Non-prescription medicine use by outpatients of a hospital in north-central Trinidad living with hypertension, and the potential clinical risks

Rian Marie Extavour, Ruth Edwards

Research output: Contribution to journalArticle

Abstract

Objective To describe the reported use of non‐prescription medicines (NPMs) and the reported frequency of use by outpatients living with hypertension; to identify potential drug‐drug and drug‐disease interactions between reported NPMs and either antihypertensives prescribed or hypertension.

Setting Adult outpatient clinics of the Eric Williams Medical Sciences Complex Adult Hospital in Trinidad.

Method Outpatients were interviewed about their use of NPMs using a structured instrument. Chi‐squared test or Fisher's exact test was used to test for associations between NPM use and selected variables: age group, gender, education level, number of prescribed medicines, use of prescribed medicines and the presence of comorbidities. Combinations of NPMs and antihypertensive drugs or hypertension itself that may lead to undesirable interactions were identified.

Key findings One hundred and fifty‐five clients were interviewed (mean age 61 years; 46% men; 56% of East Indian descent). Of these, 82% were living with a cardiac condition and 60% with diabetes mellitus. In addition, 92% reported using NPMs to treat minor illnesses. Analgesic use was reported by 81%. Some 66% reported using paracetamol, 54% reported antitussives, 48% antacids, 47% antihistamines and 39% said they used sympathomimetic drugs. The majority (98%) of NPMs were used only when needed. Sixty per cent had at least one combination a with risk of interaction with NPMs and hypertension or antihypertensive medicines: 16% had risk of interactions between enalapril (or captopril) and antacids, 13% between angiotensin‐converting enzyme (ACE) inhibitors and non‐steroidal anti‐inflammatory drugs (NSAIDs), 12% between beta‐blockers and NSAIDs and 12% between thiazide diuretics and NSAIDs. Thirty‐nine per cent had a drug‐disease interaction risk due to sympathomimetic drugs and 26% had one due to NSAID use.

Conclusion Based on self‐reports, outpatients living with hypertension in north‐central Trinidad use NPMs when needed to treat minor illnesses, mainly paracetamol for pain. Non‐prescription‐antihypertensive interactions may arise due to ACE inhibitor/antacid combinations and NPM‐hypertension interactions may result from use of sympathomimetics. Interactions may also arise as a result of the use of NPMs containing NSAIDs and sodium.
Original languageEnglish
Pages (from-to)287-293
JournalInternational Journal of Pharmacy Practice
Volume16
Issue number5
DOIs
Publication statusPublished - 1 Oct 2008

Fingerprint

Trinidad and Tobago
Medicine
Anti-Inflammatory Agents
Outpatients
Antacids
Sympathomimetics
Hypertension
Antihypertensive Agents
Pharmaceutical Preparations
Enzyme Inhibitors
Acetaminophen
Antitussive Agents
Nonprescription Drugs
Sodium Chloride Symporter Inhibitors
Enalapril
Histamine Antagonists
Captopril
Ambulatory Care Facilities
Analgesics
Comorbidity

Cite this

@article{1cc0edb13b344a4d964e737ed04856fe,
title = "Non-prescription medicine use by outpatients of a hospital in north-central Trinidad living with hypertension, and the potential clinical risks",
abstract = "Objective To describe the reported use of non‐prescription medicines (NPMs) and the reported frequency of use by outpatients living with hypertension; to identify potential drug‐drug and drug‐disease interactions between reported NPMs and either antihypertensives prescribed or hypertension.Setting Adult outpatient clinics of the Eric Williams Medical Sciences Complex Adult Hospital in Trinidad.Method Outpatients were interviewed about their use of NPMs using a structured instrument. Chi‐squared test or Fisher's exact test was used to test for associations between NPM use and selected variables: age group, gender, education level, number of prescribed medicines, use of prescribed medicines and the presence of comorbidities. Combinations of NPMs and antihypertensive drugs or hypertension itself that may lead to undesirable interactions were identified.Key findings One hundred and fifty‐five clients were interviewed (mean age 61 years; 46{\%} men; 56{\%} of East Indian descent). Of these, 82{\%} were living with a cardiac condition and 60{\%} with diabetes mellitus. In addition, 92{\%} reported using NPMs to treat minor illnesses. Analgesic use was reported by 81{\%}. Some 66{\%} reported using paracetamol, 54{\%} reported antitussives, 48{\%} antacids, 47{\%} antihistamines and 39{\%} said they used sympathomimetic drugs. The majority (98{\%}) of NPMs were used only when needed. Sixty per cent had at least one combination a with risk of interaction with NPMs and hypertension or antihypertensive medicines: 16{\%} had risk of interactions between enalapril (or captopril) and antacids, 13{\%} between angiotensin‐converting enzyme (ACE) inhibitors and non‐steroidal anti‐inflammatory drugs (NSAIDs), 12{\%} between beta‐blockers and NSAIDs and 12{\%} between thiazide diuretics and NSAIDs. Thirty‐nine per cent had a drug‐disease interaction risk due to sympathomimetic drugs and 26{\%} had one due to NSAID use.Conclusion Based on self‐reports, outpatients living with hypertension in north‐central Trinidad use NPMs when needed to treat minor illnesses, mainly paracetamol for pain. Non‐prescription‐antihypertensive interactions may arise due to ACE inhibitor/antacid combinations and NPM‐hypertension interactions may result from use of sympathomimetics. Interactions may also arise as a result of the use of NPMs containing NSAIDs and sodium.",
author = "Extavour, {Rian Marie} and Ruth Edwards",
year = "2008",
month = "10",
day = "1",
doi = "10.1211/ijpp.16.5.0003",
language = "English",
volume = "16",
pages = "287--293",
journal = "International Journal of Pharmacy Practice",
issn = "0961-7671",
publisher = "Pharmaceutical Press",
number = "5",

