Real or fake? Sourcing and marketing of non-prescribed benzodiazepines amongst two samples of people who regularly use illicit drugs in Australia.

INTRODUCTION: There is concern around non-prescribed benzodiazepine use, particularly with increasing detections of counterfeit products containing high-risk novel compounds. The aims of this study were to investigate how and which non-prescribed benzodiazepines are being sourced; forms, appearance and packaging; and awareness of risks associated with non-prescribed benzodiazepines. METHODS: Data were collected from a sample of Australians who inject drugs or use ecstasy and/or other illicit stimulants on a monthly or more frequent basis, and who reported past 6-month use of non-prescribed benzodiazepines (n = 235 and n = 250, respectively). Data were collected on source, diversion from a known/trusted prescription, product name and aesthetic characteristics for the last non-prescribed benzodiazepine obtained. RESULTS: Amongst participants who injected drugs, 71% reported that their last non-prescribed benzodiazepines were diverted from a known/trusted prescription, compared to 59% of participants who used ecstasy/other stimulants. Sourcing via cryptomarkets was rare. Across both samples, the majority reported last obtaining substances sold/marketed as diazepam or alprazolam. Participants sourcing via non-diverted means were twice as likely to obtain alprazolam. Known sourcing of novel compounds was rare. Amongst participants who used ecstasy/other stimulants, 36% reported confidence in the content/dose of non-prescribed benzodiazepines even when the source is unknown. DISCUSSION AND CONCLUSIONS: Most participants obtained substances sold as classic/registered benzodiazepines, mostly via diverted prescriptions, with a substantial minority potentially unaware of counterfeits circulating. While diverted use undeniably presents risks, tightening of prescriptions in Australia could inadvertently lead to greater supply of novel benzodiazepines as seen internationally, reinforcing prioritisation of demand and harm reduction strategies.

Four years later: Do South Africans know what pre-exposure prophylaxis for HIV is?

HIV incidence remains high among South Africans, with low uptake of preventative measures such as condom use. Pre-exposure prophylaxis (PrEP), which protects HIV-negative individuals from infection, was first introduced in SA in 2016. This study determined the knowledge of PrEP among university students (n = 282) and primary health care clinic users (n = 358) in KwaZulu-Natal, South Africa. Data were collected using a cross-sectional survey. The study population was at high-risk of HIV infection, with early age of sexual debut, multiple concurrent sexual partners and inconsistent condom usage. Only 12.3% (n = 79) stated that they had a full understanding of PrEP, which was higher among university students (9.8%; n = 63) than clinic users (2.5%; n = 16; p < 0.001). Specific PrEP knowledge was, however, low. Health Science students did not have a better knowledge than students from other faculties. Neither did users of clinics offering PrEP have a better knowledge than users of clinics not offering PrEP. Moreover, few participants (15%; n = 96) were aware of the availability of PrEP at their local clinic. Interventions to address the low level of PrEP knowledge within the population are required, to reduce the high HIV incidence.

Acenocumarol: uso, adherencia y conocimiento del usuario. Oportunidades para la Atención Farmacéutica / Acenocumarol: use, adherence and knowledge. Opportunities for Pharmaceutical Care

Objetivo: El acenocumarol se mantiene como terapia anticoagulante (TAO) de primera elección. El objetivo de este estudio es valorar y mejorar el conocimiento que sobre el medicamento tienen sus usuarios y favorecer la personalización de la Atención Farmacéutica. Método: 60 pacientes usuarios de acenocumarol de 6 farmacias de Tenerife han participado en una encuesta anónima para valorar el uso, la adherencia y el conocimiento del fármaco. Resultados: 16% de los usuarios desconoce la indicación para la que se les prescribe el anticoagulante, un 32% son pacientes sin adherencia terapéutica y existe un alto grado de desconocimiento (47%) sobre cómo actuar en caso de olvido de una toma. La duplicidad de dosis es un PRM (Problema Relacionado con el Medicamento) real para el 12% de los pacientes. El 87% usa otros tratamientos junto con el acenocumarol (antihipertensivos (24%), antihipercolesterolémicos (11%), ansiolíticos/sedantes (13%) y antiulcerosos (13%)) destacando el uso conjunto de acenocumarol y analgésicos/antiinflamatorios en el 11% de nuestros usuarios de acenocumarol lo que se identifica como un riesgo potencial grave de PRM por interacción. El 35% de los pacientes desconoce las interacciones del acenocumarol, un 70% afirma haber recibido información sobre el fármaco y sólo un 42% de los pacientes manifiesta no haber leído el prospecto. Conclusiones: Se pone de manifiesto la necesidad de mejorar el conocimiento sobre este fármaco por parte del paciente. La intervención farmacéutica mediante la dispensación activa e informada y el seguimiento fármaco terapéutico personalizado permitiría la detección y prevención de PRM durante el uso de acenocumarol.(AU)

