Handle with Care

More of us are reading labels and checking out possible side effects, but we still have far to go.

THE American public buys more than five billion over-the-counter drug products each year. A June 2003 national survey examining use of OTC medications indicated more of us are reading labels and checking out possible side effects, but we still have far to go, the National Council on Patient Information and Education noted last fall when it launched its latest consumer education campaign, "Be MedWise Prescription for Taking OTC Medicines."

OTC meds are a major contributor to much-admired U.S. productivity. Products ranging from pain remedies to cough drops prevent absenteeism at millions of work sites. Self-medicating on the job rarely causes problems, but when employees misuse or overuse meds, they can endanger themselves and their co-workers without even knowing it. (For example, OTC pain relievers commonly contain acetaminophen, ibuprofen, naproxen sodium, and/or aspirin. Cold and flu meds also may contain one or more of these. NCPIE warns not to combine medications with the same active ingredient because that can cause overuse.)

U.S. Surgeon General Richard H. Carmona joined NCPIE's campaign last September when he issued an educational "prescription" at a Washington, D.C. press conference. It was a list of five questions (similar to the questions listed in the sidebar below) consumers should ask their doctor, pharmacist, or other health care professional before taking over-the-counter medications.

OTC Medications Checklist

Read the label carefully before taking any kind of medication. Failing to do this could cause errors and preventable drug interactions with potentially serious consequences. Make sure, as well, to follow these good practices when buying and taking over-the-counter meds.

  • Check the ingredients. Does this medication include anything you should avoid or to which you are allergic?
  • If you are on a low-salt or low-sugar diet, what are its sodium and sugar contents?
  • What limits on taking this medication are listed, if any?
  • What are the possible side effects of taking it?
  • Are there foods, beverages, herbal products, or dietary supplements you should avoid while taking it?
  • What symptoms are listed that should alert you to stop taking the medication?
  • Check the dosage level. How and how often should this medication be taken?
  • Which activities, if any, does the label recommend you avoid while taking the medication?
  • What should you do if you take an accidental overdose of the medication?
  • When does the medication expire?
  • "By improving the health literacy of Americans, we can improve our nation's overall health," Dr. Carmona said. "This information, combined with an ongoing dialogue between consumers and pharmacists, will enable more Americans to get the most benefit from their over-the-counter medicines."

    NCPIE has used its "Be Medwise" online site (www.bemedwise.com) to spread awareness of the prescription. Through tips, a brochure, advisories, a quiz, and other features, the site explains that more than 100,000 over-the-counter drugs are available without a prescription, and "all have one thing in common: they are serious medicines that need to be taken with care."

    In NCPIE's June 2003 survey, 8 percent said they don't read anything on the "Drug Facts" label when buying an OTC medication.

    The original Be MedWise campaign commenced in early 2002. It was a partnership with the U.S. Food and Drug Administration to promote smart use of OTC medicines and awareness of the "Drug Facts" label spelling out their active ingredients, purpose, warnings, and dosage instructions. NCPIE itself is a non-profit coalition of consumer, government, and public health organizations working together to improve communication between patients and health professionals about safe use of medicines.

    2003 Survey Results
    NCPIE's June 2003 survey was a national poll of 1,009 adults. More than half, 51 percent, said they had taken an OTC medication and a prescription drug simultaneously. Other key findings:

    • 48 percent of the respondents said they had taken more than the recommended dose of an OTC med by taking a dose sooner than directed, taking more than the recommended amount at one time, or taking it more times per day than recommended
    • 56 percent were aware of the "Drug Facts" label
    • 44 percent said they look for the active ingredient (up from 34 percent in 2002)
    • 20 percent try to learn about possible side effects (up from 10 percent in 2002)
    • 23 percent read dosage information (up from 16 percent in 2002)
    • 8 percent said they don't read anything on the label
    • 43 percent consult a pharmacist when shopping for OTC meds

    Encouragingly, 80 percent of the respondents said they would buy a particular OTC med if their pharmacist recommended it, and 82 percent indicated they would not buy one if their pharmacist advised against it.

    Online Purchasing

    Online shopping for prescription medicines and other health care products is increasingly popular, but this purchasing method has its own risks.

    These include outdated, inappropriate, unapproved, or even fake products, as well as incorrect diagnosis. Substandard packaging, product adulteration, breach of patient confidentiality, and insecure transactions are additional risks.

    NCPIE, FDA, and allied organizations urge consumers to get any prescriptions from their own doctor or authorized health care professional. Consumers shouldn't buy meds from a site offering to prescribe them without an initial physical exam by the consumer's doctor or offering to sell prescription meds without a prescription, the organizations say. Look for a written prescription verification policy on a site before purchasing, don't provide personal information such as a Social Security number unless you are confident the site is secure, and make sure it is a licensed pharmacy in good standing in your state.

    Managing OTC Use at Work
    A workplace's manager can promote safe OTC use by ensuring that workers understand potential hazards, including which injuries are most likely to occur. If your management provides over-the-counter medications on site, you should have a written policy on use and abuse of OTCs and should explain this policy to all employees. Tell them about the serious risks of overusing and misusing meds. Consider controlling your site's dispensing through vending machines, on-site medical staff, or locking the med boxes securely in an office.

    Employees should alert a supervisor when they become aware of a medication problem. Policies in force and ongoing training should explain workers' responsibility in this area and their duty to seek help if necessary. The best approach is to make sure your employees know the hazards as well as the healthy benefits of OTC medications.

    This article originally appeared in the April 2004 issue of Occupational Health & Safety.

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