}

TY - JOUR

T1 - Non-prescription medicine use by outpatients of a hospital in north-central Trinidad living with hypertension, and the potential clinical risks

AU - Extavour, Rian Marie

AU - Edwards, Ruth

PY - 2008/10/1

Y1 - 2008/10/1

N2 - Objective To describe the reported use of non‐prescription medicines (NPMs) and the reported frequency of use by outpatients living with hypertension; to identify potential drug‐drug and drug‐disease interactions between reported NPMs and either antihypertensives prescribed or hypertension.Setting Adult outpatient clinics of the Eric Williams Medical Sciences Complex Adult Hospital in Trinidad.Method Outpatients were interviewed about their use of NPMs using a structured instrument. Chi‐squared test or Fisher's exact test was used to test for associations between NPM use and selected variables: age group, gender, education level, number of prescribed medicines, use of prescribed medicines and the presence of comorbidities. Combinations of NPMs and antihypertensive drugs or hypertension itself that may lead to undesirable interactions were identified.Key findings One hundred and fifty‐five clients were interviewed (mean age 61 years; 46% men; 56% of East Indian descent). Of these, 82% were living with a cardiac condition and 60% with diabetes mellitus. In addition, 92% reported using NPMs to treat minor illnesses. Analgesic use was reported by 81%. Some 66% reported using paracetamol, 54% reported antitussives, 48% antacids, 47% antihistamines and 39% said they used sympathomimetic drugs. The majority (98%) of NPMs were used only when needed. Sixty per cent had at least one combination a with risk of interaction with NPMs and hypertension or antihypertensive medicines: 16% had risk of interactions between enalapril (or captopril) and antacids, 13% between angiotensin‐converting enzyme (ACE) inhibitors and non‐steroidal anti‐inflammatory drugs (NSAIDs), 12% between beta‐blockers and NSAIDs and 12% between thiazide diuretics and NSAIDs. Thirty‐nine per cent had a drug‐disease interaction risk due to sympathomimetic drugs and 26% had one due to NSAID use.Conclusion Based on self‐reports, outpatients living with hypertension in north‐central Trinidad use NPMs when needed to treat minor illnesses, mainly paracetamol for pain. Non‐prescription‐antihypertensive interactions may arise due to ACE inhibitor/antacid combinations and NPM‐hypertension interactions may result from use of sympathomimetics. Interactions may also arise as a result of the use of NPMs containing NSAIDs and sodium.

AB - Objective To describe the reported use of non‐prescription medicines (NPMs) and the reported frequency of use by outpatients living with hypertension; to identify potential drug‐drug and drug‐disease interactions between reported NPMs and either antihypertensives prescribed or hypertension.Setting Adult outpatient clinics of the Eric Williams Medical Sciences Complex Adult Hospital in Trinidad.Method Outpatients were interviewed about their use of NPMs using a structured instrument. Chi‐squared test or Fisher's exact test was used to test for associations between NPM use and selected variables: age group, gender, education level, number of prescribed medicines, use of prescribed medicines and the presence of comorbidities. Combinations of NPMs and antihypertensive drugs or hypertension itself that may lead to undesirable interactions were identified.Key findings One hundred and fifty‐five clients were interviewed (mean age 61 years; 46% men; 56% of East Indian descent). Of these, 82% were living with a cardiac condition and 60% with diabetes mellitus. In addition, 92% reported using NPMs to treat minor illnesses. Analgesic use was reported by 81%. Some 66% reported using paracetamol, 54% reported antitussives, 48% antacids, 47% antihistamines and 39% said they used sympathomimetic drugs. The majority (98%) of NPMs were used only when needed. Sixty per cent had at least one combination a with risk of interaction with NPMs and hypertension or antihypertensive medicines: 16% had risk of interactions between enalapril (or captopril) and antacids, 13% between angiotensin‐converting enzyme (ACE) inhibitors and non‐steroidal anti‐inflammatory drugs (NSAIDs), 12% between beta‐blockers and NSAIDs and 12% between thiazide diuretics and NSAIDs. Thirty‐nine per cent had a drug‐disease interaction risk due to sympathomimetic drugs and 26% had one due to NSAID use.Conclusion Based on self‐reports, outpatients living with hypertension in north‐central Trinidad use NPMs when needed to treat minor illnesses, mainly paracetamol for pain. Non‐prescription‐antihypertensive interactions may arise due to ACE inhibitor/antacid combinations and NPM‐hypertension interactions may result from use of sympathomimetics. Interactions may also arise as a result of the use of NPMs containing NSAIDs and sodium.

UR - https://onlinelibrary.wiley.com/doi/abs/10.1211/ijpp.16.5.0003

U2 - 10.1211/ijpp.16.5.0003

DO - 10.1211/ijpp.16.5.0003

M3 - Article

VL - 16

SP - 287

EP - 293

JO - International Journal of Pharmacy Practice

JF - International Journal of Pharmacy Practice

SN - 0961-7671

IS - 5

ER -