Use Of Over-the-counter Medications Research Articles

Chronic bromine intoxication complicated with Fanconi syndrome: A case report.

In this report, we describe a unique case of an 80-year-old woman who developed chronic bromine poisoning due to the prolonged ingestion of over-the-counter (OTC) medication containing bromovalerylurea (BVU), thus leading to the onset of drug-induced partial Fanconi syndrome and resultant osteomalacia. The patient's condition improved following the cessation of bromide intake. This case highlights the potential risks of chronic BVU exposure and the importance of caution regarding the use of OTC medications containing BVU.

Improving health and well-being through over-the-counter counselling – an observation study

Abstract Introduction The use of over-the-counter (OTC) medication in self-care gives patients empowerment in their healthcare. However, if the patients do not know enough about the medication, it may lead to misuse.[1] Pharmacies are easily accessible, low threshold first-line health providers, where these products are sold. Considering the United Nations Sustainable Development Goals (SDGs),[2] pharmacy personnel are in an excellent position to educate the public on correct self-care, increasing good health and well-being (3rd goal). By ensuring that the customer buys the correct product and does not self-treat unnecessarily, pharmacies may contribute to responsible consumption (12th goal).[2] Aim Assessing the impact of OTC medication counselling in the 3rd and 12th SDG context: which aspects help promote good health and well-being, and how can counselling influence responsible consumption of OTC medication? Methods Observations with detailed notes of encounters on OTC medications were performed by two observers, for validity, in 7 pharmacies in and around a Nordic capital city. Pharmacies were recruited through convenient sampling, aiming to include pharmacies of different sizes and locations. The study population consisted of 253 observations. Results were analysed using thematic analysis focusing on evidence-based advice concerning the 3rd and 12th SDGs. Results The theme “customer autonomy” shows that most customers come to the pharmacy with a known product in mind. Employees rarely address the appropriateness of the customers’ chosen product, and only correct the customer if they clearly found the wrong one. Responsible consumption is not addressed. Considering good health and well-being, the theme “Presumed Knowledge” contains how employees most often ensure that the customer has previous experience, taking this as proof of the customer´s health literacy. When the employee informs about the product, they rarely give explanations for the advice, as described in the theme “Coaching opportunity”. Conclusion Pharmacy employees rarely take advantage of the opportunity to educate the public on proper OTC medication use, and thus do not contribute sufficiently to increase knowledge of good health. There is a lot of potential for pharmacies to utilise evidence-based advice in everyday practice, and ways of promoting good health knowledge in pharmacy practice need to be explored. Pharmacy employees do not contribute substantially to reducing consumption, as they most often sell the product the customer asks for without considering the necessity. Tailored OTC counselling could shape consumer behavior towards responsible OTC medication use, ultimately contributing to improved health outcomes, reduced waste, and a more sustainable healthcare landscape. A strength of using the observation method is that it is possible to examine how pharmacy personnel work in everyday situations. One limitation might be that since both the customer and employee were informed that observers were present, the employee might be inclined to improve their performance. However, the observers could clearly see the instances where the employee changed their conduct, and in most instances, the extra effort did not improve the information exchange.

Public Awareness and Practice Regarding Over-the-Counter Medications: A Cross-Sectional Study in Al-Ahsa, Saudi Arabia.

