Over-The-Counter Remedies in Older Adults

Evidence suggests that consumption of over-the-counter cyclooxygenase (COX) inhibitors may interfere with the positive effects that resistance exercise training has on reversing sarcopenia in older adults. This study examined the influence of acetaminophen or ibuprofen consumption on muscle mass and strength during 12 wk of knee extensor progressive resistance exercise training in older adults. Thirty-six individuals were randomly assigned to one of three groups and consumed the COX-inhibiting drugs in double-blind placebo-controlled fashion: placebo (67 ± 2 yr; n = 12), acetaminophen (64 ± 1 yr; n = 11; 4 g/day), and ibuprofen (64 ± 1 yr; n = 13; 1.2 g/day). Compliance with the resistance training program (100%) and drug consumption (via digital video observation, 94%), and resistance training intensity were similar ( P > 0.05) for all three groups. Drug consumption unexpectedly increased muscle volume (acetaminophen: 109 ± 14 cm3, 12.5%; ibuprofen: 84 ± 10 cm3, 10.9%) and muscle strength (acetaminophen: 19 ± 2 kg; ibuprofen: 19 ± 2 kg) to a greater extent ( P < 0.05) than placebo (muscle volume: 69 ± 12 cm3, 8.6%; muscle strength: 15 ± 2 kg), when controlling for initial muscle size and strength. Follow-up analysis of muscle biopsies taken from the vastus lateralis before and after training showed muscle protein content, muscle water content, and myosin heavy chain distribution were not influenced ( P > 0.05) by drug consumption. Similarly, muscle content of the two known enzymes potentially targeted by the drugs, COX-1 and -2, was not influenced ( P > 0.05) by drug consumption, although resistance training did result in a drug-independent increase in COX-1 (32 ± 8%; P < 0.05). Drug consumption did not influence the size of the nonresistance-trained hamstring muscles ( P > 0.05). Over-the-counter doses of acetaminophen or ibuprofen, when consumed in combination with resistance training, do not inhibit and appear to enhance muscle hypertrophy and strength gains in older adults. The present findings coupled with previous short-term exercise studies provide convincing evidence that the COX pathway(s) are involved in the regulation of muscle protein turnover and muscle mass in humans.

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Improving Patient-Pharmacist Encounters with Over-The-Counter Medications: A Mixed-Methods Pilot Study

INNOVATIONS in pharmacy ◽

10.24926/iip.v11i1.2295 ◽

2020 ◽

Vol 11 (1) ◽

pp. 11

Author(s):

Aaron Gilson ◽

Ka Xiong ◽

Jamie Stone ◽

Nora Jacobson ◽

Cynthia Phelan ◽

...

Keyword(s):

Older Adults ◽

Mixed Methods ◽

Original Research ◽

Pharmacy Staff ◽

Post Intervention ◽

Chi Square ◽

Over The Counter ◽

Medication Selection ◽

Medication Decisions ◽

The Impact

Background and Objectives: Over-the-counter (OTC) medication use has increased safety risks for adults older than 65. Most older adults purchase OTC medications from community pharmacies, where the considerable distance or visual obstructions between the prescription area and OTC aisles undermine pharmacists’ ability to assist patients with OTC medication decisions. An innovative redesign of an abbreviated medication section specifically for older adults (called the Senior SectionTM) can facilitate pharmacy staff/patient interaction, potentially improving safe medication selection and use. This study evaluated the impact of the Senior Section on the frequency and content of OTC encounters between pharmacy staff and patients. Research Design and Methods: An intervention mixed-methods design generated data from patient OTC encounters, and interviews with two pharmacists and two technicians, throughout the study. NVivo was used to code interview transcripts, and frequencies and chi-square analyses demonstrated pre/post-intervention comparisons for the OTC encounter variables. Results: After Senior Section implementation, pharmacy staff were more likely to initiate (and be involved in) patient encounters, address more topics or problem/symptoms, provide details about OTC products, discuss appropriateness of OTC use, and discuss medication classes highlighted in the Senior Section. Pharmacy staff were less likely to need to leave the prescription department for extended periods; they also had fewer prolonged encounters or encounters about product location. Importantly, the Senior Section did not impede pharmacy workflow. Discussion and Implications: The Senior Section prompted more frequent, effective, and efficient engagements between pharmacy staff and patients, which may substantially reduce OTC-related harms among older adults. Article Type: Original Research

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Case Report: The Complexities of Managing Medications and the Importance of Deprescribing Anticholinergics in Older Adults

Frontiers in Pharmacology ◽

10.3389/fphar.2021.584667 ◽

2021 ◽

Vol 12 ◽

Author(s):

