Title: Patient perspectives to self medication in a community pharmacy setting in Malta.
Objective: To determine the perspectives of patients regarding OTC medication, incidence of irresponsible medication, reasons for, predisposing factors that contribute to, and methods used to reduce these events from occurring. The misuse and abuse of OTC medications was also discussed.
Design: Questionnaire of approximately 15 minutes duration administered using a structured interview technique.
Setting: National Pharmacy, Hamrun, Malta.
Subjects: 200 people above the age of 16 years entering the pharmacy.
Results: Three quarters of participants visited a community pharmacy at least once a month and over half of participants (56.5%) reported buying OTC drugs during the same period. Most respondents (85%) preferred seeking advice from a chemist rather than a doctor when their condition was not serious enough to visit the latter. Patients with higher managerial, administrative and professional occupations were more likely to follow the directions on the packet. Patients with manual occupations were more likely to seek the advice of a pharmacist rather than a doctor if a given OTC product did not work within a recommended time period. Only 1% of participants asked for an OTC product that did not correspond with the symptoms they were treating. Three quarters of participants were knowledgeable about the potential for abuse of some OTC drugs and most named analgesics as the most liable for abuse. Almost one third (31.5%) of the participants came across cases of OTC abuse.
Conclusion: Participants were positive towards the health care being provided by their local pharmacy. They felt that pharmacists play an important role in providing advice on OTC medicines use. The OTC drug abuse problem needs to be tackled urgently as shown by the number of participants witnessing such abuse. Further studies are required to determine on a larger scale the perspectives of OTC use in Malta.
Table of Contents
1. Introduction
Maltese Health Care System
Maltese Classification of Pharmaceuticals
Cost of medicines in Malta – Economic Aspects
Deregulation from POM to P
Collaborative Care
Misuse vs. Abuse
OTC misuse
OTC abuse
Studies on OTC use (self medication)
2. Aims and objectives
3. Methodology
Literature Review
Modifications to questionnaire of Waizaify et al. 2005
Validity testing
Administration of Questionnaire
Structure of questionnaire
Coding data into SPSS
Analysis of Data
Researching published studies into OTC drug related trends to aid in improving pharmaceutical care
4. Results
Reliability testing
Demographics
Patient interaction with a local pharmacy
Views on OTC use
OTC selection
OTC abuse
5. Discussion
Drug-related trends to improve pharmaceutical care.
Drug adherence
Health Literacy
OTC abuse
Facilitating behaviour change
6. Conclusion
Research Objectives and Themes
This thesis aims to investigate patient perspectives regarding over-the-counter (OTC) medication use in a Maltese community pharmacy setting. The research addresses the prevalence of self-medication, identifies the drivers of irresponsible medication practices, and explores the role of pharmacists in patient education and the mitigation of drug misuse and abuse.
- Patient attitudes towards OTC safety and efficacy.
- Incidence and nature of OTC drug misuse and abuse in Malta.
- Pharmacist-patient interactions and the potential for improved pharmaceutical care.
- The impact of health literacy and patient education on self-medication behaviors.
- Potential solutions for preventing medication errors and abuse, such as health identity cards.
Excerpt from the Book
OTC abuse
From the definitions of misuse and abuse one can infer that all OTC medications can be misused. On the other hand, some medications have a higher abuse potential than others (Hughes et al.1999). Drugs identified as having a high abuse potential include those containing opiods, antihistamines, sympathomimetics and laxatives (ibid).
Several authors have focused on the fact that the long-term use of stimulant laxatives can have serious negative health consequences (Fleming et al. 2004). They are often abused in the mistaken belief that their use will either prevent calorie absorption and weight gain or maintain good health for those who believe that daily bowel evacuation is healthy (Hughes et al. 1999). Abuse of stimulant laxatives may lead to a number of complications including diarrhoea with associated sodium and water loss, potassium loss and hypokalaemia, possibly hypocalcaemia and hypomagnesaemia which can result in tetany (ibid). These combined effects have been referred to as “metabolic madness” and can result in renal damage (ibid).
Fleming et al. (2004:282) stated that “with regard to antihistamines, reports of abuse have centred around older, sedating products such as dimenhydrinate, diphenyhydramine and cyclizine”. In high doses, they can cause euphoria, hallucinations, disorientation and ataxia with reports often involving teenagers seeking euphoric effects (ibid).
Summary of Chapters
1. Introduction: Provides an overview of the Maltese healthcare system, pharmaceutical classification, and the regulatory environment regarding the shift from prescription-only to OTC medications.
2. Aims and objectives: Defines the research goal to analyze patient perspectives on self-medication and identifies specific objectives regarding current practices and potential improvements.
3. Methodology: Details the literature review process, adaptation of the questionnaire for the Maltese population, and the quantitative statistical methods used to validate findings.
4. Results: Presents data on patient demographics, interaction patterns with local pharmacies, and findings related to OTC use, misuse, and abuse perceptions among participants.
5. Discussion: Interprets the findings in the context of international studies and discusses strategies for enhancing pharmaceutical care, including behavior change and health literacy.
6. Conclusion: Summarizes the key findings, emphasizing the positive role of pharmacists and the urgent need for systemic interventions to address OTC abuse in Malta.
Keywords
OTC medication, Self-medication, Community Pharmacy, Malta, Pharmaceutical care, Drug abuse, Drug misuse, Patient perspectives, Pharmacist, POM to P switch, Health literacy, Drug adherence, Patient safety, Questionnaire, Health identity card
Frequently Asked Questions
What is the core focus of this research?
The research focuses on understanding patient perspectives regarding over-the-counter (OTC) medication, including how these drugs are used, the incidence of misuse and abuse, and the role of the community pharmacist in managing these issues.
What are the primary thematic areas covered?
The study covers the Maltese healthcare system, the economic aspects of medicine pricing, the regulatory shift from Prescription Only Medicines (POM) to OTC, and strategies for improving pharmaceutical care.
What is the main objective or research question?
The primary aim is to identify the trends in self-medication practices within a Maltese community pharmacy and to explore patient knowledge and attitudes toward the safety and potential abuse of OTC products.
Which scientific methodology was employed?
The researcher conducted a structured interview-based survey with 200 participants, complemented by a comprehensive literature review and statistical analysis using SPSS for data processing.
What topics are discussed in the main body?
The main body examines factors predisposing patients to irresponsible medication use, the impact of occupation and demographics on adherence, and the role of community pharmacists in providing advice and monitoring therapeutic outcomes.
How are the results characterized by key terms?
The research is characterized by terms such as OTC drug misuse, OTC abuse, pharmaceutical care, health literacy, and collaborative care between health professionals.
What specific role does the pharmacist play according to the study?
The study indicates that pharmacists are viewed as convenient and accessible sources of advice, playing a crucial role in patient education, screening, and potentially acting as a first line of intervention for OTC misuse.
What is the proposed solution for tracking drug usage?
The author proposes the introduction of a health identity card to track patient medication history, which could help pharmacists identify patterns of drug overuse or potential interactions across different pharmacies.
- Quote paper
- Michael Debrincat (Author), 2011, Patient perspectives to self medication in a community pharmacy setting in Malta., Munich, GRIN Verlag, https://www.grin.com/document/265172