Background Pharmaceuticals classified as over-the-counter (OTC) medications are also known as self-medications, in which drugs are sold directly to customers without a valid prescription. According to the World Health Organization, self-medicationrefers to taking medication for ailments that one has self-diagnosed. The public viewed OTC medications as safer, more effective, and beneficial, but misuse can lead to other health issues. Therefore, this study aimed to assess awareness and practices regarding OTC medications. Methodology The study employed a cross-sectional design involving the public residing in Al-Ahsa in eastern Saudi Arabia. The study setting was primary health centers (PHCs) in Al-Ahsa. Four PHCs were chosen by the cluster sampling method. One PHC from each of the four health clusters (northern, southern, middle, and eastern)was selected and a total of 326 people were chosen by simple random sampling from those four PHCs. Data were collected through a structured self-administered questionnaire. Descriptiveand inferential statistics such as mean, standard deviation, chi-square, and correlation analyses were used to analyze the results. Results The mean age of the participants was 38.26 ± 9.73 years. The overall meanknowledge score regarding OTC medications was 14.21 (SD = 3.3). About 39 (11.96%) of the participants had adequate knowledge, 184 (56.44%) had moderately adequate knowledge, and 103 (31.6%) had inadequate knowledge about the safety of using OTC medications. The overall mean score of practices was 20.7 ± 4.42. The chi-square test results showed a significant (p < 0.01) association between the level of knowledge and age, occupation, nationality, and marital status. Additionally, a positive linear relationship (r=+.386) was found between knowledge and practices regarding OTC medications. Conclusion In conclusion, many people in the present study had moderate knowledge and good practices regarding OTC medications. To protect the public from harm, there is an urgent need for more concrete regulatory control over OTC drugs and self-medication. So, it is recommended to create awareness about the proper use of OTC medications.

Home medication inventory method to assess over-the-counter (OTC) medication possession and use: A pilot study on the feasibility of in-person and remote modalities with older adults

BackgroundThere is a need for reproducible methods to measure over-the-counter (OTC) medication possession and use. This is because OTC medications are self-managed, variably monitored by healthcare professionals, and in certain populations such as older adults some OTC medications may introduce risk and cause more harm than benefit. Objective(s): To develop and assess the feasibility of the Home Medication Inventory Method (HMIM), a novel method to measure possession and use of OTC medications. MethodsWe benchmarked, adapted, and standardized prior approaches to medication inventory to develop a method capable of addressing the limitations of existing methods. We then conducted a pilot study of the HMIM among older adults. Eligible participants were aged ≥60 years, reported purchasing or considering purchasing OTC medication, and screened for normal cognition. Interviews were conducted both in person and remotely. When possible, photographs of all OTC medications were obtained with participant consent and completion times were recorded for both in-person and remote modalities. ResultsIn total 51 participants completed the pilot study. Home medication inventories were conducted in-person (n = 15) and remotely (n = 36). Inventories were completed in a mean (SD) of 20.2 min (12.7), and 96 % of inventories completed within 45 min. A total of 390 OTC medications were possessed by participants, for a mean (SD) of 7.6 (6.3) per participant. No differences in duration of interviews or number of medications reported were identified between in-person and remote modalities. Anticholinergic medications, a class targeted in the pilot as potentially harmful to older adults, were possessed by 31 % of participants, and 14 % of all participants reported use of such a medication within the previous 2 weeks. ConclusionsImplementing the HMIM using in-person and remote modalities is a feasible and ostensibly reproducible method for collecting OTC medication possession and use information. Larger studies are necessary to further generalize HMIM feasibility and reliability in diverse populations.

A resurgence of tinea cruris caused by Epidermophyton floccosum: An outbreak among Thai naval cadets

BackgroundA decreasing trend in tinea cruris caused by Epidermophyton floccosum, an anthropophilic dermatophyte, has been observed. MethodsThis retrospective study involved Thai naval cadets aged 18 years or older with suspected groin lesions. Both clinical evaluations and laboratory investigations were conducted. ResultsIn total, 86 male participants with a median age of 19 years who presented with groin rash were enrolled in the study. Branching septate hyphae from KOH examination were found in 55 patients (64.0 %). Fungal identifications were Epidermophyton floccosum (42 cases; 76.4 %), Trichophyton mentagrophytes complex (3 cases; 5.5 %), and no growth (10 cases; 18.2 %). An E. floccosum outbreak was identified, with a prevalence of 76.4 %. Most lesions exhibited admixed erythema and hyperpigmentation. Approximately two-thirds displayed prominent, easily visible scaling. Scrotal involvement was absent in 95.2 % of lesions, with 87.2 % presenting bilaterally. A gradual symptom onset lasting up to 2 months was observed in 78.9 % of cases. Lesion morphologies included annular (73.8 %), patchy (14.3 %), and polycyclic (9.5 %). Severe itching disrupting daily activities was reported by only 7.1 % of participants. Approximately two-thirds used over-the-counter (OTC) topical medications without consulting a physician. Risk factors related to clothing included sharing clothes (59.5 %), wearing sweaty clothes (100 %), and reusing unwashed clothes (81.0 %). ConclusionsThe E. floccosum tinea cruris outbreak among naval cadets was characterized by a gradual onset and mild symptoms. OTC medication use without physician consultation was prevalent.

