|
|
 |
 |
 |
| Friday, 1 August 2003 |
 |
|
 |
Features | |
| News Business Features Editorial Security Politics World Letters Sports Obituaries
|
Educating patients on self-treatment Last week at a seminar on drugs registration held at the SLAAS auditorium in Colombo, Dr. Lucian Jayasuriya ex-additional Secretary, Ministry of Health cautioned the authorities on the dangers to health of not having adequate personnel to monitor and check on the proper sale of drugs in the pharmacies. He said as it is not only the OTC drugs but even the prescription drugs could be had by anybody from some of the pharmacies in the country. Today we highlight an article published in a recent issue of the American Family Physician on this subject where even in respect of the OTC drugs the need to educate the public on its proper use has been emphasised. Educate patients in their quest to self-treat by Toni Lapp
If you're concerned, it's with good reason. Considerable evidence indicates that many patients do not read labels or heed warnings about possible drug interactions or side effects of OTC products. And because there is a general perception that these drugs are safe, patients may not seek the necessary information before making a selection. The danger is only increasing, says one Fimily Physician. "In the last five years, there's been an incredible burst of new pharmaceuticals, and with it an awareness among physicians of interaction problems", says Susan Montauk, M.D., who co-wrote a new AAFP monograph on the subject. In fact, more than 100,000 drugs are available without a prescription, according to recent data reported in JAMA. "There's no way you can know about 100,000 medicines, so you have to educate your patients on how to assess and use OTCs," says Montauk, professor of clinical family medicine at the University of Cincinnati College of Medicine. To be sure, OTC medicines can be beneficial. Patients who study the choices can treat themselves appropriately for minor conditions without the inconvenience of visiting or calling their physicians. But physicians should impress on patients the need to read labels carefully - especially the small print - and ask questions if they're uncertain of what's appropriate for their ailment. Assuming that all OTCs are benign can prove disastrous, especially if a patient already is taking another medicine or several others. Easy to overdose Catherine Little, 67, of Cincinnati, used to pride herself on the fact that she never caught cold. Already taking blood pressure medicine and a nonsteroidal anti-inflammatory drug. Little was struggling with a cold when she started taking an OTC cold medicine. But a wracking cough persisted, so she also took a cough medicine she had on hand. She didn't have a measuring spoon handy, so she estimated her dose. "And that's about all I remember", she says. She woke up in the hospital. At first, ER doctors weren't sure what was causing Little's dementia. Tests for stroke, masses and metabolic events were negative. Only after she became more lucid was she able to say what she had taken. Hospital workers determined that she overdosed on OTC medicines, says Montauk, her physician. Montauk says it is common for medicine to have different effects in patients over age 65. Even if there is no concern about drug interactions, older patients should start with the OTC drug's dose. Another common mistake patients make is to take OTC drugs for longer than recommended. This information is on the label, often in tiny print. Polypharmacy presents another potential danger. For instance, naproxen and ibuprofen are safe and effective, but many patients experience problems if they take both at the same time, says Montauk. And these days, many people take an aspirin a day for cardiac benefits. However, aspirin mixed with non-sterodial anti-inflammatory drugs can increase the risk of gastrointestinal problems. Mixing caffeine or tobacco - agents that already increase blood pressure - with any medicine that raises blood pressure can cause disaster as well. It's not enough to ask patients what OTC medicines they are taking. "You must ask what they have in their cabinets," Montauk says. "Better yet, have them bring them in. "Anything that's in their cabinet could be used when a patient is ill and perhaps not thinking clearly. But the biggest danger may well be unfamiliarity. Sometimes a patient doesn't know what they're taking, says Montauk. "It's not uncommon for people to tell me they're taking an antihistamine and then tell me that the 'antihistamine' they're taking is Sudafed. "And when you hear, 'Oh I just take a vitamin,' you have to ask for more specifics; it could be a diet drug containing ephedra or an inappropriately high dose of a fat-soluble vitamin." ###### Handwashing at school reduces absence through illness A study in Detroit showed handwashing to be effective in reducing absence through illness in elementary school children." "A single school with 305 children aged 5-12 years in 14 classes was chosen, and classes were divided into experimental and control without formal randomisation. Six classrooms with 143 children formed the experimental group and eight with 162 children the control group. The intervention was that children in the handwashing classes were required by their teachers to wash their hands after arrival at school, before eating lunch, after the lunch break and before going home. This was done as a class activity. Children in the control group had no required hand washing. The outcome was absence from school, recorded daily and monitored by telephone contact with parents to investigate the nature of any illness. Illness was regarded as respiratory if it included cough, sneeze, sinus trouble etc., and gastrointestinal if it included abdominal pain or diarrhoea or vomiting. Both were used, and total days of absence for illness. Children with both respiratory and gastrointestinal reasons for absence were included in both groups, so the total may be less than the sum of these two reasons. They found: "Absences were recorded as a percentage of the total number of possible days of attendance. Absences were lower in the handwashing than in the control group. (Courtesy Bandolier 26th May, 2003 sent to Health page by Dr. Dennis J. Aloysius) ###### From Lanka Alzheimer's Foundation to you The focus of our mission is the well being and quality of life of elders, especially, those who are afflicted with dementia, their families and carers. Frailties of old age, traditionally, are a family responsibility. We applaud that fact. However, awareness of dementia, which is a collection of some 100-200 brain disorders, the principal of which is Alzheimer's disease, is scant. The tragic effects of dementia, commences with the loss of short term memory. There isn't a cure for dementia. Every person of senior years, without exception, is at risk. We offer awareness and correct understanding of dementia, and provide care giver support. Our intention is to develop a national service philosophy, encompassing training and education and mobile services. In cooperation with the Ceylon Social Service League, we have an ideal location in the hub of Colombo for our model centre for dementia care and the establishment of appropriate services islandwide. The historic building needs extensive restoration and alterations. A summary descriptor of the proposed Centre is noted in the Second Annual Report - 2002/2003. We seek capital expenditure of some rupees six million and the first two year's operating expenses of rupees four million. A business plan and the project proposal, including architectural site drawings are available. Thus far we have raised 15% of the total financial requirements. During two years of fund raising we discovered that the care of elders is not a priority in the international and national donor agency network, and individual donor community. Our task is to dispel that belief in the light of the current global reality and unprecedented societal change. For any contributions to support this cause please contact us. Tami Tamitegama, President |
|
News | Business | Features
| Editorial | Security
Produced by Lake House |
Think you have a hand on your patients' self-prescribing habits? This
might surprise you: More than 70 per cent of American adults and about 50
per cent of children take over-the-counter medications in any given week,
according to a study in the Jan. 16 Journal of the American Medical
Association.
