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Many Consumers Misuse Nonprescription Medicines

Donna Young

One third of adults in the United States have taken more than the recommended dosage of a nonprescription medicine, according to the results of a survey sponsored by the National Council on Patient Information and Education (NCPIE).

Also, 59 percent of adults have used a nonprescription medicine in the past six months. Of those who used a nonprescription medicine to relieve a headache, 66 percent could not correctly identify the active ingredient in that product.

NCPIE, a nonprofit coalition of health care-related organizations, commissioned the survey to find out how well U.S. adults understand and process information about nonprescription medicines. Release of the survey results was timed to coincide with the launch of a public education campaign.

The telephone survey, conducted by Harris Interactive, consisted of two polls designed to determine the attitudes and beliefs of the general public and those of health care practitioners.

Between Oct. 25 and Nov. 11, 2001, Harris polled 1,011 adult consumers, age 18 or older. The second survey polled 151 pharmacists, 150 nurses, and 150 general practice physicians between Nov. 17 and December 7.

Harris found that consumers are more likely to read a label for dosage instructions when taking a nonprescription drug product for the first time. But only one in 10 consumers reads the label for possible adverse effects or usage warnings when he or she takes the product for the first time.

Consumers who had taken more than the recommended dosage of a nonprescription medicine did so for the following reasons:

  • The high dosage was believed to bring relief more quickly (69 percent),
  • The recommended dosage did not bring relief (64 percent), and
  • The nonprescription product contained the same ingredients as a previously taken prescription (38 percent).

Slightly more than half of the adults said incorrectly that the dosage of a nonprescription medicine for a child younger than 12 should be based on age and weight, rather than weight alone. A similar percentage also said incorrectly that nonprescription medicines for infants are less concentrated than formulations for older children.

Nearly 40 percent of the adults said they have received information about nonprescription products from pharmacists, and 47 percent reported they received the information from physicians.

Among those adults who said they did not receive information about nonprescription drugs from a health care professional, the most often-mentioned reason was a lack of access.

Of the health care professionals surveyed, 65 percent reported spending more than a minute discussing nonprescription medicines with patients. However, physicians tended to spend less time than pharmacists or nurses discussing nonprescription products with patients.

Forty-two percent of the health care professionals said they rely on product labels to learn about nonprescription medicines.

The Food and Drug Administration (FDA) and the National Council on Patient Information and Education (NCPIE) have launched a public education program on the safe use of nonprescription medications.

A television commercial, a new Web site, brochures, and other publications are being used to tell Americans about the risks and responsibilities of taking nonprescription medicines, said W. Ray Bullman, NCPIE’s executive vice president.

Bullman, at a press conference Tuesday in Washington, D.C., said NCPIE and FDA have timed their "Be MedWise" campaign to coincide with the changeover to the new standardized labels on most nonprescription medicines. A 1999 FDA regulation requires conversion to the standardized format by this May.

The new labels tell consumers to "Ask a doctor or pharmacist" if they have questions about possible drug or food interactions.

Prominent on the new labels is a "Drug Facts" box that lists a product’s active ingredients and the purpose for each, followed by uses, warnings, directions, and inactive ingredients. This information must be printed in type large enough to be easily read and use other graphical elements, such as bullets, to improve readability. Technical words like "precautions" and "contraindications" should no longer appear on the labels, according to FDA.

Linda M. Katz, a physician and deputy director of the FDA group that oversees nonprescription products, said the typical label does not have enough space to include information about drug interactions. But that limitation "doesn’t preclude" drug companies from publishing consumer-oriented pamphlets with information on possible interactions and warnings about adverse events, she said.

The American Society of Health-System Pharmacists (ASHP) and other pharmacy groups had strongly urged FDA, when it was developing the regulation on the new labels, to add "pharmacist" as an information source for consumers who have questions about nonprescription drug use.

ASHP is a member of NCPIE.