The use of nonprescription medicines among elderly patients with chronic illness and their need for pharmacist intervention

Objective: The use of over-the-counter (OTC) products and complementary medicines (CM) often results in adverse events. Little is known about the type of pharmacist interventions needed by elderly patients to optimize their use of such products. This study examines the prevalence of OTC/CM products used among chronically ill elderly patients and the types of pharmacist interventions the patients need. Gender differences were also investigated. Design: Retrospective cohort study. Setting: Homes of 51 patients recruited from a major metropolitan hospital in Melbourne, Australia. Patients: Fifty-one elderly patients with chronic illness referred to the Outreach Medication Review program. Intervention: Pharmacists’ interventions to optimize the use of OTC/CM products. Main Outcome Measures: Number of OTC/CM products used and the number and type of pharmacists’ interventions. Results: 80.4% of patients were using OTC products, while 21.6% used CM products. Many OTC products were not used at the right dose, requiring pharmacists to adjust the dose in 18.7% of cases. Other patients (18.8%) were unaware of dosing regimens, while about one-third of patients needed to be educated on managing the ailment that required their use of the OTC/CM product in the first place. Men showed a nonsignificant increase in their need for pharmacist interventions. Conclusion: Elderly patients in this study used OTC/CM products, often without a proper understanding of the management principles of their condition or the dosing regimens of the products they use. Men may need more pharmacist interventions in relation to their use of OTC/CM products. Pharmacists should offer comprehensive advice on managing presenting ailments and requests for OTC/CM products. Abbreviations: CM = Complementary medicine, NSAID = Nonsteroidal anti-inflammatory drug, OMR = Outreach Medication Review, OTC = Over the counter.