Aims: Acenocoumarol remains the first-line anticoagulant therapy (OAT). The objective of this study is to assess and improve the knowledge that users have about this drug and advance in the personalization of pharmaceutical care. Method: 60 acenocoumarol patients from 6 Tenerife pharmacies have participated in an anonymous survey to assess the use, adherence and knowledge of the drug. Results: 16% of acenocoumarol users do not know the indication for which the anticoagulant is prescribed, 32% are patients without therapeutic adherence and there is a high degree of ignorance (47%) about how to act in case of forgetting a dose. Duplication of doses is a real DRP (Drug Related Problem) for 12% of patients. 87% of those surveyed use other treatments together with acenocoumarol (antihypertensive (24%), antihypercholesterolemic (11%), anxiolytic / sedative (13%) and antiulcer (13%)), highlighting the joint use of acenocoumarol and analgesic/anti-inflammatory in 11% of our acenocoumarol users this is identified as a potential serious risk of DRP by interaction. 35% of the patients admit that they are unaware of the possible interactions of acenocoumarol, 70% of the patients affirm that they have received information about the drug, and only 42% of the patients state that they have not read the package leaflet. Conclusions: The need to improve knowledge about this drug by the patient is highlighted. Pharmaceutical intervention through active and informed dispensing and personalized therapeutic drug monitoring would allow the detection and prevention of DRP during the use of acenocoumarol.(AU)

Research on the Health Literacy Status and Compliance Behavior of Patients with Acute Coronary Syndrome.

This study is aimed at assessing the current status of ACS patients' health literacy and medication compliance, analyzing the relationship between the two, and providing ideas for clinically improving the medication compliance of ACS patients and preventing the recurrence of cardiovascular events. ACS patients need long-term medication to prevent vascular restenosis after surgery, and bad living habits and mood swings will affect postoperative recovery, so clinical interventions are needed to help patients establish a healthy lifestyle. The effect of conventional care is not ideal. Therefore, this paper uses regression analysis to analyze the correlation between the health literacy status of ACS patients and the compliance behavior, combines the investigation and experiment to perform regression analysis and uses mathematical statistics to process data. The connection between health literacy level and compliance behavior is discovered via a study, providing a point of reference for future research.

A casemix study of patients seen within an urban Aboriginal Health Service dermatology clinic over a five-year period.

This is the largest study of Aboriginal and Torres Strait Islander dermatologic presentations to an urban specialist clinic within a community-controlled health organisation. It adds to our understanding of Aboriginal and Torres Strait Islander dermatoepidemiology. Patient files were reviewed over the five-year audit period, with age, gender, Indigenous status, diagnosis, disease category, 'new' or 'review consultation' and 'did not attend' (DNA) data recorded. Our study shows that eczema and benign, pre-malignant or malignant neoplasms are the most common presentations for urban Aboriginal and Torres Strait Islander patients. Lupus erythematosus and cutaneous infections were less prominent in comparison to data from rural and remote populations. Overall, a broad casemix of dermatologic presentations was observed. Similar to other studies, adult male patients were under-represented. Most skin malignancies were diagnosed in this cohort; this, therefore, identifies a possible target for public health intervention. A high ratio of new to review patients is consistent with the clinic offering a consultation model of care facilitated by primary health-care providers' support within Aboriginal Community-Controlled Health Service. DNA rates in this study were lower than hospital outpatient rates in a comparative study and may be attributed to specialist dermatology care being offered in a more culturally sensitive environment. The dermatology clinic at the Victorian Aboriginal Health Services (VAHS) provides a good breadth of specialist dermatology care. The community health-care model could be replicated in centres elsewhere, including interstate, to help overcome barriers to specialist dermatology care experienced by Aboriginal and Torres Strait Islander populations. Additionally, this model improves trainee exposure and understanding of Aboriginal and Torres Strait Islander health.

