Misuse of medication
Dirk J Booysen
Introduction.
The extent of the problem of medication misuse can perhaps be realised most fully when considering that it involves not only prescribed drugs and medications, but also polypharmacy (using more than one drug concurrently), self-diagnosis which leads to over the counter (OTC) self-medication or the dispensing of medication by a pharmacist without an accurate diagnosis or recommendations for the correct use of the medication, and the nonmedical use of prescription pain relievers and other medications. All medication and drugs carry risks and, if these risks are not managed by a health care professional such as a doctor or specialist, they can be harmful and even life threatening to a person.
The Concise Oxford English dictionary (2006:915) defines misuse as “use wrongly.” When a person takes any legal prescription medication for a reason other than the purpose for which it has been prescribed, is regarded as the misuse of medication. Additionally, if a person takes any medication not specifically prescribed for him or her, or takes medication or drugs not in the manner or dose as prescribed by a health care professional, he or she is misusing the medication because, in fact, he or she is treating him- or herself.
This essay highlights some of the complexities of the problem of medication misuse, concluding with the misuse of topical OTC and prescription ophthalmic drugs.
Misuse of prescription medication.
The misuse of medication and drugs as prescribed by a health care provider involves three aspects, namely, compliance, adherence, and concordance. Compliance is the degree to which a patient follows the prescribed regimen of medicines; adherence refers to the degree to which a patient follows the rules, guidelines and recommendations from a health care professional; and concordance pertains to the agreed upon opinions, actions and recommendations between the patient and prescriber or
Cited: Armstrong, R. A. (2003, June). Bug Eyed. The Microbiologist , 26-29. Aston University. (2009, March). Monitoring concordance with and responses to treatment. OP4OT1 lecture notes . Birmingham, United Kingdom: Aston University. Bartlett, J. D., & Jaanus, S. D. (1995). Clinical Ocular Pharmacology (Third ed.). Boston: Butterworth-Heinemann. Bonini, S., Rama, P., Ozli, D., & Lambiase, A. (2003). Neurotrophic keratitis. Eye , 17, 989-995. Chien, K. H., Lu, D. W., & Chen, J. T. (2009). Extensive skin pigmentation after latanoprost treatment. Cutan Ocul Toxicol , 28, 185-187. Conn, V. S. (1992). Self-management of over-the-counter medications by older adults. Public Health Nursing , 9 (1), 29-36. Fleiszig, S. M., Evans, D. J., Do, N., Vallas, V., Shin, S., & Mostov, K. (1997). Epithelial cell polarity affects susceptibility to pseudomonas aeruginosa invasion and cytotoxicity. Infection and Immunity , 65 (7), 2861-2867. Fraunfelder, F. T., Bagby, G. C., & Kelly, D. J. (1982). Fatal aplastic anemia following topical administration of ophthalmic chloramphenicol. American journal of ophthalmology , 93 (3), 356-60. Goldstein, M. H., Kaowalski, R. P., & Gordon, Y. J. (1999). Emmerging flouroquinolone resistance in bacterial keratitis: a 5 year review. Ophthalmology , 106 (7), 1313-18. Hanlon, J. T., Schmader, K. E., & Samsa, G. P. (1992). A Method for assesing drug therapy appropriateness. Journal of clinical epidemiology , 45, 1045. Hurwitz, W. (2005). The Challenge of prescription drug misuse: a review and commentary. Pain Medicine , 6 (2), 152-161. Kadri, R., Hedge, S., Kudva, A. A., & Achar, A. (2010). Over the counter ophthalmic drug misuse, are we aware? Online Journal of Health and allied sciences , 9 (2), 1-3. Kadri, R., Hedge, S., Kudva, A. A., Achar, A., & Shenoy, S. P. (2011). Self-medication with over the counter ophthalmic preperations: is it safe. Int J Biol Med Res , 2 (2), 528-530. Karpecki, P., Paterno, M. R., & Comstock, T. L. (2010). Limmitations of current antibiotics for the treatment of bacterial conjunctivitis. Optometry and vision science , 87 (11), 908-919. Pawaskar, M. D., & Balkrishnan, R. (2007). Switching from prescription to over the counter medications: a consumer and managed care perspective. Managed care interface , 20 (1), 40-41. Royal Pharmaceutical Society of Great Britain. (1997). From Compliance to concordance: achieving shared goals in medicine taking. London: RPS. Soparkar, C. N., Wilhelmus, K. R., Koch, D. D., Wallace, G. W., & Jones, D. B. (1997). Acute and chronic conjunctivitis due to over the counter ophthalmic decongestants. Arch Ophthalmol , 115 (1), 34-38. Sosa, A. B., Epstein, S. P., & Asbell, P. A. (2008). Evaluation of toxicity of commercial ophthalmic fluoroquinolone antibiotics as assesd on imortalized corneal and conjunctival epithelial cells. Cornea , 27 (8), 930-934. Tarn, D. M., & Flocke, S. A. (2011). New Prescriptions: How well do patients remember important information. Fam Med , 43 (4), 254-259. Webb, D. (2011, September). Avoiding drug errors in the pharmacy. The Journal of modern pharmacy , 8-11. Zarowitz, B. J. (2006). Medication overuse and misuse. Geriatric Nursing , 27 (4), 204-206.