An underrecognized cause of hepatomegaly in uncontrolled type I diabetes.

A 29-year-old woman with a past medical history of poorly controlled type 1 diabetes and autoimmune hypothyroidism presented to the emergency department for evaluation of abdominal pain, nausea and vomiting. The patient was a cocaine user, but she did not use alcohol and did not smoke. Her current medications included Insulin aspart, Insulin degludec, L-thyroxine and Pantoprazole. She reported no use of over-thecounter medication or herbal and dietary supplements. acute distress. The abdomen was nondistended and soft with diffusely tenderness and a smooth palpable liver 3 to 4 cm below the costal margin. Laboratory studies was significant for glucose 539 mg/dL (normal 65-110), alkaline phosphatase 153 U/L (normal 35-105), gamma-GT 44 U/L (normal &lt;36), lactate 42,1 mg/dL (normal 4,5-19,8), arterial pH 7,32 (normal 7,35-7,45) and HbA1c 11% (4,5-6). A computed tomography (figure 1; panel A and B) and liver biopsy (figure 1; panel C and D) were performed.

Elevating Safe Use of Over-The-Counter Medications in Older Adults: A Narrative Review of Pharmacy Involved Interventions and Recommendations for Improvement.

Over-the-counter (OTC) medications are products that have been made easily accessible to allow patients to treat common ailments without a prescription and the cost of a doctor's visit. These medications are generally considered safe; however, there is still a potential for these medications to lead to adverse health outcomes. Older adults (ages 50+) are especially susceptible to these adverse health outcomes, due to age-related physiological changes, a higher prevalence of comorbidities, and prescription medication use. Many OTC medications are sold in pharmacies, which provides pharmacists and technicians with the opportunity to help guide safe selection and use for these medications. Therefore, community pharmacies are the ideal setting for OTC medication safety interventions. This narrative review summarizes the findings of pharmacy-involved interventions that promote safe OTC medication use for older adults.

A report of Kabul internet users on self-medication with over-the-counter medicines

Self-medication (SM) with over-the-counter (OTC) medications is a prevalent issue in Afghanistan, largely due to poverty, illiteracy, and limited access to healthcare facilities. To better understand the problem, a cross-sectional online survey was conducted using a convenience sampling method based on the availability and accessibility of participants from various parts of the city. Descriptive analysis was used to determine frequency and percentage, and the chi-square test was used to identify any associations. The study found that of the 391 respondents, 75.2% were male, and 69.6% worked in non-health fields. Participants cited cost, convenience, and perceived effectiveness as the main reasons for choosing OTC medications. The study also found that 65.2% of participants had good knowledge of OTC medications, with 96.2% correctly recognizing that OTC medications require a prescription, and 93.6% understanding that long-term use of OTC drugs can have side effects. Educational level and occupation were significantly associated with good knowledge, while only educational level was associated with a good attitude towards OTC medications (p < 0.001). Despite having good knowledge of OTC drugs, participants reported a poor attitude towards their use. Overall, the study highlights the need for greater education and awareness about the appropriate use of OTC medications in Kabul, Afghanistan.