Difficulties in reporting purpose and dosage of prescribed medications are associated with poor cognition and depression.

Knowledge on prescribed medication is important for medication adherence. We determined the presence of cognitive impairment in neurological patients who report not to know reasons and dosages of their medication. Data from 350 patients were collected: sociodemographic data, German Stendal Adherence to Medication Score (SAMS), Montreal Cognitive Assessment (MoCA), and Beck Depression Inventory-II (BDI-II). Eighty-eight (29.0%) patients did not know the reasons for taking their prescribed medication and 83 (27.4%) did not know the doses. Sixty-three (20.8%) knew neither reasons nor dosage. The latter were characterized by higher nonadherence, higher number of prescribed medication per day, lower MoCA, higher BDI, and had more often a lower education level compared with patients who knew the reasons. The MANOVA revealed a significant multivariate effect for not knowing the reasons and not knowing the dosages of medication on MoCA and BDI. Significant univariate effects for not knowing reasons were found for depressive mood, but not for cognitive performance. Significant univariate effects for not knowing dosages were found for cognitive performance, but not for depressive mood. Inaccurate medication reporting is not solely associated with cognitive problems, but also with depression, which has to be taken into account in daily practice and research.

Encuesta de opinión a pacientes con psoriasis moderada-grave sobre la persistencia de los tratamientos biológicos / Opinion Survey on Persistence of Biologic Therapies in Patients with Moderate to Severe Psoriasis

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Medication Counselling in Older Patients Prior to Hospital Discharge: A Systematic Review.

BACKGROUND: Older patients are regularly exposed to multiple medication changes during a hospital stay and are more likely to experience problems understanding these changes. Medication counselling is often proposed as an important component of seamless care to ensure appropriate medication use after hospital discharge. OBJECTIVES: The purpose of this systematic review was to describe the components of medication counselling in older patients (aged ≥ 65 years) prior to hospital discharge and to review the effectiveness of such counselling on reported clinical outcomes. METHODS: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology (PROSPERO CRD42019116036), a systematic search of MEDLINE, EMBASE and CINAHL was conducted. The QualSyst Assessment Tool was used to assess bias. The impact of medication counselling on different outcomes was described and stratified by intervention content. RESULTS: Twenty-nine studies were included. Fifteen different components of medication counselling were identified. Discussing the dose and dosage of patients' medications (19/29; 65.5%), providing a paper-based medication list (19/29; 65.5%) and explaining the indications of the prescribed medications (17/29; 58.6%) were the most frequently encountered components during the counselling session. Twelve different clinical outcomes were investigated in the 29 studies. A positive effect of medication counselling on medication adherence and medication knowledge was found more frequently, compared to its impact on hard outcomes such as hospital readmissions and mortality. Yet, evidence remains inconclusive regarding clinical benefit, owing to study design heterogeneity and different intervention components. Statistically significant results were more frequently observed when counselling was provided as part of a comprehensive intervention before discharge. CONCLUSIONS: Substantial heterogeneity between the included studies was found for the components of medication counselling and the reported outcomes. Study findings suggest that medication counselling should be part of multifaceted interventions, but the evidence concerning clinical outcomes remains inconclusive.

Evidence on factors influencing contraceptive use and sexual behavior among women in South Africa: A scoping review.

