Zavaleta-Monestel Esteban, Villalobos-Madriz Jorge Arturo, Serrano-Arias Bruno, Arguedas-Chacón Sebastián, Diaz-Madriz José Pablo, Ferreto-Meza Mery Alejandra, Romero-Chavarría Betzy María, Zumbado-Amerling Priscila
Department of Pharmacy, Hospital Clinica Biblica, San José, Costa Rica.
Faculty of Pharmacy, Universidad de Ciencias Médicas, San José, Costa Rica.
Explor Res Clin Soc Pharm. 2023 Jul 6;11:100300. doi: 10.1016/j.rcsop.2023.100300. eCollection 2023 Sep.
The importance of access to medicines in promoting global health cannot be overstated, particularly as an estimated 2 billion people lack access to basic medicines, particularly in developing nations. While over-the-counter (OTC) medications are relatively safe and cost-effective, there is a risk of misuse due to factors such as inaccurate self-diagnosis, inadequate dosing, addiction, adverse drug reactions, and drug interactions. To ensure proper use and prevent irrational self-medication, pharmacists can play a crucial role in guiding patients. However, the legislation in Costa Rica only covers OTC and prescription drugs, and health authorities are proposing a new decree to include a list of drugs that can be recommended by pharmacists without a prescription to treat minor ailments, which would be classified as behind-the-counter (BTC).
Characterize the pharmaceutical consultation, compare the medications recommended by pharmacy professionals for minor ailments with the legislation in force in Costa Rica, and determine whether the current OTC medications are sufficient to treat minor ailments.
This study is a descriptive, observational, cross-sectional study that focuses on a sample of the Costa Rican population that comes to consult with a pharmacist in one of the four pharmacies of the Hospital Clínica Bíblica (HCB) in San José, Costa Rica. Consultations included users over 18 years of age or caregivers of underage patients seeking advice or assistance from publicly accessible pharmacies, excluding consultations that involved information related to other hospital departments. This study aims to analyze the pharmaceutical consultation for minor ailments and compare the medications recommended by pharmacists with the list of medications allowed in Costa Rica. The study also aims to determine if the current OTC medications are adequate for treating minor ailments.
A total of 1537 consultations were gathered, which were divided into four categories: pharmaceutical recommendation (48%), medication information (31%), other consultations (18%), and referrals to another health professional (3%). Among the consultations classified as pharmaceutical recommendations, 90% were related to minor ailments. Prescription drugs accounted for 75.3% of the medications recommended and consulted. However, when the BTC category was included, the percentage of recommended prescription drugs decreased to 29.6%, while BTC drugs constituted 45.7%. Finally, the chi-square test rejected the null hypothesis that there was no association between the availability of OTC drugs and the minor ailments for which patients sought consultation.
Most cases of pharmacy consultations involve minor illnesses such as digestive symptoms, joint pain, and respiratory issues. The proposed decree by health authorities in Costa Rica is noteworthy as it establishes standardized protocols for the prescription of BTC medications to ensure the safety of patients.
药品可及性对促进全球健康的重要性再怎么强调都不为过，尤其是据估计有20亿人无法获得基本药物，在发展中国家尤为如此。虽然非处方药（OTC）相对安全且具有成本效益，但由于自我诊断不准确、剂量不当、成瘾、药物不良反应和药物相互作用等因素，存在滥用风险。为确保正确使用并防止不合理的自我药疗，药剂师在指导患者方面可发挥关键作用。然而，哥斯达黎加的法律仅涵盖非处方药和处方药，卫生当局正在提议一项新法令，纳入一份可由药剂师无处方推荐用于治疗小病的药物清单，这些药物将被归类为柜台后（BTC）药品。
描述药学咨询情况，将药学专业人员针对小病推荐的药物与哥斯达黎加现行法律进行比较，并确定当前的非处方药是否足以治疗小病。
本研究是一项描述性、观察性横断面研究，重点关注哥斯达黎加圣何塞市圣经临床医院（HCB）四家药房之一咨询药剂师的哥斯达黎加人群样本。咨询对象包括18岁以上的用户或为未成年患者寻求建议或帮助的护理人员，这些咨询来自可公开访问的药房，不包括涉及其他医院科室信息的咨询。本研究旨在分析针对小病的药学咨询，并将药剂师推荐的药物与哥斯达黎加允许的药物清单进行比较。该研究还旨在确定当前的非处方药是否足以治疗小病。
共收集到1537例咨询，分为四类：药学推荐（48%）、用药信息（31%）、其他咨询（18%）和转诊至其他卫生专业人员（3%）。在归类为药学推荐的咨询中，90%与小病有关。推荐和咨询的药物中，处方药占75.3%。然而，当纳入BTC类别时，推荐的处方药百分比降至29.6%，而BTC药物占45.7%。最后，卡方检验拒绝了非处方药的可及性与患者咨询的小病之间无关联的零假设。
大多数药房咨询案例涉及消化症状、关节疼痛和呼吸问题等小病。哥斯达黎加卫生当局提议的法令值得关注，因为它为BTC药物的处方制定了标准化方案，以确保患者安全。
