vs. 8.2%, p = 0.01), and were more likely to contract Covid-19 (76.5% vs. 42.9%, p = 0.02). Among the N = 53 who reported very good or excellent ADPKD disease management pre-pandemic, N = 47(89%) reported no significant change during the pandemic.ConclusionsIn this highly educated, high-income cohort with a mean age of 46.1 years, most people reported well-managed ADPKD prior to the pandemic. This may explain why less than half of participants expressed high concern for contracting Covid-19. Overall, there was no significant pandemic-related decline in self-reported ADPKD management. This was likely due to this cohort’s excellent access to, and uptake of, telehealth services. Notably, 1 in 4 participants reported healthcare avoidant behavior, the effect of which may only be seen years from now. Future studies should investigate potential impacts of avoidant behaviors, as well as expand investigation to a more diverse cohort whose care may not have been as easily transitioned to telehealth.

Characterizing the Impact of the Covid-19 Pandemic on Adults with Autosomal Dominant Polycystic Kidney Disease: A Cross-Sectional Study.

The Covid-19 pandemic greatly affected those with chronic diseases, impacting healthcare access and healthcare seeking behaviors. The impact of the pandemic on adults with Autosomal Dominant Polycystic Kidney Disease (ADPKD) has not been investigated. Participants were recruited from a cohort of 239 ADPKD patients enrolled in a longitudinal study at the University of Maryland. Patients on renal replacement therapy were excluded. N = 66 patients participated in a phone questionnaire from June 2022-December 2022 about ADPKD-related complications, concern about contracting Covid-19, healthcare-seeking behaviors, and telehealth utilization before and after March 2020. N = 34 (51.5%) of participants reported a positive Covid-19 test result and N = 29 (44%) expressed high concern of contracting Covid-19. Those who avoided medical care at least once (N = 17, 25.8%) had similar demographics and ADPKD severity to those who did not, but reported greater telehealth utilization (88.2% vs. 42.9%, p = 0.002), greater use of non-prescribed medication for Covid-19 treatment or prevention (35.3% vs. 8.2%, p = 0.01), and were more likely to contract Covid-19 (76.5% vs. 42.9%, p = 0.02). Among the N = 53 who reported very good or excellent ADPKD disease management pre-pandemic, N = 47(89%) reported no significant change during the pandemic. In this highly educated, high-income cohort with a mean age of 46.1 years, most people reported well-managed ADPKD prior to the pandemic. This may explain why less than half of participants expressed high concern for contracting Covid-19. Overall, there was no significant pandemic-related decline in self-reported ADPKD management, like due to excellent access to, and uptake of, telehealth services. Notably, 1 in 4 participants reported healthcare avoidant behavior, the effect of which may only be seen years from now. Future studies should investigate potential impacts of avoidant behaviors, as well as expand investigation to a more diverse cohort whose care may not have been as easily transitioned to telehealth.

Nontraditional Healing Utilization and Disclosure Among Dermatology Patients: A National Cross-Sectional Survey Study

Nontraditional healing (NTH) consists of spiritual and religious healing (SRH) and complementary and alternative medicine (CAM). SRH includes faith healing, prayer, and meditation. CAM includes use of nonprescribed medications or behaviors such as supplements, plant-based remedies, and behavioral changes.

Gender differences among persons entering medication treatment for opioid use disorder in the community.

We evaluated gender differences among persons initiating medications for opioid use disorder (MOUD). Analyses of baseline assessments for a study evaluating the impact of MOUD on outcomes included: demographics, DSM-5 diagnoses, depression severity, quality of life (QoL), and medication history (N = 125). When compared to men, women had a greater prevalence of generalized anxiety and posttraumatic stress disorders; and worse psychological QoL. Women were less likely to be prescribed psychiatric medications. Women may benefit from tailored multidisciplinary programs with MOUD. This study identified that women with OUD seeking MOUD in the community had greater sedative hypnotic nonprescribed medication use and psychiatric comorbidity than men, all of which can contribute to poorer retention on MOUD and higher risk of morbidity and mortality. Thus, concurrent psychiatric disorder screening and treatment integrated with MOUD may improve retention on MOUD, opioid relapse and overdose for women.

The prevalence of self-medication in breastfeeding mothers during the COVID-19 pandemic.

