지역약국에서 다제 처방약물을 복용하는 만성질환 환자에서 OTC 약물의 사용 패턴 분석

Abstract

Abstract: Along with a growing population of senior citizens, the number of patients with chronic disease is also on the increase. Chronic disease is a medical condition that requires continuous drug treatments due to the symptoms which last longer than three months without any sign of improvements. Chronic disease includes cardiovascular, musculoskeletal, endocrine, respiratory systems and cancers. The increase in life expectancy that resulted from improvements of medical technologies and changes in lifestyle are the main causes of prevalence of chronic disease. For these reasons, the rate of patients taking multiple medications is increasing. The purpose of this study is to analyze and evaluate the patterns of OTC drug usage taken from the survey of patients taking multiple medications in community pharmacy, and to provide appropriate database related to efficiency and safeness of taking OTC drugs. Our pharmacy posted a reserch notice (Among chronic disease patients who visited this pharmacy from September of 2014 to August of 2015, patients who are older than 18 years old and taking more than two drugs continuously for more than three months) and surveyed selected 345 patients among 587 volunteers, who corresponded to study inclusion criterion and prospectively analyzed OTC usage patterns. The survey was approved by the IRB and was collected and analyzed after coding for the protection of personal privacy. Inappropriate and unnecessary medication uses were evaluated by 2012 Beers Criteria for patients over 65 years old who were subjected to the survey. Drug-Drug interactions between prescribed medicines and OTC drugs were analyzed by using clinical medical pharmacology database, Micromedex. An analyzed result of OTC drug usage patterns by age and gender, antipyretic, anti-inflammatory drugs (150 patients, 43.5%) were the most used OTC drugs by gender followed by anti-histamine drugs (89 patients, 25.8%), digestive medicine (62 patients,18%), antitussive expectorants (47 patients,13.6%) and antacid (33 patients, 9.6%). Patients under 65 years old took more OTC drugs than the others for the ease of pain. Frequently used OTC ingredients were acetaminophen, followed by caffeine and chlorpheniramine. An analyzed result of patients over 65 years old using inappropriate drugs, antigastric-secretion drugs ranked highest followed by NSAIDs and antiplatelet agent, according to 2012 Beers Criteria. Using MicromedexⓇ Solutions, amlodipine and ibuprofen, thiazide and ibuprofen found out to be the potential risk factors of the interaction between prescribed drugs-OTC drugs. Continuous monitoring and active medication counselling are needed for the prevention of inappropriate interaction between multiple medicines and OTC drugs among patients taking multiple medications. The role of community pharmacy for chronic disease patients is considered to be an efficient disease management and a health care cost reducing factor.