INTRODUCTION: Contraceptive use and sexual health behavior remain a prominent public health concern in South Africa (SA). Despite many government interventions, unintended pregnancies and termination of pregnancies remain relatively high. This review aimed to map evidence on factors influencing contraceptive use and sexual behavior in SA. METHODS: We conducted a scoping review guided by Arksey and O'Malley's framework. We searched for articles from the following databases: PubMed/MEDLINE, American Doctoral Dissertations via EBSCO host, Union Catalogue of Theses and Dissertations (UCTD) and SA ePublications via SABINET Online and World Cat Dissertations, Theses via OCLC and Google Scholar. Studies published from January 1990 to March 2018 were included. We used the Population, Concept, and Context (PCC) framework and the PRISMA chart to report the screening of results. The Mixed Method Appraisal Tool (MMAT) version 11 and ACCODS tools were used to determine the quality of the included studies. RESULTS: A total of 2030 articles were identified by our search criteria for title screening. Only 21 studies met our inclusion criteria and were included in quality assessment stage. We found that knowledge of a contraceptive method, length of a relationship, sexual debut, age difference between partners availability of a contraceptive method, long waiting hours, and nurse's attitudes toward human immunodeficiency virus (HIV) positive or younger clients predict whether or not women use a contraceptive method or improve sexual behavior. CONCLUSION: There remains a necessity for improving educational programs aimed at transferring knowledge on contraceptives and sexual behavior to both women and their male counterparts, alongside the public health systems' improvements.

Attitudes toward and Barriers to Acetaminophen Use in the Chronic Pain Population: A Cross-Sectional Study.

The use of acetaminophen is recommended in pain management, particularly acute pain management, to reduce opioid utilization and opioid related adverse drug events. Acetaminophen's role in chronic pain conditions is understudied. This cross-sectional study was performed in a pain management office to explore how chronic pain patients use acetaminophen. The final study sample included 100 patients. Current users of acetaminophen were most likely to report that a doctor had recommended acetaminophen to them (86.4%) compared to ever (66.7%) and never (55.6%) users (p < .001). Patients who were recommended taking acetaminophen by a physician were 3.60 times as likely (95% CI 1.58, 8.25) to be a current or ever user of acetaminophen as compared to those who did not receive such a recommendation from their physician. There were no significant differences between current, ever, and never users on their knowledge of the maximum daily dose of acetaminophen of 4 g (p = .925). The study suggests that patients are often unaware of acetaminophen's role in the treatment of their chronic pain.

Prognostic Value of Knowledge of Cancer and Used Unconventional Therapy Methods on Quality of Life in Advanced, Metastatic Colorectal Cancer in Clinical Practice.

Colorectal cancer (CRC) is the third most common malignancy in the world and the second cause of cancer-related deaths. Despite the search for new therapeutic agents, there are still many doubts concerning the quality of life (QOL) improvement in palliative patients. In this study, we assessed the impact of oncology knowledge on QOL and the relationship between QOL and various environmental factors and unconventional treatment methods in patients with CRC treated with chemotherapy and targeted therapy. The results of first-line palliative chemotherapy in 330 patients with colorectal cancer treated between January 2010 and December 2016 in two centers were analyzed. The average age of patients was 66 ± 11.7 years. Median survival time was 25 months. In multivariate analysis, the performance status and response to treatment had a significant effect on survival time. A trend towards shorter survival was also observed in patients receiving 5-FU monotherapy, in elderly patients and in patients with less oncology knowledge. A relationship between general quality of life and performance status (PS 0 vs. PS > 0), response to treatment and oncology knowledge was found. Patients with limited oncology knowledge more often used unconventional therapy methods in parallel with the treatment. In patients over 70 years of age and in patients with worse overall condition, 5-FU monotherapy was more commonly used (p < 0.01). The level of oncology knowledge of the treated patients observed in everyday clinical practice may be related to some parameters of treatment effectiveness assessment, such as QOL and may be related to the use of unconventional treatment methods. Those, in turn may have an impact on the QOL of the treated patients.

[Validation of the "Conocimiento del Paciente sobre sus Medicamentos" (CPM-ES-ES) questionnaire]. / Validação do questionário "Conocimiento del Paciente sobre sus Medicamentos" (CPM-ES-ES).

