Promoting Safe and Effective Use of OTC Medications
Promoting Safe and Effective Use of OTC Medications
Research on the ways older people use prescription medications (Rx) is a mainstay of the gerontological literature because use of Rx medications is common, and appropriate use is central to effective management of chronic disease. But older adults are also major consumers of over-the-counter (OTC) medications, which can be equally significant for self-care. Nearly half of older adults aged 75–85, for example, are regular users of an OTC product. Ensuring that consumers safely and effectively use OTC products is critical in order to minimize potential drug–drug interactions and unintentional misuse. Yet we know surprisingly little about the ways older adults select OTC medications and decide when to start or stop use, how older people actually take these medications, or how involved clinicians and family members are in older adult OTC behavior. Research in this area is critical for developing interventions to help ensure safe and appropriate OTC use. For this reason, The Gerontological Society of America (GSA), in partnership with the Consumer Healthcare Products Association (CHPA), convened a summit of experts to set an agenda for research in OTC behaviors among older adults. The panel suggested a need for research in 5 key areas: Health literacy and OTC behavior, decision making and OTC use, the role of clinicians in OTC medication behavior, older adult OTC behavior and family care, and technologies to promote optimal use of OTC medications.
Older adults aged 65 and older comprise 13% of the population but account for 34% of prescription (Rx) and 30% of nonprescription over-the-counter (OTC) medication use in the United States (National Center for Patient Information and Education, n.d.). Regular use of OTC medications among older adults in the National Social life, Aging, and Health Project (NSHAP) was estimated to be as high as 47.2% in people aged 75–85 (Qato et al., 2008). Based on the nationally representative NSHAP, 4% of U.S. older adults' medication regimens include a potentially major drug–drug interaction, and half of these involve a nonprescription medication.
Although Rx behavior is a mainstay of geriatric research, OTC behavior has not received the attention it deserves. We know surprisingly little about the ways older adults select OTC medications and decide when to start or stop use, how older people actually use the medications, or how involved clinicians and family members are in older adult OTC behavior. This effort is critical for developing interventions to help ensure safe and appropriate OTC use.
The Gerontological Society of America (GSA), in partnership with the Consumer Healthcare Products Association (CHPA), called together experts from academia, industry, government, and medical practice to synthesize existing research regarding OTC use by older adults in order to prioritize research needs. Areas of focus included OTC medication literacy, the perceptual and cognitive basis of OTC medication decision making, the interface between clinical and family care in OTC use, and technologies to support optimal OTC medication behavior.
The experts convened for a Summit in Washington, DC, on April 9 and 10, 2013. Speakers included academicians, clinicians, geriatricians, psychologists, and entrepreneurs. Participants included experts in the fields of cognitive science, health services research, nursing, packaging, preventive medicine, social science, pharmacy, and pharmacology, as well as professionals from pharmaceutical companies, NIH, and the U.S. Food and Drug Administration (FDA). Information about the speakers, the participants, and the working group that organized the Summit is included in the Supplementary Appendix http://gerontologist.oxfordjournals.org/content/54/6/909/suppl/DC1.
Despite their prevalence, use of dietary supplements (with or without botanical products) and "nutraceuticals" and "medicinal foods" were excluded from Panel review. (In fact, the terms "nutraceutical" and "medicinal food" have no regulatory definition in the United States.) While recognizing the importance of such products for self-care among older adults, the Panel opted for a narrower focus on OTC medicines due to the great potential for innovations to improve safe and effective OTC use. Also, the FDA places supplements under a different set of regulations, again suggesting that separation of the two domains is reasonable. For these reasons, the Panel excluded supplements from its review.
Abstract and Introduction
Abstract
Research on the ways older people use prescription medications (Rx) is a mainstay of the gerontological literature because use of Rx medications is common, and appropriate use is central to effective management of chronic disease. But older adults are also major consumers of over-the-counter (OTC) medications, which can be equally significant for self-care. Nearly half of older adults aged 75–85, for example, are regular users of an OTC product. Ensuring that consumers safely and effectively use OTC products is critical in order to minimize potential drug–drug interactions and unintentional misuse. Yet we know surprisingly little about the ways older adults select OTC medications and decide when to start or stop use, how older people actually take these medications, or how involved clinicians and family members are in older adult OTC behavior. Research in this area is critical for developing interventions to help ensure safe and appropriate OTC use. For this reason, The Gerontological Society of America (GSA), in partnership with the Consumer Healthcare Products Association (CHPA), convened a summit of experts to set an agenda for research in OTC behaviors among older adults. The panel suggested a need for research in 5 key areas: Health literacy and OTC behavior, decision making and OTC use, the role of clinicians in OTC medication behavior, older adult OTC behavior and family care, and technologies to promote optimal use of OTC medications.
Introduction
Older adults aged 65 and older comprise 13% of the population but account for 34% of prescription (Rx) and 30% of nonprescription over-the-counter (OTC) medication use in the United States (National Center for Patient Information and Education, n.d.). Regular use of OTC medications among older adults in the National Social life, Aging, and Health Project (NSHAP) was estimated to be as high as 47.2% in people aged 75–85 (Qato et al., 2008). Based on the nationally representative NSHAP, 4% of U.S. older adults' medication regimens include a potentially major drug–drug interaction, and half of these involve a nonprescription medication.
Although Rx behavior is a mainstay of geriatric research, OTC behavior has not received the attention it deserves. We know surprisingly little about the ways older adults select OTC medications and decide when to start or stop use, how older people actually use the medications, or how involved clinicians and family members are in older adult OTC behavior. This effort is critical for developing interventions to help ensure safe and appropriate OTC use.
The Gerontological Society of America (GSA), in partnership with the Consumer Healthcare Products Association (CHPA), called together experts from academia, industry, government, and medical practice to synthesize existing research regarding OTC use by older adults in order to prioritize research needs. Areas of focus included OTC medication literacy, the perceptual and cognitive basis of OTC medication decision making, the interface between clinical and family care in OTC use, and technologies to support optimal OTC medication behavior.
The experts convened for a Summit in Washington, DC, on April 9 and 10, 2013. Speakers included academicians, clinicians, geriatricians, psychologists, and entrepreneurs. Participants included experts in the fields of cognitive science, health services research, nursing, packaging, preventive medicine, social science, pharmacy, and pharmacology, as well as professionals from pharmaceutical companies, NIH, and the U.S. Food and Drug Administration (FDA). Information about the speakers, the participants, and the working group that organized the Summit is included in the Supplementary Appendix http://gerontologist.oxfordjournals.org/content/54/6/909/suppl/DC1.
Despite their prevalence, use of dietary supplements (with or without botanical products) and "nutraceuticals" and "medicinal foods" were excluded from Panel review. (In fact, the terms "nutraceutical" and "medicinal food" have no regulatory definition in the United States.) While recognizing the importance of such products for self-care among older adults, the Panel opted for a narrower focus on OTC medicines due to the great potential for innovations to improve safe and effective OTC use. Also, the FDA places supplements under a different set of regulations, again suggesting that separation of the two domains is reasonable. For these reasons, the Panel excluded supplements from its review.
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