Out From Behind the Bench: The Importance of Counseling Patients About Self-Care and Nonprescription Products

JANUARY 01, 2005
Stefanie Ferreri, PharmD, CDE

As people live longer, work longer, and take a more active role in their own health, they need to become better informed about self-care options. No health care professional is better suited to help them than the practicing pharmacist. Individuals may find health information overwhelming and confusing. The pharmacist has the expertise to screen this information and apply it to each individual's needs. Consumers need to know which self-care practices to adopt and how and why to do so, and pharmacists should incorporate this concept into their daily practices.

The involvement of health care practitioners will increase people's ability to understand the risks and benefits of OTC remedies. According to a consumer poll conducted by the National Council on Patient Information and Education, almost as many individuals now get their information about nonprescription medicines from the mass media (49%) as they do from health professionals (57%).

The reason for this finding is not that health professionals are unwilling to discuss OTC product use with their patients. In fact, 3 in 4 of the practitioners surveyed said that they ask their patients directly about OTC drug use most or all of the time. Just 27% of health professionals said that they wait for patients to volunteer information about their OTC medication use.

Self-care is anything patients undertake on their own to identify, treat, or prevent disease. It includes but is not limited to self-administration of nonprescription medications. Although most Americans over age 65 are likely to visit a doctor, 54% said that they prefer to treat themselves, 67% have used an OTC in the past 6 months, and 57% have used a dietary supplement in the past 6 months.

The use of nonprescription or OTC medications is widespread. According to the survey, 3 in 5 Americans have used at least one OTC medication in the past 6 months. With more than 100,000 products on the market, it is easy to understand why patients can become overwhelmed with their OTC choices. Many consumers feel that OTC drugs are safe because they are available without a prescription. This feeling is far from the truth. Nonprescription agents are powerful drugs.

The pharmacist is the health care professional with the most training concerning nonprescription, OTC products. Talking with patients can have a direct and measurable positive impact. Therefore, it is the pharmacist's responsibility to help patients make educated choices. Increased pharmacist involvement in self-care can improve adherence to drug therapies, resulting in improved efficacy. It also can minimize the risk of drug interactions and negative side effects. Ultimately, pharmacists can guide patients to wiser health care decisions.

The pharmacist is the triage expert with regard to nonprescription products and self-care. Pharmacists have knowledge specific to nonprescription agents, they know what type of information they should gather about their patients, and they know how to convey that information to their patients.

The first step in the triage process is to assess, by interview and observation, the patient's physical complaints or symptoms and medical condition. This step includes gathering patientspecific information, such as age, duration of condition, nature of condition, medical history, and concurrent medications. The next step is to differentiate self-treatable conditions from those requiring medical intervention. A pharmacist's last responsibility is to advise and counsel patients on the proper course of action. There are 3 possible courses of action: treat the patient, not treat the patient, or refer the patient for medical care.

If self-treatment is appropriate, the pharmacist has these responsibilities:

  • To aid in product selection
  • To assess risk factors
  • To counsel on the appropriate use of products
  • To keep a profile
  • To monitor for drug interactions, drug-disease interactions, allergies, and overuse of medications

If self-care is not appropriate, the pharmacist must encourage the patient to seek the proper medical care. When no treatment is necessary, it is the pharmacist's duty to explain why, with some patience, the problem will go away on its own.

Pharmacists can increase self-care and nonprescription counseling by taking the following steps:

  • Acquire a full working knowledge of OTC drugs
  • Gather information from patients through the interview process
  • Analyze information by considering all product-related and patientrelated factors
  • Counsel patients about any problems presented

By following all of these steps, pharmacists can help their patients make informed decisions.

Dr. Ferreri is a clinical assistant professor at the University of South Carolina School of Pharmacy.