Khalifeh Malak M, Moore Nicholas D, Salameh Pascale R
INSERM U 1219 - Pharmaco-épidémiologie et évaluation de l'impact des produits de santé sur les populations, University de Bordeaux, Bordeaux, France.
Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.
Pharmacol Res Perspect. 2017 Aug;5(4). doi: 10.1002/prp2.323.
Regulations usually distinguish between prescription-only (POM) and over-the-counter (OTC) medicines. The former requires medical prescription; the latter are available for SM of common minor or easily treated ailments. However, in the Eastern Mediterranean countries, theoretical prescription medicines can easily be purchased without a prescription, as self-medication (SM) resulting in potential misuse and unnecessary risk for patients. The magnitude of this activity is uncertain. The aim of this article, therefore, is to undertake a comprehensive review to identify the different types of medicines that can easily be purchased as SM in Middle East and recognized as misused. An extensive review of the published literature (1990-2015) was conducted using Pubmed, web of science, Cochrane, and Google Scholar databases, for OTC medicine misuse in the Middle East. A total of 72 papers were identified. Medicines involved in misuse included: codeine containing products, topical anesthetics, topical corticosteroids, antimalarial, and antibiotics. Self-medication misuse of medicines seemed widespread. Individual treatment patterns were not clearly identified. Studies were not standardized, limiting the comparability between studies and the estimation of the scale of misuse. Pharmacists, friends, or parents were found to be the main sources of SMs. Knowledge and attitudes are an important contributing factor in the misuse of these medications. Strategies and interventions to limit misuse were rarely identified in literature. In conclusion, a massive problem involving a range of medicines was found in Middle East. Standardization of studies is a prerequisite to the understanding and prevention of misuse of self-medication.
法规通常会区分处方药（POM）和非处方药（OTC）。前者需要医生处方；后者可用于治疗常见的轻微或易于治疗的疾病。然而，在东地中海国家，理论上的处方药无需处方就很容易买到，因为自我药疗（SM）可能会导致患者误用并带来不必要的风险。这种行为的规模尚不确定。因此，本文的目的是进行全面综述，以确定在中东地区可以很容易作为自我药疗买到且被认定为误用的不同类型药品。利用PubMed、科学网、考克兰图书馆和谷歌学术数据库，对已发表的文献（1990 - 2015年）进行了广泛综述，以研究中东地区非处方药的误用情况。共识别出72篇论文。涉及误用的药品包括：含可待因产品、局部麻醉剂、局部用皮质类固醇、抗疟药和抗生素。药品的自我药疗误用似乎很普遍。个体治疗模式未明确识别。研究未标准化，限制了研究之间的可比性以及对误用规模的估计。药剂师、朋友或父母被发现是自我药疗的主要来源。知识和态度是这些药物误用的一个重要促成因素。文献中很少能找到限制误用的策略和干预措施。总之，在中东地区发现了一个涉及多种药品的严重问题。研究的标准化是理解和预防自我药疗误用的先决条件。
