[Self-medication and the elderly. The reality of the home medicine cabinet.]

Aten Primaria. 2009 May 12; Vacas Rodilla E, Castellà Dagà I, Sánchez Giralt M, Pujol Algué A, Pallarés Comalada MC, Balagué Corbera MOBJECTIVE: To estimate the prevalence of self-medication in the elderly, to describe the characteristics of self-medication and home medicine cabinets. DESIGN: Cross-sectional descriptive study. SETTING: An urban primary health care (PHC) centre in Spain. PARTICIPANTS: A total of 240 patients 75 years of age or older. MAIN MEASUREMENTS: A structured questionnaire filled in by home care nurses from April to June 2006. Self-medication was classified into 4 sub-groups: pharmacological or herbal, exclusively pharmacological, exclusively herbal and pharmacological and herbal. The study variables were: age, sex, living alone, number of chronic diseases, number of chronic prescriptions and medicine cabinet characteristics (drugs accumulation, expired drugs, chronic drugs out of prescription, location of medicine chest and periodic review). Other variables were: drug types, source, and acute/chronic reason for self-medication. RESULTS: Self-medication frequency was 31,2% (95% CI, 26-36), with 22.9% (95% CI, 17.5-27.5) being pharmacological and 15.4% (95% CI, 23.1-17.3), herbal. The drugs most used in self-medication were analgesics (30.9%) and cold remedies (27.2%). The pharmacy was the most usual source (49.3%). A total of 41.6% contained drugs that were out of chronic prescription, and 34.4% accumulated more than three boxes of the same medication. CONCLUSIONS: There is a significant prevalence of self-medication among the elderly. Accumulating drugs in homes is a very extensive practice. Pharmacists and PHC professionals need to be trained in the responsible use of chronic and self-medication. Although self-care has to be encouraged, PHC professionals must make their patients aware of the harmful effects of self-medication.

The use of herbal medicines by people with cancer: a qualitative study.

BMC Complement Altern Med. 2009 May 14; 9(1): 14Gratus C, Wilson S, Greenfield SM, Damery SL, Warmington SA, Grieve R, Steven NM, Routledge PABSTRACT: BACKGROUND: Between 7% and 48% of cancer patients report taking herbal medicines after diagnosis. Because of the possibility of unwanted side effects or interactions with conventional treatments, people with cancer are generally advised to tell the professionals treating them if they are taking any form of medication, including herbal medicines and supplements. Studies suggest that only about half do so, and that the professionals themselves have at best very limited knowledge and feel unable to give informed advice. This study is intended to inform the future development of information resources for cancer patients, survivors and healthcare professionals including tools for use before or during consultation to make it easier for patients to mention, and for healthcare professionals to ask about, use of herbal medications. Methods/design This is a three-phase study. In phase 1, a systematic review of the literature on self-medication with herbal medicines among UK populations living with cancer will establish the current evidence base on use of herbal medicine, sources of information, characteristics and motivations. This will allow us to better understand what aspects need further investigation and inform the topic guide for a qualitative study (phase 2). Six focus groups of six to eight cancer patients who have used at least one herbal preparation since diagnosis will explore behaviour, beliefs, knowledge, information sources and needs in an informal conversational setting. Informed by the findings of the systematic review and qualitative study, in phase 3 we will construct and pilot a questionnaire for a future large-scale survey to quantify and prioritise people's beliefs, needs and information preferences DISCUSSION: Despite known interactions with conventional cancer treatments and contraindications for some herbal remedies with specific cancers, reliable information resources for patients are very limited. Identifying cancer patients' information needs and preferences is the first step in creating a suitable resource for both the public and the professionals advising them.

The use of natural products for sleep: A common practice?

Sleep Med. 2009 May 6; Sánchez-Ortuño MM, Bélanger L, Ivers H, Leblanc M, Morin CMBACKGROUND: Despite a paucity of data on efficacy and safety of natural (herbal and dietary) products, their use appears to be widespread. This study aimed at examining the frequency of natural products' use for sleep and their correlates in a population-based sample. METHODS: A randomly selected sample of adults (n=997; 59.9% women) from the province of Quebec completed a postal survey on sleep, use of sleep-promoting products (natural products, prescribed medication, over-the-counter medication and alcohol), physical and mental health, lifestyle habits and demographics. RESULTS: A total of 18.5% of participants reported having used natural products as sleep aids in the past 12months, with chamomile being the most popular product. Participants who exclusively used natural products as sleep aids (10.3% of the sample) were predominantly females, younger and had a higher educational level than those using prescribed medications. Natural products users reported engaging in more health-promoting behaviors than the nonusers of sleep aids and, despite the presence of subthreshold insomnia symptoms (mean Insomnia Severity Index score=9.33), they tended to perceive themselves as healthier when compared with prescribed medication users and nonusers of sleep aids. CONCLUSIONS: The use of natural products as sleep aids is a common practice. Often associated with a general health-promoting lifestyle, it may reflect the common perception that natural products are necessarily beneficial for sleep and without risks.

Antidiabetic effect of Ficus bengalensis aerial roots in experimental animals.

J Ethnopharmacol. 2009 May 4; 123(1): 110-4Singh RK, Mehta S, Jaiswal D, Rai PK, Watal GETHNOPHARMACOLOGICAL RELEVANCE: Herbal preparations of Ficus bengalensis had been considered as effective, economical and safe ethnomedicines for various ailments in Indian traditional system of medicine. AIM OF STUDY: The present study was aimed to explore scientifically the antidiabetic potential of Ficus bengalensis aerial roots as its bark had already been reported to possess antidiabetic efficacy. MATERIALS AND METHODS: Effect of variable doses of aqueous extract of Ficus bengalensis aerial roots on blood glucose level (BGL) of normal-, sub- and mild-diabetic models have been studied and the results were compared with the reference drug Glipizide and elemental Mg and Ca intake as glycemic elements. RESULTS: The dose of 300 mg kg(-1) showed the maximum fall of 43.8 and 40.7% in BGL during FBG and glucose tolerance test (GTT) studies of normal rats, respectively. The same dose showed a marked reduction in BGL of 54.3% in sub- and 51.7% in mild-diabetic rats during GTT. The concentration of Mg (1.02%) and Ca (0.85%) identified through laser induced breakdown spectroscopy (LIBS) in the most effective dose could be responsible for this high percentage fall in BGL as they take part in glucose metabolism. CONCLUSION: The hypoglycemic effect in normoglycemic and antidiabetic effect in sub- and mild-diabetic models of aqueous extract of aerial roots of Ficus bengalensis are due to the presence of these glycemic elements in high concentration with respect to other elements.