lecture 1_Pharmacy (OTC & selfcare ).pdf

Self-care & OTCs Introduction Table of contents ▪ Self-Care and Nonprescription Pharmacotherapy ▪ The Current Self-Care Marketplace ▪ Legislative and Regulatory Issues Affecting Self-Care ▪ Roles for the Pharmacist and Student Pharmacist in Self-Care Practice ▪ Pharmacists’ Patient Care P...

Self-care & OTCs Introduction Table of contents ▪ Self-Care and Nonprescription Pharmacotherapy ▪ The Current Self-Care Marketplace ▪ Legislative and Regulatory Issues Affecting Self-Care ▪ Roles for the Pharmacist and Student Pharmacist in Self-Care Practice ▪ Pharmacists’ Patient Care Process (PPCP) What is self-care? A simple definition of self-care is as the independent act of preventing, diagnosing, and treating one’s illnesses with or without seeking professional advice. (Public Definition) What is self-care? Health care providers (e.g., doctors, pharmacists, nurses) typically consider self-care to include the clinical management of self-care conditions and use of relevant self-care products available to patients without a prescription. Why is Self-Care Growing? 1. Increased Awareness: People are recognizing the significance of taking proactive steps to maintain good health, both physically and mentally 2. Stressful Lifestyles: Modern lifestyles often come with increased stress, hectic schedules, and various pressures. As a result, individuals are seeking ways to manage stress and prevent burnout, leading them to adopt self-care practices. 3. Empowerment and Individual Responsibility: There's a cultural shift toward empowerment and individual responsibility for health. People are becoming more proactive in managing their own health and well-being, seeking information and resources to make informed choices. 4. Digital Age and Information Access: The ease of access to information, particularly through the internet and social media, allows individuals to educate themselves about health and wellness. 5. Preventive Healthcare: Rather than waiting for illness to occur, individuals are increasingly focused on preventive healthcare. This includes activities like regular exercise, healthy eating, and stress management to maintain good health and prevent future health issues. 6. Technological Advances: The development of health and wellness apps, wearables, and other technologies has made it easier for individuals to track and manage their health. Technology facilitates self-monitoring and provides tools for adopting healthier lifestyles. 7. Cultural Shifts: Societal attitudes toward self-care have evolved, and taking time for oneself is increasingly viewed as a positive and necessary practice rather than a luxury. This cultural shift supports the growth of self-care as a mainstream concept. 8. Global Health Challenges: Events such as the COVID-19 pandemic have underscored the importance of health and well-being. These challenges have prompted individuals to prioritize self-care as a means of coping with stress and uncertainty. 9. Marketing and Media Influence: Advertisements, social media influencers, and marketing campaigns often promote self-care products and practices, contributing to the mainstream adoption of these ideas. Types of self-care Preventive SelfCare Involves maintaining wellbeing and appearance through exercise and a healthy lifestyle. Sickness SelfCare Involves diagnosing their conditions and obtaining products for relieving symptoms. What is The Source of Information for Self-care? For better or worse, there is no shortage of information, given the wealth of health-related books, newspaper articles, television advertisements, magazine and radio programs, instructional audioand videotapes, and Internet sites, all of which provide self-care advice. Options for Self-Medications 1. Nonprescription Medications (OTC) 2. Dietary Supplements 3. Other products specific for complementary and integrative health therapies and approaches Over the Counter medicines (OTC) Over-the-counter medicine is also known as OTC or non-prescription medicine. All these terms refer to medicine that patient can buy without a prescription. They are safe and effective when a patient follow the directions on the label and as directed by health care professionals including pharmacists Characteristics of OTCs ▪ The potential for misuse and abuse is low ▪ Consumers can use them for self-diagnosed conditions ▪ They can be adequately labeled for safe consumer use ▪ Health practitioners are not needed for the safe and effective use of the product FDA approved OTCs must be ▪ Safe ▪ Effective ▪ Manufactured safely ▪ Labeled with a Drug Facts Label that is easy to understand Some People Do Not Understand ▪ “More is not better” ▪ They need to take as directed on the Drug Facts Label ▪ Drugs can cause serious illness or even be fatal if taken incorrectly OTC • Self Medication • Off-the-Shelf • For general public use FDA Regulated Drugs Potential sideeffects Rx • Doctor prescribes • Pharmacy • Prescribed use for 1 person The Current Self-Care Marketplace The OTC Market performance in the Middle East Self-care is a lifestyle shift that’s here to stay, accelerated by the COVID-19 pandemic. In Saudi Arabia, for example, up to 81.4% of the general population has reported using medicine without a prescription at some point in their lives to treat minor illnesses. Mahzari YI, Aldhfyan YM, Aldossary AM, Alghamdi EA, Alsubaie ML, Abdullah M. Selfmedication in Saudi Arabia-a cross sectional study. Int J Med Search. 2019;8(2): 79-85. Distribution of The Type of Medication Used Without Prescription From a healthcare professional in the KSA Bestselling Non-pharmaceutical Products Sold in Community Pharmacy Legislative and Regulatory Issues Affecting Self-Care Regulation of OTC Drugs The SFDA regulates the registration, import, distribution, and sale of pharmaceutical products, including OTC drugs. The authority ensures that these products meet safety and efficacy standards before they are made available to the public. Regulations and procedures for approving advertisements for non- prescription medications https://www.sfda.gov.sa/sites/default/files/2021-08/Drug-reg-987423E.pdf Roles for the Pharmacist and Student Pharmacist in Self-Care Practice Roles for the Pharmacist and Student Pharmacist in Self-Care Practice The role of the pharmacist has been slowly evolving from primarily dispensing medications to a health care provider role of improving medication use and health outcomes for patients. ▪ Pharmacists reported that patients most frequently requested assistance for the following self-care therapeutic areas: • Cough and cold: 87% • Seasonal and environmental allergies: 53% • Gastrointestinal complaints: 28% • Dermatologic conditions: 14% • Dietary supplements: 11% • Nicotine replacement therapy: 2% Pharmacists’ Patient Care Process (PPCP) What is Pharmacists’ Patient Care Process (PPCP) ? It is a contemporary, consistent, and comprehensive process. It is applicable to all areas of pharmacy practice. It is applicable to any practice setting in community- based or clinic –based ambulatory care. PPCP component: 1. Collect. 