A Short Review on Misuse of Over-the-Counter Drugs

Over-the-counter (OTC) medications can help people manage their symptoms on their own. However, addiction and harm are increasingly recognized, and some OTC medications can be used. This review describes the current knowledge and understanding of OTC drug abuse. Practicing self-care and self-healing is an important part of a health care regimen System. Using over-the-counter (OTC) medications is part of the self-medication process. The popularity of OTC medications among patients may increase OTC abuse Drug. Because it is available as a prescription drug, it is often the first choice for patients and has the potential to educate and advise patients on OTCs. Drug use. The presence of a pharmacist ensures the safe and effective use of OTC drugs. Pharmacists may interact with other health professionals in managing self-care practices Patients. However, pharmacists are not usually employed in this role. This article provides A brief overview of OTC drugs with abuse potential and the impact of self-medication on OTC Drug. This review further explains the challenges faced by pharmacists in managing the use of OTC medications, given the new potential for OTC-prescription diversion. Year. In addition, the drug’s potential to improve the patient’s pharmacology Interactions are discussed. Current reviews support the positive role played by pharmacists Management of OTC drug abuse. This review contributes to the knowledge base of barriers Confronts the pharmacy to prevent the use of OTC drugs by developing appropriate intervention strategies.

Over-the-Counter Medication Use among Parents in Saudi Arabia.

Self-medication is a growing public health concern worldwide. Studies have shown a gap between best practice and the current practice of using over-the-counter (OTC) medications. Despite being a well-recognised problem in Saudi Arabia, few studies have investigated OTC medication use in Saudi Arabia. Therefore, this study aimed to investigate the attitudes and knowledge of parents regarding OTC medication use in the Jeddah region, Saudi Arabia. A cross-sectional study was carried out via an electronic questionnaire sent randomly to parents over four months, from 1 January to 30 April 2022. The participants' characteristics and categorical variables were represented descriptively by frequency and percentage. A Chi-square test was used to test the relationship between the variables. In total, 211 questionnaires were included in this study. Females represented 54.5% of the participants included in the study. Parents belonging to the 18-to-30-year-old group comprised the highest percentage (37.9%), and most of the parents (72.9%) had received an undergraduate education. Family physicians were the most common source (37.3%) of information about OTC medications, whereas more than half of parents purchased OTC medications from the community pharmacy (58.8%). While almost half of the parents (52.1%) visited a family physician when side effects of OTC medications appeared in their children, only (33.6%) stopped giving their children the OTC medicine. The relationship between the sociodemographic characteristics (including educational level, marital status, and employment status) and OTC drug consumption was significant (p &lt; 0.001). Educational campaigns are needed to guide patients about the proper use of OTC medications. Studies on OTC medication use are lacking in Saudi Arabia in terms of its frequency, reasons for use, type of self-medication, and contributing factors.

Effective Determinants of Consumer Buying Decision on OTC Medications: Digital Marketing, Brand Experience, and Reference Groups

The growing over-the-counter (OTC) medication sector within the pharmaceutical industry gains competitive advantages through digital marketing where the companies must reevaluate their infrastructure and their marketing techniques to get through this evaluation. This study aims to analyze the influence of developing pharmaceutical marketing on consumer purchase decision of OTC medication. An empirical online survey was conducted based on a self-administrated questionnaire to assess the impact of pharmaceutical digital marketing, reference groups, and brand experience toward consumer decision on OTC purchase. Primary data were collected using the questionnaire from 158 pharmacies’ consumers in North Cyprus (Famagusta, Nicosia, and Kyrenia), and SPSS software is used to analyze the data. Eventually, the findings indicated that consumers in North Cyprus are aware of the use of OTC medications for common ailments and that pharmaceutical companies, the government, and other health stakeholders have a responsibility to increase consumer knowledge and awareness about the safe and effective use of OTC medications, particularly through the digital channels.