Self-medication is an important health and social issue, especially for women due to critical periods such as pregnancy and lactation. Accordingly, this study aimed to investigate the use of nonprescribed medications by lactating mothers visiting health centers affiliated to Kerman University of Medical Sciences during the COVID-19 pandemic. This descriptive-analytical cross-sectional study was conducted in Kerman from October to December 2020. The research population included all lactating women who visited health centers affiliated to Kerman University of Medical Sciences to receive health services. The data in this study were collected using a checklist. A total of 228 mothers who met the inclusion criteria participated in the study. A total of 221 mothers (97.0%) received nonprescribed medications (377 drugs in total). Among 377 nonprescribed medications, 279 drugs (74.0%) could be used while breastfeeding. The three most commonly used nonprescribed medications were acetaminophen tablets (84 [22.3%]), gelofen compound (51 [13.5%]), and adult cold medications. The majority of the mothers, 153 (40.6%), chose nonprescribed medications based on pharmacy staff recommendations. The COVID-19 outbreak was the most common reason for using 246 (65.3%) nonprescribed drugs. There was a statistically significant relationship between the mothers' education and the accuracy of their information about the side effects of nonprescribed medications use. The prevalence of self-medication by lactating women during the COVID-19 pandemic was very high. A significant percentage of the mothers did not have correct information about the adverse effect of arbitrary use of nonprescribed drugs on their babies.

Mother's Knowledge, Attitudes, and Practices of Antibiotics Use for Children with Upper Respiratory Tract Infections in Babylon Governorate

Background: Self-medication with antibiotics (AB) is an ongoing main global health problem. It is defined as the use of nonprescribed medications by people on their own initiative or on the advice of another individual, without physician consultation. Lack of knowledge among parents regarding the prudent use of AB in managing common childhood illnesses can result in its misuse. On the other hand, physicians commonly prescribe AB as their first response for several symptoms, usually relating such over-prescription to patients’/parents’ pressure. Although AB are targeted to kill or inhibit the growth of bacteria and have no effect on viral agents, it is often inappropriately used to treat viral infections, such as most upper respiratory tract infections (URTI). Problems associated with the overuse of AB include development of antibacterial resistance, increasing the burden of chronic diseases, rising costs of health services. Objectives: To evaluate mothers’ Knowledge, Attitudes, and Practices (KAP) related to antibiotic use for children with URTI in a sample of mothers in Babylon Governorate and assess the associated factors with antibiotic misuse among mothers who attended primary healthcare centers and hospitals. Materials and Methods: A cross-sectional study was carried out in Babylon Governorate during the period from April 10 to June 20, 2021. Two primary healthcare centers (one in the periphery of Babylon Governorate and the other in center of Babylon Governorate) and two hospitals (one in the periphery of Babylon Governorate and the other in center of Babylon Governorate) were selected conveniently and 270 mothers who attended these centers interviewed 3–4 days per week during the period of the study. Data were gathered through structured questionnaire that was used to identify different variables in the study during the interview. Statistical analysis was carried out using Statistical Package for the Social Sciences. Results: The mean age of mothers was (30 ± 7) years old. Small percentage had adequate knowledge about antibiotic use (26.3%), and only 8.52% had positive attitudes. Also, only 10.37% had good practice. Self-medication of AB was in a large proportion of mothers (67%) and most of them depend on pharmacists as a source of information (61.24%). There was a significant association between inadequate knowledge and mothers who were housewives, school-educated, and had self-medication practice. There was a significant association between negative attitude and poor practice with mothers who had self-medication. This study revealed that mothers who lived in rural areas, school-educated, housewives, and had enough monthly income tend to self-medicate their children with AB. Conclusions: Inadequate knowledge related to mothers with school education and housewives. Self-medication with AB is related to poor KAP. Self-medication occurs mostly among mothers who are housewives, residents in rural area, had school education, and have enough income.

Risk Factors of Suicide in Zanjan- Iran Population

Background: Few studies have examined the risk factors among Iranians attempting suicide. Objectives: The present study aimed to explore the risk factors of suicide among patients admitted to hospitals due to suicide attempts. Patients and Methods: Suicidal participants (N = 200, 104 males and 96 females, aged 18 to 40) were recruited via judgmental sampling method, and non-suicidal participants (n = 300, 166 males and 134 females, aged from 18 to 40) were selected via a convincing sampling method. The participants completed a battery of questionnaires on family strength, religious identification, substance use, hopelessness, depression, sexual, emotional, and physical abuse, impulsive aggression, neuroticism, suicidal ideation, family discord, stressful life events, and anxiety. Data were analyzed by independent t-test, chi-square and hierarchical logistic regression. Results: The current use of cigarettes/hookah, lifetime non-prescribed medication use, suicidal ideation (suicidal thoughts/tendencies), and depression significantly predicted suicide attempts. In addition, lower levels of religious belief were significantly associated with a higher likelihood of attempting suicide. Conclusions: Suicide prevention programs should explore the efficacy of treating individuals with substance abuse disorders, depression, and suicidal thoughts/tendencies for the reduction of suicide attempts. Furthermore, family, media, and school-based programs to internalize religious values would be valuable components of prevention programs for suicide in Iran.

