Transnational trends in prescription drug misuse among women: A systematic review

Medicine misuse: A systematic review and proposed hierarchical terminology

“…3,7,8,37,53 These 5 definitions were coherent, and implied that patients "receive the appropriate medicines, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost both to them and the community". 7 F I G U R E 1 Flowchart of study selection 6 (8.5%) did not distinguish between intentional and unintentional misuse 9,10,21,26,43,50 ; and 1 (1.4%) only considered unintentional misuse (i.e. misunderstanding of instructions).…”

“…6,27,31,33,34,41 For the remaining 11 definitions (15.5%), no distinction between therapeutic and nontherapeutic uses was made, both being considered as medicine misuse. 5,9,11,17,32,38,39,50,52,55 The terms misuse and abuse generally had distinct definitions, 6,14,[31][32][33][34]41 The context of potential medicine misuse was mentioned in 50 definitions (70.4%). For 27 (38.0%), misuse occurs when medicines are not used as prescribed (or medical misuse), 9,10,[15][16][17]21,23,26,27,33,34,38,43,55 when prescription-only medicines are used without prescription (or nonmedical misuse) 5,23,33,55 or both.…”

“…For 27 (38.0%), misuse occurs when medicines are not used as prescribed (or medical misuse), 9,10,[15][16][17]21,23,26,27,33,34,38,43,55 when prescription-only medicines are used without prescription (or nonmedical misuse) 5,23,33,55 or both. 23,25,29,32,35,39,[50][51][52] In 14 definitions (19.7%), misuse occurs when initiators do not follow summary of product characteristics (SmPCs, i.e. off-label), medical guidelines or either.…”

“…Some authors, mostly when using definitions from regulatory authorities, 3,28,30,36,40,45,46,54 instructions. As it appeared only in a few definitions 9,10,21,26,42,43,50 and referred to situations quite different from misuse, such as mistakes in administration route or forgetting to take medicines, this definition is out-of-scope and should be avoided. Regarding inappropriate prescribing, when it is unintentional and unjustified (e.g.…”

“…Furthermore, nontherapeutic use of medicines, 5,9,11,15,17,32,38,39,50,52,55 such as substance use disorders, use of medicines for recreational purposes or cognitive enhancement, should be considered separately from medicine misuse. It was formerly called abuse, but was considered too judgemental and replaced by the term misuse, 15 thus introducing a further element of confusion.…”