Use of Over-the-Counter Products in Lebanese Adults with Cardiovascular Disease
DOI:
https://doi.org/10.29169/1927-5951.2021.11.14Keywords:
Cardiovascular disease, drug-interaction, nonprescription drugs, over-the-counter, pharmacies, supplementsAbstract
Background: While selling over-the-counter (OTC) products in pharmacies is convenient to individuals and can be beneficial, it might potentially cause harm. We hereby describe the patterns of OTC product consumption amongst adults with cardiovascular disease (CVD) in Lebanon and the potential interactions with prescription medications and patient diseases.
Methods: This was a cross-sectional study in the setting of nine community pharmacies across different governorates of Lebanon. Data of interest were collected from adult patients with CVD history through face-to-face interviews using a short questionnaire.
Results: Out of 201 adult patients included in the study, 190 (94.5%) were using at least one OTC product, with a mean of 3.2 ± 2.4 per patient (range of 1 to 12 products). The proportion of patients taking analgesics was the greatest (81.1%), followed by those taking vitamins (48.8%), minerals (29.9%), and herbal products (13.9%). Several potentially harmful OTC product- drug or -disease interactions were identified. Only 65.3% of OTC users reported obtaining information about the used products from healthcare professionals (HCPs), and 35.3% did not disclose the use of the products to their HCPs.
Conclusion: The use of OTC products was highly prevalent among patients with CVD with potential interactions with prescription medications and patient diseases. In order to ensure optimal patient outcomes, clinicians are strongly encouraged to inquire about OTC product use and counsel patients about the risks and benefits associated with such products.
References
Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol 2017; 70(1): 1-25. https://doi.org/10.1016/j.jacc.2017.04.052
Mokdad AH, Tehrani-Banihashemi A, Moradi-Lakeh M, El Bcheraoui C, Charara R, Khalil I, et al. Burden of cardiovascular diseases in the Eastern Mediterranean Region, 1990-2015: findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63(Suppl): 137-49.
Consumer Healthcare Products Association. The value of OTC medicine to the United States. CHPA; https://www.chpa.org/PDF/ValueofOTCMeds2012.aspx (accessed May 2020)
Mattila M, Boehm L, Burke S, Kashyap A, Holschbach L, Miller T, et al. Nonprescription medication use in patients with heart failure: assessment methods, utilization patterns, and discrepancies with medical records. J Card Fail 2013; 19(12): 811-5. https://doi.org/10.1016/j.cardfail.2013.10.009
Pharand C, Ackman ML, Jackevicius CA, Paradiso-Hardy FL, Pearson GJ. Use of OTC and herbal products in patients with cardiovascular disease. Ann Pharmacother 2003; 37(6): 899-904. https://doi.org/10.1345/aph.1C163
Shorog EM, Alburikan KA. The utilization of nonprescription medications in Saudi patients with cardiovascular diseases. Saudi Pharm J 2018; 26(1): 120-4. https://doi.org/10.1016/j.jsps.2017.10.003
Cooper RJ. Over-the-counter medicine abuse–a review of the literature. J Subst Use 2013; 18(2): 82-107. https://doi.org/10.3109/14659891.2011.615002
Liperoti R, Vetrano DL, Bernabei R, Onder G. Herbal medications in cardiovascular medicine. J Am Coll Cardiol 2017; 69(9): 1188-99. https://doi.org/10.1016/j.jacc.2016.11.078
Extavour R, Edwards R. Non‐prescription medicine use by outpatients of a hospital in north‐central Trinidad living with hypertension, and the potential clinical risks. Int J Pharm Prac 2008; 16(5): 287-93. https://doi.org/10.1211/ijpp.16.5.0003
Rahmawati R, Bajorek BV. Self-medication among people living with hypertension: a review. Fam Pract 2017; 34(2): 147-53. https://doi.org/10.1093/fampra/cmw137
Lexicomp, Inc. Lexi-Drugs®. Hudson: Lexicomp, Inc.; 2020.
Danelich IM, Wright SS, Lose JM, Tefft BJ, Cicci JD, Reed BN. Safety of nonsteroidal antiinflammatory drugs in patients with cardiovascular disease. Pharmacotherapy 2015; 35(5): 520-35. https://doi.org/10.1002/phar.1584
US Food and Drug Administration. FDA Drug Safety Communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes. Accessed August 2015; 25.
Dreischulte T, Morales DR, Bell S, Guthrie B. Combined use of nonsteroidal anti-inflammatory drugs with diuretics and/or renin–angiotensin system inhibitors in the community increases the risk of acute kidney injury. Kidney Int 2015; 88(2): 396-403. https://doi.org/10.1038/ki.2015.101
Sheikh-Taha M, Dimassi H. Use of over the counter products in older cardiovascular patients admitted to a tertiary care center in USA. BMC Geriatr 2018; 18(1): 301. https://doi.org/10.1186/s12877-018-0989-7
Sunkara A, Raizner A. Supplemental Vitamins and Minerals for Cardiovascular Disease Prevention and Treatment. Methodist Debakey Cardiovasc J 2019; 15(3): 179.
Moyer VA. Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med 2014; 160(8): 558-64. https://doi.org/10.7326/M14-0198
Office of Dietary Supplements - Vitamin D. NIH Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/ VitaminD-health Professional/#en1
Greenblatt DJ, von Moltke LL. Interaction of warfarin with drugs, natural substances, and foods. J Clin Pharmacol 2005; 45(2): 127-32. https://doi.org/10.1177/0091270004271404
FDA (2017, 11) Biotin (Vitamin B7): Safety Communication - May Interfere with Lab Tests. Retrieved from: ttps://www.fda.gov/medicaldevices/safety/alertsandnotices/ucm586505.htm. (Accessed May 2020).
Artz MB, Harnack LJ, Duval SJ, Armstrong C, Arnett DK, Luepker RV. Use of nonprescription medications for perceived cardiovascular health. Am J Prev Med 2006; 30(1): 78-81. https://doi.org/10.1016/j.amepre.2005.08.038
Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, et al. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev 2018; 11(11): CD003177. https://doi.org/10.1002/14651858.CD003177.pub4
Ulbricht C, Chao W, Costa D, Rusie-Seamon E, Weissner W, Woods J. Clinical evidence of herb-drug interactions: a systematic review by the natural standard research collaboration. Curr Drug Metab 2008; 9(10): 1063-120. https://doi.org/10.2174/138920008786927785
Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2019; 74(10): e177-e232. https://doi.org/10.1016/j.jacc.2019.03.010
Ruiz ME. Risks of self-medication practices. Curr Drug Saf 2010; 5(4): 315-23. https://doi.org/10.2174/157488610792245966
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