Survey on common trends for non-prescribed medication use among the young generation in Dhaka, Bangladesh: A cross sectional study

Background: Use of drugs without prescription is a worldwide phenomenon especially among the general people in the developing countries. Alarmingly the use of medication without prescriptions among the young generations for longer duration is increasing day by day. The study was meant to evaluate the prevalence of non-prescribed medications among the young generations living in the capital of Bangladesh.Methods: It was a cross-sectional survey conducted in the Dhaka South City Corporation (DSCC) from September-November, 2019. Data was collected from patients having self-administration of drugs with semi-structured questionnaire in English and analysed applying descriptive statistics.Results: The study revealed the occurrence of non-prescription medication use among 75% of the respondents (N=400). The participants were students (67%), service holder (19%) and housewife (9%). Male and female were 49% and 51%; aged between 15-35 years (average 25.8 years). Mostly used medication groups were NSAIDs (34%), antacids (24%) and antibiotics (17%). Duration was more than one year 206 (69%) and from six to twelve months 94 (31%). The compliance reported as better (62.33%) and extremely good (34.33%). The crucial diseases treated were fever (27.73%), gastric acidity (22.13%), headache and other pains (15.13%), dysentery and diarrhea (8.68%) and allergy (8.40%). Interestingly 42% participants suggested their medication to others.Conclusions: In the young generation occurrence of non-prescribed medication is highest amidst the students. The authority should assure rational use of medications. The DGDA may campaign against the haphazard use of medicines involving the young generations.

Treatment Status and Use of Psychoactive Substances in Deceased Drug Users

Background: Studies on drug use are limited by the study populations available, which usually only include drug users in treatment settings. Therefore, the knowledge base is limited on drug users not entering treatment for drug use disorder (DUD). Using registers from departments of forensic medicine enables research on decedents with DUD, irrespective of treatment status. Objectives: The aim of this study is to characterize and compare drug users not receiving treatment and drug users receiving treatment, in relation to cause of death, toxicological findings, and use of nonprescribed medication. Methods: Retrospective register-based study on deceased drug users with supplemental data from the Registry of Drug Abusers Undergoing Treatment and the Register of Medicinal Product Statistics in 2 observation periods: 2001–2002 and 2011–2012. Results: Two-thirds of the population were not receiving treatment at the time of death in both observation periods. Drug users receiving treatment were more likely to die from accidental poisonings than drug users not receiving treatment. There was no difference in mean age at the time of death between the 2 groups, and both groups were older in the second observation period. There was no difference in toxicological findings according to treatment status and the 2 groups did not differ in the presence of nonprescribed medication found in the blood at the time of death. Discussion/Conclusions: The proportion of drug users that received treatment prior to death has not increased, and deceased drug users are mostly not in treatment for their drug use at the time of death.

E-cigarette Use Is Associated with Non-prescribed Medication Use in Adults: Results from the PATH Survey.

E-cigarette Use Is Associated with Non-prescribed Medication Use in Adults: Results from the PATH Survey.

Predisposing factors to the practice of self-medication in Brazil: Results from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM).

ObjectiveTo understand the predisposing factors that lead to the practice of self-medication and the factors associated with the use of medicines via self-medication in the adult population of Brazil.MethodsThe analyzed data are part of the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), a survey whose population consisted of individual residents permanently domiciled in urban areas in Brazil. In this work, the data references the 31 573 respondents aged 20 or higher (76.2% of the final PNAUM sample). Poisson regression models with robust variance were used for estimating the independent effect of each variable with medicine use via self-medication.ResultsOf the interviewees, 73.6% stated they had used some medication without medical recommendation if they had previously used the same product; 73.8% stated they had used non-prescribed medicine when the medicine was already present at home; and 35.5% stated they had used some non-prescribed medication when they knew someone who had already taken the same medication. The prevalence of self-medication was 18.3%. The variables associated with the highest probability of using medicine via self-medication were: geographic region within Brazil, gender, age group, per capita income, self-assessment of health, self-reported use of previously used non-prescribed medication, and self-reported use of non-prescribed medication when that medication was already present at home.ConclusionsThe use of medicines via self-medication in Brazil is relatively frequent and influenced by previous experience and familiarity with the medications, and is more common among women and individuals with low self-assessment of health.

