Background:
Nowadays self-medication is one of the most common public health issues in many countries, as well as in Iran. According to need to epidemiological information about self-medication, the aim of this study was to systematic review and meta-analysis of prevalence and cause of self-medication in community setting of Iran.

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Prevalence and cause of self-medication in Iran: a systematic review and meta-analysis article.

Background Improper disposal of medications potentially poses a significant environmental risk and storage of expired and unused medications in households provides an increased risk of accidental childhood poisonings. Objective The objective of this study was to investigate the storage and disposal habits of medications amongst the population in the South Backa District of Serbia, and to gain insight into the attitudes and knowledge of the population about the proper disposal of medications. Setting Households in South Backa District. Method The study was conducted during the 6-month period from February 2010 to July 2010 and involved a random sample of households. The questionnaire-based study was performed by a trained interviewer. Main outcome measure number of expired and unused medications in families, behavior and knowledge about the disposal of medications. Results Of 230 families, 208 (108 urban and 100 rural) agreed to participate and complete the questionnaire(90 % response rate). The drugs were mostly kept in a specific place-home pharmacy (89.8 % [urban] and 89.0 % [rural]). Exposure of children to medications in the home environment was similar in urban and rural families (19.6 % [urban] and 23.1 % [rural]). The frequency of expired medications was not observed to be different between the urban and rural households (10.3 % [urban] and 11.8 % [rural]). The most common method for disposal of household medications is disposal in the garbage (85.6 % [urban] and 74.5 % [rural]) or in the toilet (8.7 % [urban] and 6.4 % [rural]). However, inconsistent with disposal practices, half of the urban and rural participants thought that throwing medications in the garbage, toilet, or sink has a detrimental effect on the environment. Conclusion Public services in Serbia, including government and health sectors, need to be more proactive about educating people on how to store and dispose medications, as well as finding a way for implementation of the law on medications wastage destruction.

Storage and disposal of unused medications: knowledge, behavior, and attitudes among Serbian people

• Bei chronischer Migräne mit oder ohne Übergebrauch von Schmerzoder Migränemitteln sind Topiramat und OnabotulinumtoxinA wirksam. Die Wirksamkeit anderer Substanzen zur Prophylaxe der chronischen Migräne ist nicht ausreichend belegt. • Valproinsäure, Topiramat und Amitriptylin wurden in der Migräneprophylaxe bei Kindern und Jugendlichen untersucht. Angesichts einer sehr hohen Placeborate konnte keine therapeutische Überlegenheit zu Placebo gezeigt werden. • Der Verschluss eines offenen Foramen ovale bei Migräne mit Aura führt nicht zur Attackenfreiheit.

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Therapie der Migräneattacke und Prophylaxe der Migräne

In collaboration with some of the leading headache centres in Germany, Switzerland and Austria, we have established new guidelines for the treatment of migraine attacks and the prevention of migrai...

https://journals.sagepub.com/doi/pdf/10.1177/2514183X18823377

Treatment of migraine attacks and prevention of migraine: Guidelines by the German Migraine and Headache Society and the German Society of Neurology:

Worldwide the demands on emergency and primary health care services are increasing. General practitioners and accident and emergency departments are often used unnecessarily for the treatment of minor ailments. Community pharmacy is often the first port of call for patients in the provision of advice on minor ailments, advising the patient on treatment or referring the patient to an appropriate health professional when necessary. The potential for community pharmacists to act as providers of triage services has started to be recognised, and community pharmacy triage services (CPTS) are emerging in a number of countries. This review aimed to explore whether key components of triage services can be identified in the literature surrounding community pharmacy, to explore the evidence for the feasibility of implementing CPTS and to evaluate the evidence for the appropriateness of such services. Systematic searches were conducted in MEDLINE, EMBASE and International Pharmaceutical Abstracts (IPA) databases from 1980 to March 2016. Key elements of community pharmacy triage were identified in 37 studies, which were included in the review. When a guideline or protocol was used, accuracy in identifying the presenting condition was high, with concordance rates ranging from 70 % to 97.6 % between the pharmacist and a medical expert. However, when guidelines and protocols were not used, often questioning was deemed insufficient. Where other health professionals had reviewed decisions made by pharmacists and their staff, e.g. around advice and referral, the decisions were considered to be appropriate in the majority of cases. Authors of the included studies provided recommendations for improving these services, including use of guidelines/protocols, education and staff training, documentation, improving communication between health professional groups and consideration of privacy and confidentiality. Whilst few studies had specifically trialled triage services, results from this review indicate that a CPTS is feasible and appropriate, and has the potential to reduce the burden on other healthcare services. Questions still remain on issues such as ensuring the consistency of the service, whether all pharmacies could provide this service and who will fund the service.