Prevalence and pattern of use of medications amongst undergraduate students of a Nigerian University

University undergraduates in Nigeria use prescription and over-the-counter (OTC) medications for cognitive enhancement and relaxation during examination periods. Such practices can lead to increased toxicity, drug interactions, and other adverse effects. This study investigated the prevalence and pattern of use of prescription and OTC medications amongst undergraduate students at the University of Lagos. Quantitative data were collected from 386 students in 2018. The collected data was analysed using SPSS version 22. The study found that 68% of respondents frequently used prescription and OTC medications, such as non-medical analgesics, caffeine-containing drugs, cough syrups containing codeine, diphenhydramine combinations, bromazepam, antimalarials, and antibiotics, during the examination period. The medications were accessed through community pharmacies and leftover medications at home. The findings highlight the ease of access to these medications as a major contributor to their non-medical use by students. This suggests the need for legislation and a functional regulatory framework to control the sale of medications without a prescription from a qualified medical practitioner and sustained public awareness campaigns on medication use and the potential danger of self-medication.

1471. Treatment of Influenza with Baloxavir was Associated with Reduced Absenteeism Compared with Oseltamivir in a Patient-Generated Health Data Study

Abstract Background Lost productivity from workplace absenteeism is a significant component of the economic burden of influenza [1]. Antiviral treatment together with influenza vaccination may help reduce work time lost from influenza illness [2]. In clinical trials, baloxavir, an oral single dose treatment for influenza, demonstrated comparable symptom resolution to oseltamivir taken twice daily for 5 days [3]. We examined baloxavir real-world outcomes using patient generated health data (PGHD) to investigate the association between antiviral use and workplace absenteeism. Methods Using data from a participatory influenza-like illness (ILI) surveillance program (ISP), we identified participants who self-reported ILI using the online Evidation platform during the 2019-2020 influenza season in the United States. Participants who self-reported treatment with baloxavir or oseltamivir were included. We conducted an ordinal logistic regression to estimate the odds of missing work due to ILI, while adjusting for use of over-the-counter (OTC) medication, age, number of symptoms, US region, and comorbidities. Results Of 3658 participants eligible for inclusion in the analysis, 3285 (89.8%) were prescribed oseltamivir and 373 (10.2%) were prescribed baloxavir. A majority of participants (81.7%) reported missing at least one day of work. In the ordinal logistic regression, use of baloxavir was associated with lower odds of absenteeism, compared to oseltamivir (odds ratio [OR]: 0.748, 95% confidence interval [CI]: 0.616, 0.907). In addition, a higher number of symptoms (OR 2.922, 95% CI: 2.454, 3.481), older age (OR: 1.425, 95% CI: 1.162, 1.747), and use of OTC medication (OR: 1.242, 95% CI: 1.086, 1.420) were associated with higher odds of absenteeism. Due to a high rate of missing data on the timing of antiviral use (24.5% missing), its association with absenteeism could not be adequately assessed. Conclusion Treatment of patients with ILI with single dose baloxavir was associated with reduced workplace absenteeism compared to oseltamivir after adjusting for measured confounders. This study provides useful insight into factors associated with ILI-related workplace absenteeism and the potential real-world utility of baloxavir. Disclosures Hao Xu, MSc, Hoffmann-La Roche Limited: Employee Vincent Ukachukwu, n/a, Roche Products Ltd: Employee Devika Chawla, PhD, Genentech: Employee.

A study on over-the-counter drug use in community pharmacies

Background: The usage of over-the-counter (OTC) medications has steadily increased in recent years. Improper use of OTC medications might result in health and other drug-related issues. Easy access to OTC medications has become a more critical concern in developing countries. Objective of the study was to assess the OTC drugs dispensed in community pharmacies.Methods: A prospective cross-sectional study was conducted in selected community pharmacies. To evaluate the OTC drugs dispensed; 700 participants were polled using questionnaires through a validated data collection form, and a patient interview respectively. Descriptive statistics and multivariate logistic regression were performed using statistical package for the social sciences (SPSS) (version 20). The Chi-square test was used to test for significant differences between groups (p&lt;0.05).Results: A total of 700 patients were recruited for the study to assess the use of OTC drugs. Analgesics/NSAIDs are the most often used OTC medications, accounting for (30.4%), followed by antacids (15.7%). The primary sources of information to purchase OTC medications were taken from community phapharmacists1.6%). Recurrence of minor ailments (68%) is the major influencing factor for OTC drug purchase, whereas (80.9%) agree that OTC medication is cheaper and more convenient.Conclusions: As per the findings of the study; OTC medication dispensing is prominent, and there is a need for awareness programs to ensure rational drug usage.

