Self-medication of upper gastrointestinal symptoms: a community pharmacy study.
BACKGROUND
Upper gastrointestinal (GI) symptoms are a common reason for self-treatment with over-the-counter (OTC) medication. However, data are scarce on the typology of GI complaints for which individuals seek self-medication and, more importantly, on the prevalence of alarm symptoms in this population.


OBJECTIVE
To investigate: (1) the nature of GI symptoms that people intend to self-medicate, (2) prevalence of alarm symptoms, (3) adherence to referral advice given by the pharmacist, and (4) self-reported efficacy and frequency of use of OTC medication for minor complaints.


METHODS
This descriptive study was performed in 63 community pharmacies. Participants (N = 592, aged 18-82 y) completed a questionnaire to assess symptom characteristics and previous medical consulting. Based on this information, the pharmacist referred subjects to a physician or advised self-treatment. Four weeks later, participants were presented a follow-up questionnaire evaluating their adherence to referral advice or efficacy of self-treatment.


RESULTS
The most frequently reported GI symptoms were burning retrosternal discomfort (49.2%), acid regurgitation (53.2%), and bothersome postprandial fullness (51.2%). At least one alarm symptom was present in 22.4% of the individuals, with difficulty in swallowing being the most prevalent (15.4%). Although 21% of the customers were referred, only 51.7% of these contacted a physician. Almost all (95.1%) of the remaining customers who were advised self-treatment reported symptom relief with the OTC drug obtained.


CONCLUSIONS
Mild GI symptoms will mostly resolve with self-treatment. Yet, the value of pharmacist counseling on OTC treatment should be recognized, as community pharmacists can play an important role in distinguishing symptoms that warrant further medical examination.
Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium. els.mehuys@ugent.be
Els
E
Mehuys
Luc
L
Van Bortel
Leen
L
De Bolle
Inge
I
Van Tongelen
Jean-Paul
JP
Remon
Danny
D
De Looze
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D037001:Directive Counseling / Q000592:standards; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012017:Referral and Consultation; D012651:Self Medication / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
D004366:Nonprescription Drugs