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.
Mehuys
Els
E
Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium. els.mehuys@ugent.be
Van Bortel
Luc
L
De Bolle
Leen
L
Van Tongelen
Inge
I
Remon
Jean-Paul
JP
De Looze
Danny
D
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