Interventions to address potentially inappropriate prescriptions and over-the-counter medication use among adults 65 years and older in primary care settings: protocol for a systematic review

PurposeTo inform recommendations by the Canadian Task Force on Preventive Health Care on potentially inappropriate prescribing and over-the-counter (OTC) medication use among adults aged 65 years and older in primary care settings. This protocol outlines the planned scope and methods for a systematic review of the benefits and harms and acceptability of interventions to reduce potentially inappropriate prescriptions and OTC medication use.MethodsDe novo systematic reviews will be conducted to synthesize the available evidence on (a) the benefits and harms of interventions to reduce potentially inappropriate prescriptions and OTC medications compared to no intervention, usual care, or non- or minimally active intervention among adults aged 65 years and older and (b) the acceptability of these interventions or attributes among patients. Outcomes of interest for the benefits and harms review are all-cause mortality, hospitalization, non-serious adverse drug reactions, quality of life, emergency department visits, injurious falls, medical visits, and the number of medications (and number of pills). Outcomes for the acceptability review are the preference for and relative importance of different interventions or their attributes. For the benefits and harms review, we will search MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for randomized controlled trials. For the acceptability review, we will search MEDLINE, Embase, PsycInfo, Cochrane Central Register of Controlled Trials, and the NHS Economic Evaluation Database for experimental and observational studies with a comparator. Websites of relevant organizations, other grey literature sources, and reference lists of included studies and reviews will be searched. Title and abstract screening will be completed by two independent reviewers using the liberal accelerated approach. Full-text review, data extraction, risk of bias assessments, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be completed independently by two reviewers, with any disagreements resolved by consensus or by consulting with a third reviewer. The GRADE approach will be used to assess the certainty of the evidence for outcomes.DiscussionThe results of this systematic review will be used by the Canadian Task Force on Preventive Health Care to inform their recommendation on potentially inappropriate prescribing and OTC medication use among adults aged 65 years and older.Systematic review registrationPROSPERO (KQ1: CRD42022302313; KQ2: CRD42022302324); Open Science Framework (https://osf.io/urj4b/).

Knowledge, Attitude, and Practice Toward Over-the-Counter Medication Use; Among Selected Students at Sokoine University of Agriculture

Every day, we are practicing self-medication (SM) with over-the-counter (OTC) drugs within the frame of self-care for our wellbeing. This study aimed to assess knowledge, attitude, and practices on OTC medication use among selected students at Sokoine University of Agriculture (SUA) in the College of Veterinary Medicine and Biomedical Sciences (CVMBS). A cross-sectional study was carried out at CVMBS, in Morogoro included veterinary students and non-veterinary students. A simple random sampling technique was used to select samples and the data were collected using a self-administered questionnaire with structured and open-ended questions. Data entry, cleaning, and analysis were done using Statistical Package for Social Sciences (SPSS). The study revealed that the majority of the students 100 (64%) practice SM. Fever 69 (80.2%), emergency illness 46.0%, healthy facility charges 16.0%, distance to the health facility 12.0%, taking a long time of waiting for 11.0%, the proximity of the pharmacy shop 5.0%, no medicine in the health facilities 4.0%, 3.0% emergency illness and health facility charges, and emergency illness and takes a long time of waiting for 3.0%. The most commonly used OTC for SM in this study was painkillers (35%) and antibiotics (30%). The study revealed that community pharmacies were the major source of medicines for those who practiced SM with OTC drugs 67.0%, followed by medicines from relatives/friends 21.0%. The study also showed that there is optimal knowledge among CVMBS students, also study showed that most students have a negative attitude about SM where 38.0% strongly disagree and 37.0% disagree that SM can be practiced for all medicines. Malpractices were observed such as using remains from previous illnesses and using expired medications.

