title: Use of over-the-counter medications and natural products in patients with moderate and severe chronic renal insufficiency.
abstract: BACKGROUND
  Use of over-the-counter medications and natural products may be associated with drug-related problems among patients with chronic renal insufficiency. The aim of this study is to describe the use of nonprescription medications in patients attending a predialysis clinic and identify drug-related problems associated with the use of these products.
  
  
  METHODS
  In a 6-month cluster randomized controlled trial, patients with moderate (n = 46) and severe (n = 41) chronic renal insufficiency were interviewed over the telephone at baseline by a community pharmacist to document their use of over-the-counter medications and natural products. The safety of each product was assessed, and drug-related problems were identified independently by 2 pharmacists.
  
  
  RESULTS
  Overall, 83% (95% confidence interval [CI], 72 to 94) of patients with moderate chronic renal insufficiency and 68% (95% CI, 54 to 83) with severe chronic renal insufficiency reported using at least 1 over-the-counter medication. Contraindicated over-the-counter medications were reported by 9% of patients. Natural products were used by 22% (95% CI, 10 to 34) and 29% (95% CI, 15 to 43) of patients with moderate and severe chronic renal insufficiency, respectively. Similarly, 3% of patients reported using at least 1 contraindicated natural product. Patients had consulted a health professional for 49% of over-the-counter medications and 19% of natural products. Overall, 65 drug-related problems were identified.
  
  
  CONCLUSIONS
  The use of over-the-counter medications and natural products is highly prevalent in patients with chronic renal insufficiency and often is associated with a drug-related problem. These results emphasize the importance for community pharmacists to closely monitor the use of these products in patients with chronic renal insufficiency.
authors.affiliation: Sanofi-Aventis Endowment Chair in Ambulatory Pharmaceutical Care, Faculty of Pharmacy, University of Montreal, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Laliberté
authors.forename: Michelle
authors.initials: M
authors.lastname: Normandeau
authors.forename: Anne
authors.initials: A
authors.lastname: Lord
authors.forename: Diane
authors.initials: D
authors.lastname: Lamarre
authors.forename: Isabelle
authors.initials: I
authors.lastname: Cantin
authors.forename: Djamal
authors.initials: D
authors.lastname: Berbiche
authors.forename: Louise
authors.initials: L
authors.lastname: Corneille
authors.forename: Louis
authors.initials: L
authors.lastname: Prud'homme
authors.forename: Lyne
authors.initials: L
authors.lastname: Lalonde
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001688:Biological Products / Q000008:administration & dosage* / Q000009:adverse effects; D003157:Community Pharmacy Services; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000008:administration & dosage* / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy / Q000453:epidemiology*; D012651:Self Medication / Q000009:adverse effects; D012720:Severity of Illness Index
chemical_list: D001688:Biological Products; D004366:Nonprescription Drugs