Self Medication In General Practice Attainders In Slovenia.Ppt Beograd


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Self Medication In General Practice Attainders In Slovenia.Ppt Beograd

  1. 1. Marija Petek Šter Janko Kersnik Beograd, september 2009
  2. 2. Background - definition <ul><li>Most health care takes place outside the formal health care system </li></ul><ul><li>Self-medication describes treatment that is initiated and managed by individual rather than prescribed by a health care professional </li></ul>
  3. 3. Background-epidemilogy <ul><li>Different methods for self-medication were used in 20-70% of population (herbs, vitamins, OTC, homeopatic drugs...) </li></ul><ul><li>Slovenia: 72% of poupulation use herbs, 83,6% of population sometimes or regularly use OTC </li></ul><ul><li>Self medication is more frequently used in elderly, chronicaly ill patients (eg. patients with cancer) and patinets belong to higher socio-economical classes </li></ul><ul><li>More than half of the patients don’t discuss about the self medication use with their general practitioner </li></ul>
  4. 4. Background –benefits/risk <ul><li>Benefits of self-medication </li></ul><ul><li>Autonomy and empowerment </li></ul><ul><li>Free to set priorities, use resources, control treatment. </li></ul><ul><li>Improved adherence. </li></ul><ul><li>Self-monitoring and self-medication may affect outcomes in: </li></ul><ul><ul><li>hypertension </li></ul></ul><ul><ul><li>diabetes </li></ul></ul><ul><ul><li>asthma </li></ul></ul><ul><ul><li>anti-coagulation therapy </li></ul></ul>
  5. 5. Background –benefits/risk <ul><li>Risks of self-medication </li></ul><ul><li>Harm from adverse effects </li></ul><ul><li>Drug-drug interactions </li></ul><ul><li>Risk in older patients </li></ul><ul><li>Multiple co-morbidity </li></ul><ul><li>Poly-pharmacy </li></ul><ul><li>Physicians unaware of the OTC or CAM </li></ul><ul><li>Increasing costs from self-medication </li></ul><ul><li>OTC medication may a reduce visits </li></ul><ul><li>Reduce use of prescription drugs </li></ul>
  6. 6. Research questions <ul><li>We would like to know : </li></ul><ul><li>the prevalence </li></ul><ul><li>the reasons for self- medication </li></ul><ul><li>recognise the characteristics of patients who use self-medication </li></ul>
  7. 7. Methods <ul><li>Study population: 38 tutors in general practice collect data about use of self-medication for 564 consecutive attainders ( pysicinas didn’t report that any of the attaninders refuse participation in the study) </li></ul><ul><li>Methods: During the 17th Bled course the participants developed the qestionnaire about self-medication. We adapted and translated the questionnaire into Slovene. Patients fulfil l a questionnaire by themselves </li></ul><ul><li>The questions were about: </li></ul><ul><li>the use of self-medication by themselves </li></ul><ul><li>reasons for use of unprescribed drugs or remedies </li></ul><ul><li>their attitudes about efficacy and safety of self-medication </li></ul><ul><li>their knowledge on self-medication </li></ul>
  8. 8. Results - prevalence <ul><li>The mean age of patients was 49.5 years, 63.4 % of patients were female </li></ul><ul><li>71.8 % of patients used self-medication ( in average 1.4 different self-medicines ) </li></ul><ul><li>The most popular self-medicines were herbal tea in 59.3 % and OTC medicines in 35.8 % of those who use self medicines </li></ul>
  9. 9. Results – who reccomended <ul><li>family members or friends in 46.9 % </li></ul><ul><li>pharmacist in 22.2 % </li></ul><ul><li>physicians in 20.2 % </li></ul><ul><li>media in 14.8 %, </li></ul><ul><li>other health care professionals in 6.9 % </li></ul><ul><li>11.6 % of patients decided for self-medication by themselves </li></ul>
  10. 10. Results - reasons <ul><li>The most frequent answers: </li></ul><ul><li>it is more natural than medical treatment - 37.8 % </li></ul><ul><li>traditional - 21.0 %, </li></ul><ul><li>safer than conventional medicine - 7.2 % </li></ul><ul><li>more convenient in 4.2 % </li></ul>
  11. 11. Results-would you like to know more? <ul><li>53.5 % of patients who use self-medication would like to know more </li></ul><ul><li>70.9 % they thought that a physician would be the best person to advice them </li></ul>
  12. 12. Results – predictors of self-medication <ul><li>female sex (OR=1.73, 95 % CI 1.14-2.64) </li></ul><ul><li>higher level of education (OR=1.91, 95 % CI 1.54-2.37) </li></ul><ul><li>the presence of psychiatric disorders (OR=2.34, 95 % CI 1.02-5.34). </li></ul>
  13. 13. Discussion <ul><li>The questionnaire need some clarification (eg. unclear definitions of OTC, unclear questione about the potential risks of self-medication) </li></ul><ul><li>Fulfilment of the questionaire: Patients alone or an interview leaded by the nurse or physician? </li></ul>
  14. 14. Conclusions <ul><li>People in Slovenia frequently use self-medication because they believe that self-medication is more natural than prescribed medication </li></ul><ul><li>More than a half would like to know more about the self-medicines they use and they thought physicians are the most suitable persons for advice </li></ul>