Monday, 14 July 2014

Taking risks with medicines

Following on from my post on 25th June 2014 about the Royal Pharmaceutical Society's report into medicines compliance, survey results have now been released revealing that many people aren't taking their medicines as directed.

New research, commissioned by Pharmacy Voice, shows that a quarter of people surveyed had deliberately not followed instructions about a course of treatment prescribed by their doctor, while only a fifth always completed a course of medicine. In the survey, a quarter of people believed that a course of treatment doesn't need to be followed rigidly to get better, and 45 percent said they trust their body telling them they feel better more than they trust prescription medicines. One in seven people also said they have used out-of-date medicines and one in 20 have even used medicines that have been prescribed to family or friends.

Obviously not taking a full course of any medicine can lead to health problems, such as delayed recovery. But stopping certain medicines without medical advice can also cause serious side effects. Corticosteroid tablets, for example, should be stopped only by gradually reducing the dose under the guidance of a doctor or nurse. If you stop them suddenly, this can leave you more prone to infections. Some anti-depressants can cause severe withdrawal symptoms if you stop them abruptly, rather than reducing them slowly over a four-week period.

There is also particular concern over people not finishing courses of antibiotics (see my last blog post). The danger is that the infection will recur and will be much harder to treat when it does. In addition, the surviving bacteria may become resistant to the antibiotics and spread to other people.

The Pharmacy Voice research also highlighted that one in 10 people take more than the recommended dose and a quarter don't always measure out liquid medicines. This reminds me of several friends who were swigging Gaviscon straight from the bottle to ease their heartburn during their pregnancies!

Wednesday, 2 July 2014

Help to ease winter health pressures

A report this week by the All-Party Parliamentary Group of Primary Care and Public Health highlights the role of community pharmacies in managing winter ailments. The report focuses on the increasing pressure put on hospital A&E departments and GP practices during the winter months, and why it's important that people know the differences between 'urgent' and 'non-urgent' minor health issues. 

The report suggests that we - the public - should be going to our pharmacist before our GP when we are suffering from a cold or flu, unless we think it's a medical emergency. This is because weather-related health conditions, such as respiratory problems, are more common during the winter, increasing the pressure on A&E departments.  The cold and flu season also results in more people seeking medical advice from their GP, whether it's simply for reassurance or antibiotics, which leads to more pressure on the healthcare system as a whole.

Every year, winter health campaigns focus on the inappropriate prescribing of antibiotics and the importance of 'self care'. This year's Self Care Week, which is run by the Self Care Forum, takes place from 17th to 23rd November 2014, with the theme 'Self Care for Life - Be Healthy this Winter'.

But many people find it difficult to assess when their symptoms are 'urgent' or 'non-urgent'. And I include myself in this. 

  • When should we worry about an annoying cough that keeps us awake or a persistent sore throat that just won't disappear? 
  • Is it normal to be so congested that your face hurts or you get a seasick feeling every time you move? 
  • Should we be coughing up green or brown phlegm?
  • How long should our cough or cold last before we need to see our GP? 
Knowing more about our symptoms - and dealing with them without the need for antibiotics - doesn't just help us as individuals, but also helps to reduce the national (or rather international) crisis of bacterial resistance. Earlier today, the Prime Minister David Cameron warned about the growing threat of antibiotic resistance: there is a continual rise in drug-resistant bacterial strains, no new classes of antibiotics have been developed for more than 25 years and there is still an overuse of antibiotics globally. 

So what should we be doing? 
  • Firstly, remember that antibiotics won't help a cold or flu as they kill bacteria, not viruses. So we don't need to ask for them at the first sign of a sneeze or sniffle.
  • Secondly, if we are prescribed them, this should be because our GP thinks we already have a bacterial infection or that we are at an increased risk of one. 
  • Thirdly, if we do take antibiotics, it's vital that we finish the full course, take the antibiotics at regular intervals during the day (as prescribed) and don't skip any doses. 
Ultimately, we need to try self-help measures for our cold, cough or sore throat first, rather than simply seeing our GP for antibiotics - and this is where pharmacy advice comes in. Pharmacies aren't just there to sell us cough and cold remedies (although these can often help to relieve our symptoms).  Pharmacists and pharmacy staff are trained to advise us about self-help measures too and tell us when we really do need to see our GP. 

The Proprietary Association of Great Britain (PAGB) has a great website called Treat Yourself Better, where you can find out how to treat coughs, colds and sore throats, rather than resorting to antibiotics.