Taylor Elliott ◽

Lynne Eckmann ◽

Daniela C. Moga

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Case Report ◽

Transitions Of Care ◽

Past Medical History ◽

Over The Counter ◽

Interprofessional Team ◽

Anticholinergic Medications ◽

Clinical Complexity ◽

Tract Infections

Potentially inappropriate anticholinergic medications (including over-the-counter products), polypharmacy, and the existence of communication barriers among members of the interprofessional team frequently contribute to clinical complexity in older adults. We present the case of a frail 86-year old female from the perspective of a community pharmacist managing outpatient medications and transitions of care. CD’s past medical history is significant for dementia, multiple falls, recurrent urinary tract infections, depression, cardiac arrhythmia, macular degeneration, chronic pain, depression, and cerebrovascular disease.

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THE IMPACT OF AN EDUCATION INTERVENTION: IMPROVING COMMUNICATION BETWEEN OLDER ADULTS AND HEALTH CARE PROVIDERS

Innovation in Aging ◽

10.1093/geroni/igz038.3316 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S909-S909

Author(s):

Janna Heyman ◽

Linda White-Ryan ◽

Peggy Kelly

Keyword(s):

Older Adults ◽

Health Care ◽

Health Care Providers ◽

Educational Intervention ◽

Prescription Drugs ◽

Medication Use ◽

Care Providers ◽

Over The Counter ◽

Medical Needs ◽

The Impact

Abstract As people age, ensuing physical and psychological problems can increase, which makes it paramount to be comfortable discussing medical needs with health care professionals, particularly in light of the danger associated with misunderstanding medication use and combining alcohol with prescriptions and/or over the counter medications (National Institute on Aging, 2018). National studies found that about 40 percent of adults ages 65 and older drink alcohol and often do not understand the dangers of combining alcohol with medications (National Institute for Alcohol and Alcohol Abuse, 2008). An educational intervention was developed with a team of expert physicians, nurses, pharmacists and social workers who work in gerontology to focus on improving communication and addressing alcohol and medication use for older adults. A randomized controlled trial was conducted to assess whether the educational intervention improved older adults’ comfort in communicating with their health care providers, as well as their knowledge of the concomitant use of alcohol and prescription and over-the-counter (OTC) medications. Results of a MANCOVA showed that those in the intervention group showed larger increases in scores on communication with their health providers and knowledge about the implications of combining alcohol with prescription drugs than those in the control group (Wilks’ Lamda=.808, F(3,76)=6.039, p=.001<.05). In addition, linear regression models showed that the intervention was significantly associated with participants’ knowledge of the implications of combining alcohol with prescription drugs. The coefficient across models was approximately 1.00, which represented a substantial increase given the average score of 6.5.

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A pharmacy-based intervention to improve safe over-the-counter medication use in older adults

Research in Social and Administrative Pharmacy ◽

10.1016/j.sapharm.2020.05.008 ◽

2020 ◽

Author(s):

Aaron M. Gilson ◽

Ka Z. Xiong ◽

Jamie A. Stone ◽

Nora Jacobson ◽

Michelle A. Chui

Keyword(s):

Older Adults ◽

Medication Use ◽

Over The Counter ◽

Counter Medication

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Understanding the Factors Influencing Older Adults’ Decision-Making about Their Use of Over-The-Counter Medications—A Scenario-Based Approach

Pharmacy ◽

10.3390/pharmacy8030175 ◽

2020 ◽

Vol 8 (3) ◽

pp. 175

Author(s):

Shweta Shah ◽

Aaron M. Gilson ◽

Nora Jacobson ◽

Apoorva Reddy ◽

Jamie A. Stone ◽

...

Keyword(s):

Older Adults ◽

Decision Making ◽

Older Adult ◽

Medication Use ◽

Wait Time ◽

Sources Of Information ◽

Over The Counter ◽

Adult Participants ◽

Potential Risks ◽

Harmful Effects

The potential risks of over-the-counter (OTC) medications are often aggravated in vulnerable populations, such as older adults. The elevated patterns of older-adult OTC medication use do not necessarily translate into a greater understanding of these medications or their safety implications. The objective of this study was to assess how older adults’ knowledge, beliefs, and attitudes inform their decision-making regarding OTC use. Situational interviews were conducted in three community pharmacies with 87 older-adult participants to capture how they intended to use an OTC medication. The interviews were transcribed and qualitatively analyzed, generating seven key themes: (1) medication use concerns; (2) following label instructions; (3) wait time until medication effect; (4) responses to medication not working; (5) decision to stop medication; (6) sources of information; and (7) safety implications. This study shows substantial variations in older-adult OTC medication use while providing insight on factors that influence older adults’ appropriate OTC medication use and, in some cases, the potential for harmful effects.

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