Polypharmacy and premature aromatase inhibitor (AI) discontinuation in older women with breast cancer.

6568 Background: Treatment with AI therapy for at least five years is recommended to reduce risk of cancer recurrence in postmenopausal women with hormone-positive breast cancer, but up to 50% prematurely discontinue their AI. Prior studies have demonstrated higher rates of nonadherence in older patients. Higher rates of comorbidities are also present in older patients, many of which require treatment with prescription medications. However, in prior studies, the impact of polypharmacy on AI persistence in older women has been variable. We evaluated the relationship between use of prescription and over-the-counter (OTC) medications and AI discontinuation in older women in a randomized controlled trial of AI therapy. Methods: In the Exemestane and Letrozole Pharmacogenetics (ELPh) trial, postmenopausal women with stage 0-III hormone-positive breast cancer were randomized to receive exemestane or letrozole and followed for two years. Prescription medication and OTC supplement usage was prospectively collected. Only enrolled participants at least 65 years of age were included in this analysis. Univariate and multivariable Cox proportional hazards models evaluated the association between baseline prescription medications, OTC medications, initial assigned AI medication, and time to discontinuation of initial AI. Results: 131 women at least 65 years old with baseline medication and OTC supplement information were identified. The average age was 70.4 (SD 5). 58 participants (44%) were randomized to exemestane and 73 (56%) to letrozole. 21% had previously received tamoxifen and 18% received taxane-based chemotherapy. The average number of prescription medications at AI initiation was 4.95, and 127 patients reported taking at least one. The average number of OTC medications was 3.23, and 107 patients reported taking at least one. There was no difference in number of prescription medications or OTC medications by study arm. As previously reported, exemestane was associated with premature discontinuation (HR 1.92 [95%CI 1.06-3.50], p = 0.032). Controlling for AI, the risk of discontinuation decreased by 12% for every additional prescription medication (HR 0.88 [95%CI 0.78-0.99], p = 0.038). OTC medication use was not significantly associated with AI duration. Conclusions: Increased prescription medication usage at AI initiation was associated with decreased risk of premature discontinuation of AI. Further research is needed to evaluate this interaction and identify characteristics that impact AI persistence in older women with breast cancer. Clinical trial information: NCT00228956.

Over-the-counter (OTC) Medication And Nutraceutical Use In Patients With Heart Failure Reduced Ejection Fraction (HFrEF): A Sub-Study From The EPIC-HF Trial.

<h3>Introduction</h3> Limited data exist regarding "real world" use of OTC medications and nutraceuticals in HFrEF patients. <h3>Methods</h3> The EPIC-HF trial (NCT03334188) was a prospective, randomized study testing the implementation, effectiveness, and safety of the EPIC-HF intervention compared to usual care in HFrEF patients across a large diverse health system. Demographic data and nonprescription medication use were collected from electronic medical records. We characterized specific OTC medications and nutraceuticals used by HFrEF patients; assessed attitudes regarding knowledge, skill, and confidence for managing health and healthcare; and compared intensification of guideline directed medical therapy (GDMT) between patients who did or did not use nutraceuticals. Attitudes were assessed via the Patient Activation Measurement tool and stratified by nutraceutical use. The association between guideline-directed medical therapy (GDMT) intensification and nutraceutical use was compared between the EPIC-HF control and intervention groups. Comparisons between groups were made using Mann-Whitney-Wilcoxon tests for continuous variables and chi-squared tests or Fisher's exact test as appropriate for categorical variables. <h3>Results</h3> Of the 305 patients enrolled in the EPIC-HF trial, 92% were taking at least one OTC medication and 26% at least one nutraceutical. The most common OTC medications were aspirin, acetaminophen, cholecalciferol, and calcium. Fish oil, coenzyme Q10, melatonin, and lactobacillus were most used for nutraceuticals. Of the EPIC-HF study cohort, 9.5% of patients were taking an OTC medication or nutraceutical that could exacerbate or worsen HF. In the EPIC-HF intervention cohort (n=147), only 36.4% in the nutraceutical group had any intensification in their GDMT compared to 53.9% of those not taking nutraceuticals (P=0.05). Patients taking nutraceuticals "strongly agreed" they felt more confident when they needed medical care or could handle a health problem themselves compared to those who did not (52.6% vs 39.3%, p<0.05, respectively). <h3>Conclusions</h3> Within our study population, OTC medication use was highly prevalent in patients with HFrEF with about one-third taking nutraceuticals some of which could exacerbate or worsen heart failure. Nutraceutical use among HFrEF patients was associated with a lower likelihood for GDMT intensification.