Challenges in detecting and diagnosing substance use in women in the acute psychiatric department: a naturalistic cohort study.

BackgroundThis study examines sex differences in substance use and substance use disorder in the acute psychiatric department, and possible interactions between sex and clinical and social factors associated with this phenomenon.MethodsData concerning substance use were collected in a naturalistic cohort study (n = 384, 51.6% male, 48.4% female) in an acute psychiatric department. Recent intake of substances at admission, diagnosis of substance use disorder and demographic and socioeconomic information were recorded. At admission, serum and urine samples were analysed for substance use and breath analysis was performed for alcohol levels.ResultsTwice as many men as women were diagnosed with substance use disorder, whereas there were no gender differences in the number of positive toxicology screenings. Toxicology screening revealed the use of non-prescribed medication with addiction potential in 40% of both female and male patients many of whom did not report this in the admission interview. A low level of education in men and absence of parental responsibility in women showed a statistically significant interaction with a current diagnosis of substance use disorder.ConclusionsDespite no sex differences in positive toxicology screenings in the acute psychiatric department, twice as many men as women are diagnosed with substance use disorders. The use of prescription drugs with addiction potential was widely under-reported by both sexes, in patients with no prescriptions for the medications. Women with no parental responsibility are overrepresented among those diagnosed with substance use disorder, as are men with a low level of education.Trial registrationThe study is registered with the ClinicalTrials.gov identifier NCT01415323

6.51 MEDICATION ADHERENCE AND USE OF ILLICIT SUBSTANCES IN PEDIATRIC AND YOUNG ADULT PATIENTS PRESCRIBED STIMULANT MEDICATIONS INDICATED FOR ATTENTION-DEFICIT/HYPERACTIVITY DISORDER

This study aimed to identify potential nonadherence among pediatric, adolescent, and young adult patients prescribed attention-deficit/hyperactivity disorder (ADHD) stimulant medications and assess the differences in illicit substance and/or nonprescribed medication use in patients testing positive versus negative for the ADHD medication.

Cultural Disparities in the Use of Prescription and Nonprescription Medications Among Midlife Women in Israel.

The study aimed to examine differences in medication use among midlife women from different cultural origins and to identify socio-demographic, health, and lifestyle characteristics associated with prescribed and non-prescribed medication use. Face-to-face interviews with women aged 45-64 years were conducted during 2004-2006 within three population groups: long-term Jewish residents (LTJR), immigrants from the former Soviet Union after 1989, and Arab women. The survey instrument included current use of medications and way of purchasing (with/without prescription). The level of prescribed and non-prescribed medication use was categorized as taking none, taking 1-2, and taking 3 or more medications. The rates of medication use were 59.5% for prescribed medication and 47% for non-prescribed medications. Differences between the minority groups and LTJR were observed mainly for cardiovascular, vitamins, supplements, and hormonal medications. The analyses showed significantly lower use of prescribed medications among immigrants and of non-prescribed medications among Arab women after taking into account health and socioeconomic indicators. Increased use of prescribed and non-prescribed medications was associated with worse health status and older age. Education was associated with increased use of non-prescribed medications. The disparities in pharmaceutical care may be linked to barriers in access to health care and to cultural preferences among minorities.

The extramedical use and diversion of opioid substitution medications and other medications in prison settings in Australia following the introduction of buprenorphine–naloxone film

Around 65% of people incarcerated in prisons in Australia, America and Europe have a history of drug dependence, sometimes treated with opioid substitution treatment (OST) medications. Studies report that those in treatment in prison do engage in some level of diversion to others, whether on a voluntary or coerced basis. We aimed to examine the use of prescribed and non-prescribed OST medications by those in prisons, especially buprenorphine-naloxone film (BNX-F); the extent of non-adherence and diversion and reasons for such practices; and the impact of the introduction of BNX-F into the prison system. Mixed methods study drawing on: (i) structured interviews with current OST clients (n = 60) who reported being incarcerated in the 12 months prior to being interviewed and (ii) qualitative interviews with key experts working in corrections and prison (or justice) health settings. The majority were prescribed OST medications in prison, with 25% removing all or part of their supervised dose on at least one occasion, and 44% reporting use of non-prescribed medications. Some reported intravenous use (14% injected). One-third of OST recipients reported selling/sharing OST medications with others in prison. The introduction of BNX-F into the prison system saw different diversion methods used and removal from dosing within prison. Despite prison being a highly regulated and controlled environment, some level of diversion and sharing of psychoactive medication occurs among prisoners. The buprenorphine formulations used in OST present particular challenges with respect to supervised dosing in this setting. [White N, Ali R, Larance B, Zador D, Mattick RP, Degenhardt L. The extramedical use and diversion of opioid substitution medications and other medications in prison settings in Australia following the introduction of buprenorphine-naloxone film. Drug Alcohol Rev 2015;●●:●●-●●].

