Academic journal article Canadian Journal of Public Health

Factors Associated with the Use of Over-the-Counter Medications in Cases of Acute Gastroenteritis in Hamilton, Ontario

Academic journal article Canadian Journal of Public Health

Factors Associated with the Use of Over-the-Counter Medications in Cases of Acute Gastroenteritis in Hamilton, Ontario

Article excerpt

ABSTRACT

Background: Monitoring over-the-counter (OTC) medication sales may provide an accurate, reliable way to observe trends and detect aberrations in community health status. This study assessed demographic and symptomatic factors associated with the use of OTC anti-nauseants (AN), anti-diarrheals (AD), and rehydration therapies (RT) in cases of acute gastroenteritis (GE).

Methods: Data on 351 cases of self-reported, acute GE obtained from a population-based telephone survey were analyzed. The four outcomes of interest were use of an OTC 1) AD, 2) AN, 3) RT, and 4) use of at least one of the three. The association between each factor of interest and the use of OTC treatments was assessed.

Results: Of the 351 cases, 110 (31%) used at least one OTC AD, AN, or RT for their illness. The most significantly associated factor was primary symptom group: cases with both vomiting and diarrhea were 3.6 times more likely to use at least one of the three OTC medications than cases with either vomiting or diarrhea only. Other factors associated with the use of at least one OTC were being female (OR=1.97), being 10-14 years of age (OR=11.22), and use of antacids in the 28 days prior to illness (OR=2.31).

Conclusion: This study provides the first published assessment of factors associated with the use of OTC medications by community cases of GE. Those who use OTC medications for their illness appear to differ from those who do not. This information can inform health officials, and aid development of pharmacy-based syndromic surveillance.

MeSH terms: Gastroenteritis; antidiarrheals; fluid therapy; signs and symptoms; drugs, non-prescription

Gastroenteritis (GE) is a significant cause of morbidity in Canada.1-3 Traditionally, clinical surveillance data have been the main source of information for estimating the incidence of GE. However, due to under-reporting, these data only represent a small proportion of cases actually occurring in the community.1 In addition, a significant lag time exists between onset of illness and notification of health officials via these clinical health surveillance systems.4

Other health surveillance strategies may reduce the time between onset of illness and public health notification, enabling faster response. For example, monitoring over-the-counter (OTC) sales of pharmaceuticals may provide an accurate, reliable way to observe trends and detect aberrations in community health status.4'7 OTC medication sales have been related to epidemic curves4 and clinical health data,5 and they provide an earlier indication of the development of public health conditions than that which is provided by physician consultation and hospitalization records.4,7 One drawback is that OTC medication sales information does not necessarily indicate the buyer's location, their demographic status, or the reason for the purchase. As well, it is possible that those who purchase OTC medications for their illness may not be representative of the sick population as a whole.

From February 2001 to February 2002, the Public Health Agency of Canada (formerly Health Canada) performed a population-based survey to describe selfreported, acute GE in the population of Hamilton, Ontario.2 This was a retrospective, telephone survey with a response rate of 36.6%. Of the 3,496 respondents, 351 (10.04%) reported acute GE (diarrhea or vomiting) in the 28-day period prior to the interview. Using data from this survey, the purpose of this study was to identify the demographic and symptomatic factors associated with OTC medication use, specifically anti-diarrheals (AD), antinauseants (AN), and rehydration therapies (RT), in individuals reporting acute GE.

METHODS

Data

The survey from which the data were obtained has been described in detail elsewhere.2 We analyzed data from the 351 respondents who reported acute GE in the 28 days prior to interview. The outcomes of interest were whether or not the respondent used an OTC AD, AN, or RT because of their illness. …

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