Understanding OTC Products and Self-Care

QuEST-SCHOLAR-MAC Process for Self-Care

• The QuEST-SCHOLAR-MAC process is used to evaluate self-care situations and effectively guide patients.

Over-the-Counter (OTC) Products

• OTC products are available without a prescription.
• They treat minor, self-limiting conditions.
• There are over 300,000 OTC products available in various dosage forms.
• Pharmacists empower patients to manage their health and reduce the burden on healthcare systems.

History of OTC Medications

• Many OTC products were initially prescription medications.
• The FDA oversees the process of switching medications from prescription to OTC status.
• Significant expansion of OTC options occurred in the 1950s and 1970s.
• Patient accessibility and safety became key considerations in the 1990s and beyond.

Why Understanding OTC Products Matters

• OTC products are often used without professional guidance.
• Potential risks include incorrect self-diagnosis, drug-drug interactions, and overuse/misuse.
• Pharmacists bridge the knowledge gap, ensuring safe and effective use of OTC products.

Ethical Responsibility in Pharmacy

• Do No Harm (Nonmaleficence): Avoid causing harm by ensuring the patient is suitable for self-care.
• Recognizing situations where referral to a healthcare professional is necessary when symptoms warrant it.
• Prevent adverse effects and unnecessary delays in treatment.

QuEST-SCHOLAR-MAC Overview

• QuEST: Quickly assess, establish if self-care is appropriate, suggest care, and speak with the patient.
• SCHOLAR-MAC: Symptoms, Characteristics, History, Onset, Location, Aggravating factors, Remitting factors, Medications, Allergies, and Conditions.
• The process ensures comprehensive evaluation for safe OTC recommendations.

QuEST Process for Self-Care

• Quickly assess the patient's current complaint.
• Ask about medications (prescription, OTC, herbal, supplements).
• Inquire about coexisting conditions.
• Establish if the patient is a suitable candidate for self-care (no severe symptoms, repetitive symptoms, or self-treating to avoid medical care).
• Suggest appropriate self-care strategies, including medication, alternative treatments, and general care measures.
• Discuss selected self-care strategies, including actions, administration, expected outcomes, and follow-up.

SCHOLAR-MAC Process for Self-Care (Review)

• Symptoms: "What brings you here today?", "What is wrong?", "What other problems/symptoms have you noticed?"

• Characteristics: "What does the pain/problem feel like?", "Describe your symptoms to me", "How are your symptoms changing?", "How bothersome are your symptoms?", "To what extent do your symptoms interfere with your activities?"

• History: "Have you ever suffered from similar symptoms?", "How has the problem affected you in the past?", "What have you done to alleviate the problem?", and "What were the outcomes?"

• Onset: "When did this problem/symptoms start?", "How often do the symptoms occur?", "How did the problem start?", "What were you doing when you first noticed the symptoms?", "How long have the symptoms been present?", "How long have you had this problem?"

• Location: "Where does it hurt?", "where is the problem located?", "In what part of your body are you experiencing symptoms?"

• Aggravating Factors: "What makes the problem/symptoms worse?" and "What else do you feel when you have this problem?"

• Remitting Factors: "What makes the problem/symptoms better?", and "What have you done so far to make the problem better/relieve the symptoms, and was it successful?"

• Medications, Allergies, and Conditions: "Tell me about the medications you take," and "What allergies do you have?" and "What medical conditions do you have?"

• Key Points:

  • SCHOLAR isn't a rigid algorithm.
  • Not every question is mandatory for every patient, and the order of questions isn't fixed.
  • Assess the patient independently, as their self-diagnosis might be inaccurate.
  • Employ professional judgment and common sense.
  • Consider additional questions for patient caregivers.

Summary

• Utilizing the QuEST-SCHOLAR-MAC method will improve future patient encounters, enabling appropriate identification of underlying conditions, selection of appropriate nonprescription therapy, and safe use of OTC medications. Referral to a primary care physician should be made when necessary.

Case Examples (Applying QuEST-SCHOLAR-MAC)

• Several case studies (sore throat, knee pain) illustrate the application of the QuEST-SCHOLAR-MAC method in the pharmacy setting. Details for each case include the patient scenario, details, symptoms, characteristics, history, onset, location, aggravating/remitting factors, medications, allergies and conditions.

• These cases highlight the determination of whether self-care is appropriate, suitable OTC recommendations, and educating the patient.