Frequency of using non-prescribed medication among the community of Majmaah City

Introduction: The use of non-prescribed medication can be considered the most common form of self-health care. The use of non-prescribed medication can take place through the consumption of industrialized medication. The use of non-prescribed medication is high among the Saudi population because they can be easily obtained without a medical prescription or evidence-based indication. Objectives: To determine the frequency of using non-prescribed medication in Majmaah City, Saudi Arabia. Materials and methods: A cross-sectional community-based study was conducted in Majmaah City. The study targeted adults of both genders. The sampling was conducted with a convenience sampling technique. A self-constructed questionnaire was used to collect the data from 390 participants. Participation consent from the subjects was taken (verbally). Results: The frequency of using non-prescribed medication among the Majmaah City population was high (93.1%), and (37.9%) of participants used non-prescribed medication because they had similar symptoms before and knew the treatment. Public pharmacies were the main source for non-prescribed medication (41.8%). Gender and use of non-prescribed medication were significantly associated, whereby male respondents used non-prescribed medication more than female respondents (70.8% male, 29.2% female). Conclusions: The frequency of using non-prescribed medication in Majmaah City is high. Pain killers, antibiotics and antipyretics were the most used medications. Males used non-prescribed medications more than females.

Reporting of non‐prescribed medication usage in remote Australia: health‐seeking habits in Port Headland

Studies have indicated that the emergency department is the third most common site of hospital adverse events – many attributed to negligence.1 Because the emergency department is their first point of contact, large numbers of people are potentially exposed to mostly preventable adverse events. Further studies have indicated that the phase in care where most adverse events occur is during the medical examination and history taking.2 Clinicians in the emergency department of Port Hedland Hospital reported concern that individuals attending the emergency department were not reporting use of nonprescribed medications. Given that non-prescribed medications have the potential to cause adverse drug reactions and complementary and alternative medicines are used extensively by patients who attend Australian emergency departments,3 we sought to determine the usage of non-prescribed medications and people’s willingness to report their use in a remote town. Non-prescribed medications included bush medicines, complementary and alternative therapies and over-thecounter medicines.

Motives for the non-prescribed use of psychiatric medications: relationships with psychopathology, other substance use and patterns of use

Objectives: Psychiatric medications are commonly used without a valid prescription for therapeutic and non-therapeutic reasons. This study aimed to examine the associated features of therapeutic and non-therapeutic motives for use among non-prescribed users of anxiolytic, sedative and stimulant medications recruited from the community.Method: Participants (n = 72) completed face-to-face interviews and questionnaires assessing medication use and misuse, other substance use and non-substance-related psychopathology. Multivariate logistic regression was used to examine factors relating to primary motives for use.Results: Non-therapeutic motives for use of anxiolytics, sedatives and stimulants were associated with a more extensive history of other substance use, as compared to therapeutic motives. Men were more likely than women to report using anxiolytics and sedatives for non-therapeutic motives. No symptoms of psychopathology, including anxiety disorders or attention-deficit/hyperactivity disorder, were related to motives for non-prescribed medication use. Although patterns of use tended to correspond with self-reported motives, in some cases, users reported therapeutic motives while describing high-risk patterns of use.Conclusion: These results demonstrate important heterogeneity within non-prescribed medication users that a unitary conceptualization fails to adequately capture.

Interpretation of Urine Drug Testing in Pain Patients

Traditionally, urine drug screens have only been concerned with positive or negative results. Those results provide physicians treating patients for pain with chronic opioid therapy with information about medication compliance, use of nonprescribed medications, and use of illicit drugs. However, the analysis of urine for drugs offers additional information that, when compiled and accurately interpreted, may also be of great value to these doctors. The aim of this article was to discuss the interpretation of urine drug tests and their application to pain physician practices. We utilized a selection of recent articles on urine drug screening applicable to the pain patient population. The article provides pertinent information about interpretation of urine drug testing, which is separated into six categories: which drugs and metabolites to test for; which analytical cutoffs to use; pain medication metabolism; identification of alcohol use; determination of patient compliance; and which patient groups to consider for more frequent testing.

Personality Disorders and Unmet Needs Among Psychiatric Inpatients

Personality Disorders and Unmet Needs Among Psychiatric Inpatients