Over-the-counter cold medications. A critical review of clinical trials between 1950 and 1991

Smith, Marc D.

doi:10.1001/jama.269.17.2258

Cited by 135 publications

(107 citation statements)

References 41 publications

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“…This is important, because antidiarrhoeals are not recommended and have a poor risk-benefit relation [19], but are frequently consumed in developing countries [1,2,11]. Something similar happened concerning common-cold drugs, whose efficacy is doubtful [20].…”

Section: Discussionmentioning

confidence: 99%

Long‐term effects of an educational intervention on self‐medication and appropriate drug use in single‐sex secondary public schools, Quito, Ecuador

MALDONADO

Meléndez

Figueras

2006

Brit J Clinical Pharma

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What is already known about this subject• Self‐medication is extensively practised in both developed and less‐developed countries, sometimes inappropriately.• Educational intervention in secondary schools has been proven to be useful.• Most educational interventions in adolescent populations have focused on the reduction of addictive substance abuse.What this study adds• Educational intervention can improve knowledge about self‐medication and reduce misconceptions about diarrhoea, common cold and vitamins in an adolescent population.• A specific lecture followed by small working‐group seminars produces better results than a general lecture alone in terms of ‘knowledge’ and ‘attitude’.• The positive effects of the intervention are detectable even 1 year later. Yearly reinforcing interventions while in secondary school would allow long‐lasting effects.AimImproving knowledge about rational drug use at an early age may be a good way to increase the population’s awareness of health, medicines and self‐medication. We set out to evaluate the short‐ and long‐term effects of an educational intervention to promote rational drug use and self‐medication in secondary school students.MethodsA non‐randomized, controlled clinical trial. The participants were 367 female students (10–13 years old) from two secondary public schools of the metropolitan district of Quito (Ecuador). The educational campaign had two components [a specific lecture (intervention and control schools) and subsequent small working group seminars (intervention school)] providing short and clear messages of five topics related to rational drug use. The main outcome measures were an increase in ‘knowledge’ short term (1 month) and long term (up to 1 year) after intervention and the relative risk (RR) reduction in misconceptions or wrong ideas about medicine use.ResultsThe intervention group showed a significant increase in knowledge both short and long term and in comparison with the control group, mainly regarding oral rehydration salts preparation (+59.4%; P < 0.001), lack of multivitamin energizer action (+57.4%; P < 0.001), healthy growth effects (+53.3%; P < 0.001) and the perception that medicines’ promotional activities do not teach how to take care of health (+54.0%; P < 0.001). A RR reduction in misconceptions about drugs was found short term and long term. The intervention group was less predisposed to consume antidiarrhoeals [RR = 0.75, 95% confidence interval (CI) 0.62, 0.92], cough suppressants (0.44, 95% CI 0.35, 0.55) and other medicines for the common cold (0.56, 95% CI 0.45, 0.70). Misconceptions concerning the benefits of multivitamin preparations were reduced in 73%; additionally, the intervention group showed a decrease in their consumption (43.9% basal; 25.3% short term and 25.6% long term; P < 0.001).ConclusionIt is possible to achieve a favourable modification of attitudes to appropriate use of medicines in a teenage population and this modification lasts at least 1 year. Continuous reinforcing interventions would allow better and long‐lasting effects and could help to fill the gap in health education of the general population.

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Section: Discussionmentioning

confidence: 99%

Long‐term effects of an educational intervention on self‐medication and appropriate drug use in single‐sex secondary public schools, Quito, Ecuador

MALDONADO

Meléndez

Figueras

2006

Brit J Clinical Pharma

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“…Os fármacos com ação antiinfecciosa e os medicamentos para tosse e resfriado são os mais utilizados em crianças 2,4,8,10,23,24 , principalmente em função do grande número de infecções respiratórias que elas apresentam 26,30 . No presente estudo, os problemas respiratórios foram responsáveis pelo maior contingente de morbidade entre as crianças estudadas.…”

Section: Discussionunclassified

“…A análise do conteúdo das prescrições permitiu sua classificação em adequadas ou inadequadas. Foram consideradas adequadas as prescrições em que a escolha, via de administração, intervalo de administração e tempo de uso do medicamento eram adequados para o tratamento do sintoma ou diagnóstico e/ou uso profilático, levando-se em conta eficá-cia, segurança e preço, de acordo com dados atuais de literatura 4,5,25,26,30,31,32,33 . Foram consideradas inadequadas as prescrições em que os medicamentos prescritos eram de indicação questionável por conterem substâncias de ação não comprovada, por apresentarem uma menor relação custo/benefício em relação a outros medicamentos igualmente eficazes ou quando se tratava de fármacos de uso não indicado para crianças ou fármacos contra-indicados para a faixa etária da criança.…”