2. Assess. 3. Plan 4. Implement 5. Follow-up: monitoring and evaluate. 1-Collect Pharmacist must engage the patient in this step to begin resolving the self-care complaint. Collection of information from patient interview (subjective data). Collecting from medical record. And physical assessment (objective data). 1-Collect Comprehensive patient interview would include the following component of the patients’ health history: ▪ Chief complaint (CC) ▪ History of present illness (HPI) ▪ Past medical history (PMH) ▪ Health maintenance and immunizations. ▪ Family history (FH) ▪ Personal and social history (SH) ▪ Review of system (ROS) and physical examination.(PE) ▪ Medication history 1-Collect Most information in self-care will be subjective data. Objective data can be collected: ✓ blood pressure ✓ Temperature Case: Patient came to you in community pharmacy asking for OTC cream for sunburn relief. what type of questions are you going to ask? Chief complaint, history of the precent illness, past medical history, physical examination. 2- Assess: The pharmacist assess the collected information and analyzes the clinical effects of the patients’ therapy in the context of the patient's overall health goals to identify and prioritize problems and achieve optimal care. Assessment include: 1) Medication assessment 2) Patient history and risk assessment 3) Preventive care assessment Medication Assessment Assessment off each medication for appropriateness, effectiveness, safety and adherence. ➢ Unnecessary drug therapy. ➢ Need additional drug therapy. ➢ Ineffective drug therapy. ➢ Dosage too low. ➢ Dosage too high. ➢ Adverse drug rection. ➢ Adherence. Medication Assessment Assessment step in self-care is to use the information collected to make appropriate medication recommendation or change the medication care plan. Assessing the cause of patient complain it could be medication –related problem. Case: Patient came to community pharmacy asking for medication for his cough, but he is a hypertensive patient and taking…………… ………….,because of that you didn’t prescribe any medication. Patient History & Risk Assessment In certain self-care disorders, the collection of key information about patient's health history could lead to totally different management. Example: If a patient has congestive heart failure (CHF) and seeking self-care for the relief of a cough, the assessment would be exclusion for self-care……? Because it is a sign of deterioration of CHF. Preventive Care Assessment In self-care we focus on preventive measures regarding the precenting illness. Example: A patient encounter community pharmacy for pain of sunburn, the pharmacist could recommend sunscreen as preventive measure. 2- Assess: A unique component of self-care is the assessment of appropriateness of self-treatment. The pharmacist may determine that the patient is not a candidate for self-treatment, and required an assessment from another health care provider, so he needs referral. Examples: ▪ Patient suffer of headache for more than 10 days→ referral ▪ 7 years- old boy with water-clogged ears → referral (OTC is not indicated for children < 12 years). 3- Plan: The pharmacist develops an individualized patient-centered care plan, in collaboration with other health care professionals and patient or caregiver that is evidence –based and cost effective. Based on the collected and analyzed data: 1) Recommend self- care with pharmacologic, nonpharmacologic and/or complementary products. 2) Refer the patient to another health care provider 3) Recommend self-care until another health care provider can be consulted. 3- Plan: Plan should address 4 key areas: ○ Medication-related problems ○ Goals of therapy ○ Patient engagement ○ Care continuity Medication-related Problems ● Pharmacist should use their knowledge of medication properties and determine the safest and most cost-effective option while considering all the collected data. ● The pharmacist must consider patient-specific and therapy- specific factors as age, gender, medication history, medical condition, allergies, ingredients, adverse effects, potential drug interactions, and efficacy. ● Recommendation should be patient-centered considering patient preference, dosage forms and dosing regimens, cost, flavors. Goals Of Therapy Goal of therapy is served as endpoints to measure outcomes. It should be realistic, observable, and measurable. It must contain three components: 1. clinical parameters ( signs and symptoms) e.g.: alleviate the discomfort associated with fever 2. Laboratory values e.g.: return the temperature to normal 36.5 °C. 3. Specific time frame e.g.: within 2 hours Patient Engagement ● Engaging the patient in the plan step involves →education, empowerment, and self management ○ Pharmacist need to educate patient regarding the presenting illness, non-pharmacological measures, when to seek medical attention. Example: A patient with insomnia → prescribe OTC, educate the patient to discontinue stimulant, good sleep hygiene….?? Care Continuity Follow-up is required to teach patient what to do once the goal is achieved, what should occur if the goal is not met, and what to do if the case worsens or the patient experience adverse effect. Example: If your heartburn return after taking OTC (omeprazole) for 14 days, you must call your primary health care provider. 4- Implement ● Use all available communication method to implement patient in the treatment plan. Teach-back method: ● Explaining the information and then ask the patient to repeat key points and discussing the information to ensure understanding. Execution of the developed plan in collaboration with other health care professionals, patient (pt.), or caregiver Includes ■ Communicating goals of therapy ■ Educating the patient or caregiver ■ Referral to appropriate healthcare facility or provider 5- Follow-up: Monitor & Evaluate ● The pharmacist monitors and evaluated the effectiveness of the plan and modify it Please read chapter 1, 2, and 4 Thank you ……!