154 Development and Validation of a Survey Measuring Over-the-counter Medication Protection Motivation

OBJECTIVES/GOALS: A major barrier to older adult (65+) over-the-counter (OTC) safety is the lack of actionable research on factors affecting older adult decisions during OTC selection. This goal of this study is to develop and validate a survey instrument based on the Protection Motivation Theory to measure older adults perceived risk of OTCs. METHODS/STUDY POPULATION: The 24-item OTC Protection Motivation survey underwent revision using a consult from the UW Survey Center as well as rigorous cognitive interviewing and pilot testing with 8 older adults. It was administered to 103 community-dwelling older adults. OTC misuse data was gathered from 15 of the participants. OTC misuse evaluated by three pharmacy experts on the basis of OTC appropriateness given participants age, existing conditions, concurrent medication use, and intention to adhere to label guidelines. Multivariate linear regression was used to examine the relationship between OTC misuse and protection motivation. Exploratory factor analysis (EFA) was used to determine a model of best fit to describe the factor structure of the OTC Protection Motivation survey. RESULTS/ANTICIPATED RESULTS: The EFA yielded a 5-factor model of protection motivation, which included the components of deliberative risk perception, a combination of experiential and affective risk perception, threat severity, protective behavior intent, and perceived efficacy in protective behavior engagement. The EFA-based item reduction resulted in a final 18-item OTC Protection Motivation survey. DISCUSSION/SIGNIFICANCE: Older adults, who have the lowest health literacy levels, are responsible for 30% of OTC medication use and 61.5% of emergency department visits due to adverse drug events. This study is the first to characterize the relationship of OTC protection motivation and OTC misuse to inform patient-centered interventions for older adult OTC safety.

Perceived risks of over-the-counter medication use among pregnant Saudi mothers: A cross-sectional study

ObjectivesMany women use over-the-counter (OTC) medicines, particularly during pregnancy. Therefore, this study investigated the perceived risks of using OTC medicines among pregnant Saudi mothers. MethodsWith a cross-sectional design and purposive sampling, the 28-item Drug Use Health Belief Scale was used to collect data from pregnant Saudi mothers (n = 366) in a general tertiary hospital. The data were analyzed with descriptive and inferential statistics. After normality testing, the percentages, mean scores, and standard deviations were used to examine the demographic data. One-way ANOVA was used to identify the relationships between perceived risks on the Health Belief Scale and the participants’ sociodemographic profile variables. Post-hoc tests were used to identify differences in the independent variables among groups. The statistical significance threshold was set at p ≤ 0.05. ResultsAcross the five domains of the Health Belief Scale, the perceived susceptibility domain had the highest rank (0.36). Significant differences were observed between the mean scores of pregnant Saudi mothers’ perceptions of susceptibility and the benefits of using OTC medications (p = 0.05), perceptions of susceptibility (p < 0.001), and benefits while using OTC medications (p = 0.018) than those who did not use OTC medications. However, no significant differences were observed in the degree of perceived severity, barriers, and self-efficacy in mothers using OTC medications (p > 0.05). ConclusionNotable differences were found in pregnant women's perceptions of the risks of using OTC medications. Greater awareness of the risks of OTC medication use during pregnancy is required. To ensure mothers' safety, a collaboration between prenatal multidisciplinary team of professionals (e.g., doctors, nurses, midwives) in community and hospital settings should be prioritized.