Section: Variáveis De Estudo E Sua Operacionalizaçãounclassified

Utilização de medicamentos por crianças atendidas em creches

Bricks

Leone

1996

Rev. Saúde Pública

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ResumoPara identificar o padrão de utilização de medicamentos em crianças, foram acompanhadas 1.382 crianças matriculadas em 15 creches municipais de São Paulo (SP)(Brasil), durante 2 meses; 512 crianças (37%) utilizaram 1.409 medicamentos (média de 50,9 medicamentos/100 crianças/ mês). Mais de 80% das crianças menores de dois anos utilizaram um ou mais medicamentos, enquanto nas outras idades esse consumo foi sempre inferior a 45%. Os fármacos mais utilizados foram os antiinfecciosos, medicamentos com ação no aparelho respiratório, e analgésicos/antitérmicos utilizados, respectivamente, por 20%, 19% e 14% das crianças estudadas. A maioria dos fármacos foi prescrita por médicos (93%), porém, mais de 65% dos antibióticos utilizados foram considerados inadequados; houve grande consumo de medicamentos de ação questionável e de fármacos não aprovados para utilização em crianças. (decongestants, expectorants, vitamin and mineral supplements) and usage of as yet un approved medications for children (diclofenac, benzidamin, iodides) Uso de medicamentos

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“…This is not the case, however, if the 2 most commonly used classes of OTC medications (those for coughs and colds and antipyretics) are examined. A series of systematic reviews have found that OTC cough mixtures are no more useful than placebo, [12][13][14][15] and the use of antipyretics in controlling fevers is of dubious value. 16 In fact, it appears that both doctors and parents have unrealistic expectations regarding the natural history of childhood coughs and colds, 17 and this is fertile ground for the advertising and sale of (inefficacious) OTC medications.…”

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confidence: 99%

“Social Medication” and the Control of Children: A Qualitative Study of Over-the-Counter Medication Among Australian Children

2004

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ABSTRACT. Objective. The aim of the study was to identify the patterns of use of over-the-counter (OTC) medications among children.Methods. The study used a qualitative design, with in-depth interviews of 40 parents with children <5 years of age.Results. There were 3 striking and readily apparent themes in the use of OTC medications among children. One was the administration of OTC medications as a form of "social medication," to give parents control over children's behavior that they perceived as fractious and irritating. A related theme was the use of OTC medications to reduce the inconvenience to the parents of having a sick child, again giving parents greater control and better time-management abilities. Finally, acetaminophen was considered by many parents to have almost miraculous properties in calming, sedating, and lifting the mood of children.Conclusions. The use of OTC medications for the treatment of minor ailments among children is widespread, despite the lack of evidence of efficacy of the most commonly used medications and the potential for toxicity. With the increasing propensity to look to medication as a means of supporting changing lifestyles, there is an urgent need to review the prevalence and effects of social medication. Pediatrics 2004; 114:e378 -e383. URL: http://www.pediatrics.org/cgi/ content/full/114/3/e378; parental stress, parental perception, child behavior, drug safety, over-the-counter. ABBREVIATION. OTC, over-the-counter T he late 19th century saw a rising culture of self-medication and ready-to-use drugs for infants, many of which were opiates. In Australia, for instance, proprietary medicines became a common feature in the home and were administered to children almost as soon as they became restless or "cross" in the night. 1 Syrups, "soothers," and teething powders were used for common, minor, health concerns such as "wind" and coughs. To pacify children, chemists, confectioners, and door-to-door salesmen sold narcotic lozenges, prepared with morphine and opium. 1 Teething, which was considered a major health problem for infants and was described as a period filled with "terror to a mother's imagination," was often recorded as the actual cause of death of a child, although now it is thought that the deaths were probably caused by the teething powders themselves, which were made of chloride of mercury and opium. 2 Although these products were marketed as "perfectly mild and free from danger," a coronial inquiry into a spate of infant deaths around 1880 found that many of these medications recommended unsafe doses of alcohol, morphine, and other opiates. An Australian Royal Commission in 1907 reported that 15 000 children were killed every year by soothing syrups and similar preparations. 3 Medications in various (more benign) forms have, however, remained an important feature in the management of many minor "ailments" among children. Over-the-counter (OTC) medications, for example, are promoted through television, radio, and print advertising. The advertisements, which are prim...

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Over-the-counter cold medications. A critical review of clinical trials between 1950 and 1991

Cited by 135 publications

References 41 publications

Long‐term effects of an educational intervention on self‐medication and appropriate drug use in single‐sex secondary public schools, Quito, Ecuador

Long‐term effects of an educational intervention on self‐medication and appropriate drug use in single‐sex secondary public schools, Quito, Ecuador

Utilização de medicamentos por crianças atendidas em creches

“Social Medication” and the Control of Children: A Qualitative Study of Over-the-Counter Medication Among Australian Children

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