Drug utilization evaluation of nonprescription H₂‐receptor antagonists and alginate‐containing preparations for dyspepsia

Abstract

Aims To evaluate the use, ef®cacy and adverse effects of nonprescription H 2 -receptor antagonists and alginate-containing preparations obtained from community pharmacies. Methods Questionnaires were distributed to customers from 39 pharmacies in Scotland and Wales. Results Of 767 customers recruited, 608 (79.3%) returned an initial questionnaire and 472 (61.5%) customers a second questionnaire. The vast majority of respondents (424, 69.7%) had suffered their symptoms on three or more occasions and 369 (60.7%) had previously tried medicines to relieve their symptoms. Referrals to a doctor were less frequent than recommended in guidelines and few of those who were referred actually saw a doctor. Over a quarter of those returning the second questionnaire claimed to be taking more than one product simultaneously for symptom control. Eight customers who were taking prescribed ulcer-healing drugs obtained H 2 -receptor antagonists. The majority of respondents (355/472, 75.2%) obtained some or complete symptom relief using the product obtained and 369/472 (78.2%) were completely satis®ed with their product. H 2 -receptor antagonists were more likely to produce complete relief of symptoms than alginate-containing preparations (P<0.05). Only 14 respondents (3.0%) reported side-effects from the product used which were mostly gastrointestinal. Conclusions The study demonstrated that drug utilization studies are feasible to carry out in a community pharmacy setting. While the results support published evidence of the ef®cacy and minimal toxicity of these products, they also highlight the possibility of H 2 -receptor antagonists being used outwith their licenced indications.

Medicine safety: experiences and perceptions of the general public in Liverpool

“…Nonetheless, the frequency with which respondents themselves had experienced an ADR or knew someone else who had was high, with older people and women being more likely to report such an experience, which is in line with other studies . The finding that few ADRs were related to OTC medicines is also in line with other prospective studies . Some 38.5% of respondents themselves had experienced a suspected ADR from a prescribed medicine, which is higher than what was found in a retrospective postal survey or telephone surveys of patients who were prescribed particular medicines …”

“…Reports from the general public constituted only 15% of all Yellow Card reports submitted to the MHRA in 2009, and few of these reports relate to OTC medicines . This may be expected, as medicines available without prescription are so classified because of their low propensity to cause side effects, and several studies support a low frequency of adverse reactions arising from OTC medicines . However, ADRs are common among hospitalised patients and as a factor contributing to hospital admission .…”

Self-Medication of Upper Gastrointestinal Symptoms: A Community Pharmacy Study

“…11-13 However, data on the typology of upper GI complaints for which individuals seek self-medication and, more importantly, on the prevalence of alarm symptoms in this population are scarce. 14, 15 In this study, we aimed to evaluate the role of the pharmacist as intermediary by investigating: (1) which GI symptoms people intend to self-medicate, (2) the prevalence of alarm symptoms in this population, (3) patients' adherence to referral advice made by the pharmacist, and (4) self-reported efficacy and the frequency of use of OTC medication purchased by subjects eligible for self-care.…”

Reclassification of omeprazole: a survey of community pharmacists' early experiences and views

“…Community pharmacists have expressed concerns about their OTC availability, 19 however a drug-utilisation evaluation of non-prescription H 2 RAs in community pharmacies supported their effectiveness with minimal toxicity. 20 Galpharm Healthcare Ltd requested the reclassification of omeprazole to pharmacy status in May 2003, 21 on the basis that acid regurgitation and heartburn can be self-diagnosed, that H 2 RAs were already available OTC, that omeprazole was already available OTC in Sweden and the US and that there was low potential for misuse or overdosage. The National Pharmaceutical Association expressed concern at that time that the proposed indication (for the relief of reflux-like symptoms) was too vague, and that omeprazole was not a first-line drug according to national guidelines.…”