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Self medication – how can a pharmacist prevent it?
Submitted by nirupama on Sat, 04/26/2008 - 17:50.
in
Exams still going on! 3 more to go!
This is a topic that 2 of my fellow participants suggested that I address. I am thankful to both of them for suggesting it.
A pharmacist cannot, as such prevent someone from taking medication if he/she wants to. However, a few preventive measures do exist at large. The most important methods among these are
• Improving education of patients by government, NGOs, media etc. to help them become self sufficient about basic drugs such as paracetamol( or perhaps even ibuprofen as a participant suggested)
• Establish mechanisms for data collection, monitoring, and analysis of medication-related problems by age group.
• Regularly informing doctors and nurses about different developments in the pharmacy field by their respective hospitals
• Introducing a computerised medical record system which will help keep tabs on the different OTC drugs which are regularly along with the frequency of sale etc.
These methods can be used for regular OTC drugs and if used sensibly, even complications caused by conflicting conditions can be avoided smoothly by discussion with the pharmacist.
These methods may not only help in expansion of the “health network” as a whole, but also help trace out the pathway our health professionals are treading on to guide the general public to a healthy life.
The bottom line of self medication is that there’s nothing much anyone at all can do to prevent someone else from doing what they want to. It is important to realise that the best anyone can do is advise the patient and talk about all the possible precautions that the patient can take.
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there's a difference...
well nirupama, i agree with you...But how can you expect that patients would remember and grasp the medical knowledge you give them which we inculcate in these 4 years...iam especially focussing on the rural people. i agree that one should be a shining star in other's life...but if you are a pharmacist then you cant expect them to get all the doses, regimen, conbtraindications etc. to be grasped by heart. That makes the difference between a medical and a non-medical professional in respect that the former is incapable to rectify his/her health and that's why he/she is approaching you for betterment of his/her health....ok....take an example, cetirizine is taken commonly to treat rhinitis...Then do you expect that they grasp all the pther anti-histaminic secondary actions like reduction in inflammatory response, reduction in smooth muscle contraction, probable rise in bp etc.??well i dont think they would get all these complex ideas being a non-professional....What they just know is it is used in treatment of common cold and even if you try to educate these all facts and ways to prevent them, they would grasp very little of them...And the second thing is if they take incorrect procedures of you explained facts and actions, they may even get affected in a negative sense in terms of drug effects....at that time they would curse you and wont admit their own mistakes....this is my point...i agree,Its good to educate them but the point is how to educate them....
thanks for your comment!
The current prime minister of our country, I’m sure, hopes to educate all the people in India before he has to vacate his seat. An almost impossible task, I think you’ll agree. Even if he does manage to educate everyone, the opposition will still say that the standard of education was low or pitifully inadequate compared with the rest of the world.
Will that make our P.M. resign? Or even not contest the elections?or for that matter, any leader around the world?i think not and I’m sure you’ll agree.
This is because at the end of the day, all anyone can do is try to educate or imbibe values in someone to the maximum possible extent he/she possibly can. You cannot force-feed anyone information because either, they CANNOT UNDERSTAND what you tell them, or they DO NOT WANT TO UNDERSTAND what you tell them, or they DO NOT WANT TO ASSUME RESPONSIBILITY for anything you tell them because ultimately the info provider is the “responsible one”. This is the common psyche, many psychologists will tell you.
You are referring to scenario number one which is actually very sensible although not very practicable. In our country at least, better education at the national level is the only way to prevent that option from even existing. In better educated countries, easy to read instruction manuals are available and are very simple. My 8 year old cousin in the US read the dosage regimen for something the other day with the help of her mum and could understand it.
BTW, Cetirizine Hydrochloride in India is marketed by GlaxoSmithKline and is a Schedule H Drug and the blister strip pack says, (I quote): “Warning: To be sold by retail on the prescription of a Registered Medical Practitioner only.”
So I guess that’s not really a problem in India.
Then why such scenario exists...
Well, nirupama the example you stated may not illustrate itself in every place. Talking about US, even in India many medications provide PIL....And about patient education, if a pharmacist can educate a patient to the extent he expects to, as you suggested, then why there is high incidence of ADRs occurring in India and doctors complain of patient non-compliance??? It is not such that pharmacists are not trying to educate patients...They try to provide them with necessary info. Then, why is such a condition in existence???
What Iam stressing at is a pharmacist can certainly minimize the problem, but he can't prevent or eliminate the situation....
many OTC drugs...
hey,thanks nirupama for all the clarifications to my difficulties... But the basic question that is still unanswerable to me is that there are so many OTC in the market (and most of them are quite common in use in home) that if a pharmacist educates the patients about all those drugs, then it would be as good as aquiring more than half of the medical knowledge and such situation is very difficult because that knowledge makes the distiction between us and the health professionals and secondarily the patients would be unable to follow all those instructions (as the 1st point of the blog suggests)...So,it would be a pleasure for me if you throw some light on such circumstance...
thanks for your comment!
Well isn't that what being a pharmacist is all about?to improve the general health conditions of anyone and everyone we come across in our personal and professional life?if that also involves educating people and thus also improving the intelligence of the patients,then so be it!don't you agree?doesn't it strike you as something amazing to be able to improve health and intelligence of every person you come across?it is definitely commendable and I know I would love to be that shining beacon in someone's life. It will not mean that there is no difference between me and a layman - it will mean that I managed to bridge that gap and improve his confidence in me which is the first step towards his recovery from any health problems.
Also, you said that perhaps a normal patient will not be able to understand very important scientific terms. But that’s what I talked about in my other blog entries on role of pharmacist - Alzheimer's disease and AIDS. A pharmacist should be a complete package in that he/she should be able to explain very effectively on any topic at all in a simple lucid manner without using any complicated terms.the meaning of any medicinal term can be found on the net but it is a pharmacist's duty to learn to communicate on the same sensibly without confusing or scaring the patient.
Also,pharmacists are sensible people who will not give any confusing instructions.drug dosage regimen,timings and side effects are simple enough to understand.for the more complex problems,doctors and hospital nurses do exist u know!i'm not pushing off any responsibility onto them,its something that is mandatory by law.
I hope everything's clear now :)