1. THE PREVALENCE OF HERBAL AND OVER THE COUNTER MEDICINE USE AMONGST COMMUNITY DWELLING CASE MANAGED OLDER ADULTS
LISK C, SPEAR F, CLEM C, JONES C, NORMAN J.
GERIATRIC MEDICINE , POTTERS BAR HOSPITAL.
Introduction
Results
An increasingly ageing population is changing the demography of older patients we provide healthcare to. Older people are increasingly taking herbal medicines1 and over the counter medicines for a variety of reasons; treatment of chronic ailments, to help boost memory, prevent illness and aid longevity. Healthcare professionals are often unaware of this. This may result in adverse drug reactions due to interactions between prescribed and herbal medicines.
Aim
We evaluated the prevalence of herbal and over the counter medication in a cohort of case managed patients with the aim of identifying potential harmful interactions.
Methods
A questionnaire based survey and database review of all patients managed by the Hertsmere community matrons was undertaken in August 2010.
Data was analysed using an Excel database.
Results
114 out of 116 patients that were identified took part. 63% were female. Over half of the patients were aged above 80years (fig1). Most patients had 5 or more long term conditions; the majority being cardio-respiratory in nature. Over the counter medication and herbal medicine use accounted for 16.2 % of the total medication burden (fig4). In most cases their primary physician was unaware that they were taking these medications. The majority of over the counter medications were analgesics (27%) followed by vitamins (21%), laxatives (18%) and creams and lotions used for analgesic and skin moistening effects (11%).Cod liver oil, omega 3, antihistamines, antimotility agents, iron and nutritional supplements accounted for 23% with herbal medicine use accounting for only 2% (fig3-4). Of these patients, the range of prescribed medicines they took were 5-9 with 25 potential drug interactions identified. The majority of patients were on at least 10 medications.
This study highlights the degree of polypharmacy and potentially significant drug interactions in a cohort of case managed patients. It highlights the importance to healthcare professionals of taking a full drug history as there is increasingly availability of over the counter, herbal and homeopathic medications. Studies on the potential cost savings resulting from addressing polypharmacy are needed.
Conclusions