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Is There Potential for the Future Provision of Triage Services in Community Pharmacy

BACKGROUND: Upper gastrointestinal (GI) symptoms are a common reason for self-treatment with over-the-counter (OTC) medication. However, data on the typology of GI complaints for which individuals seek self-medication and, more importantly, on the prevalence of alarm symptoms in this population are scarce. OBJECTIVE: This study aimed to investigate: (i) the nature of GI symptoms people intend to self-medicate, (ii) prevalence of alarm symptoms, (iii) compliance with referral advice given by the pharmacist, and (iv) self-reported efficacy and frequency of use of OTC medication for minor complaints. METHODS: This descriptive study was performed in 63 community pharmacies. Participants (n=592, aged 18-80 y) completed a questionnaire to assess symptom characteristics and previous medical consulting. Based on this information, the pharmacist referred subjects to a physician or advised self-treatment. Four weeks later, participants were presented a follow-up questionnaire, evaluating compliance with referral advice or efficacy of self-treatment. Results: The most frequently reported GI complaints were burning retrosternal discomfort (49.2%), acid regurgitation (53.2%) and bothersome postprandial fullness (51.2%). At least 1 alarm symptom was present in 22.4% of the individuals, difficulty in swallowing being the most prevalent one (15.4%). Although twenty-one percent of the customers were referred, only 51.7% of these actually contacted a physician. Almost all of the remaining customers who were advised self-treatment reported symptom relief with the obtained OTC drug (95.1%). CONCLUSIONS: Mild GI symptoms will mostly resolve with self-treatment. Yet, the value of pharmacist counselling on OTC treatment should be recognized, as community pharmacists can play an important role in

Self-medication of upper gastrointestinal symptoms: a community pharmacy study

Aim This observational community pharmacy-based study aimed to investigate headache characteristics and medication use of persons with regular headache presenting for self-medication. Methods Participants (n=1205) completed ii) a questionnaire to assess current headache medication and previous physician diagnosis, (ii) the ID Migraine Screener [ID-M] and (iii) the MIDAS questionnaire. Results Forty-four % of the study population (n=528) did not have a physician diagnosis of their headache, and 225 of them (225/528, 42.6%) were found to be ID-M positive. The most commonly used acute headache drugs were paracetamol (used by 62% of the study population), NSAIDs (39%) and combination analgesics (36%). Only 12% of patients physician-diagnosed with migraine used prophylactic migraine medication, and 25% used triptans. About 24% of our sample (n=292) chronically overused acute medication, which was combination analgesic overuse (n=166), simple analgesic overuse (n=130), triptan overuse (n=19), ergot overuse (n=6) and opioid overuse (n=51). Only 14.5% was ever advised to limit intake frequency of acute headache treatments. Conclusions This study identified underdiagnosis of migraine, low use of migraine prophylaxis and triptans, and high prevalence of medication overuse among subjects seeking self-medication for regular headache. Community pharmacists have a strategic position in education and referral of these self-medicating headache patients.

[Self-medication of regular headache: a community pharmacy-based survey in Belgium].

Inflammatory bowel diseases comprise Crohn's disease, ulcerative colitis and indeterminate colitis, generally beginning in young subjects and increasing in frequency in Western countries. Despite their still unknown aetiologies, some pathogenic mechanisms have been elucidated after the recent discovery of numerous susceptibility genes and rare environmental factors. These diseases have a course consisting of episodes of flare-up alternating with periods of remission. Medical treatment for induction of a remission comprises besides aminosalicylates, corticosteroids including budesonide and immunosuppressive drugs, anti-TNF-a drugs (infliximab, adalimumab) indicated in case of failure of previous therapies. Surgery is indicated for complications and failure of medical treatment.With current therapy, most of the patients are able to fulfil their familial, social and professional projects.

De Bolle L

Papers

Self-medication of upper gastrointestinal symptoms: a community pharmacy study

[Self-medication of regular headache: a community pharmacy-based survey in Belgium].

[Home medication cabinets and self-medication: a source of potential health threats].