This work cross-culturally adapted the Spanish questionnaire `Patients' knowledge about their medications ("Conocimiento del Paciente sobre sus Medicamentos" - CPM-ES-ES) for use in Brazil. It measures the level of medication knowledge by means of 11 questions. Eighty patients ≥ 80 years were investigated and in 39 cases the caregivers were interviewed. The evaluation of conceptual and item equivalences considered the concept of knowledge and the questions that assess it as pertinent. Semantic equivalence was obtained by the correspondence in the denotative and connotative meaning of items. The study of measurement equivalence included factorial analysis and the calculation of validity and reliability estimates. As with the original questionnaire, principal component analysis identified 4 components, however, in 2 of them there were differences regarding included items. One question was removed from this analysis due to its sample inadequacy. Medication knowledge was correlated with medication regimen complexity r = -.22, p = .046. Medication knowledge of antihypertensives was correlated with their adherence r = .70, p < .001, and blood pressure control rb = .46, p = .029. The adapted version revealed functional equivalence, therefore it can be used in the Brazilian context.

Este trabalho adaptou transculturalmente o questionário espanhol "Conocimiento del Paciente sobre sus Medicamentos" (CPM-ES-ES) para uso no Brasil. Ele mede o grau de conhecimento sobre medicamentos por meio de 11 perguntas. Oitenta pacientes ≥ 80 anos foram investigados e com 39 também foi entrevistado o cuidador. A avaliação das equivalências conceitual e de item considerou o conceito de conhecimento e as perguntas que o medem como pertinentes. A equivalência semântica foi obtida pela correspondência de significado denotativo e conotativo dos itens. O estudo da equivalência de mensuração incluiu análise fatorial e o cálculo de estimativas de validade e confiabilidade. Semelhante ao questionário original, a análise de componentes principais identificou 4 componentes, porém, em 2 deles houve diferenças nos itens incluídos. Uma pergunta foi removida desta análise devido à sua inadequação amostral. O conhecimento sobre medicamentos esteve correlacionado à complexidade da prescrição r = -0,22, p = 0,046. O conhecimento sobre anti-hipertensivos esteve correlacionado à sua adesão r = 0,70, p < 0,001, e ao controle da pressão arterial rb = 0,46, p = 0,029. A versão adaptada apresentou equivalência funcional de modo que pode ser usada no contexto brasileiro.

Validação do questionário "Conocimiento del Paciente sobre sus Medicamentos" (CPM-ES-ES) / Validation of the "Conocimiento del Paciente sobre sus Medicamentos" (CPM-ES-ES) questionnaire

Resumo Este trabalho adaptou transculturalmente o questionário espanhol "Conocimiento del Paciente sobre sus Medicamentos" (CPM-ES-ES) para uso no Brasil. Ele mede o grau de conhecimento sobre medicamentos por meio de 11 perguntas. Oitenta pacientes ≥ 80 anos foram investigados e com 39 também foi entrevistado o cuidador. A avaliação das equivalências conceitual e de item considerou o conceito de conhecimento e as perguntas que o medem como pertinentes. A equivalência semântica foi obtida pela correspondência de significado denotativo e conotativo dos itens. O estudo da equivalência de mensuração incluiu análise fatorial e o cálculo de estimativas de validade e confiabilidade. Semelhante ao questionário original, a análise de componentes principais identificou 4 componentes, porém, em 2 deles houve diferenças nos itens incluídos. Uma pergunta foi removida desta análise devido à sua inadequação amostral. O conhecimento sobre medicamentos esteve correlacionado à complexidade da prescrição r = -0,22, p = 0,046. O conhecimento sobre anti-hipertensivos esteve correlacionado à sua adesão r = 0,70, p < 0,001, e ao controle da pressão arterial rb = 0,46, p = 0,029. A versão adaptada apresentou equivalência funcional de modo que pode ser usada no contexto brasileiro.

Abstract This work cross-culturally adapted the Spanish questionnaire `Patients' knowledge about their medications ("Conocimiento del Paciente sobre sus Medicamentos" - CPM-ES-ES) for use in Brazil. It measures the level of medication knowledge by means of 11 questions. Eighty patients ≥ 80 years were investigated and in 39 cases the caregivers were interviewed. The evaluation of conceptual and item equivalences considered the concept of knowledge and the questions that assess it as pertinent. Semantic equivalence was obtained by the correspondence in the denotative and connotative meaning of items. The study of measurement equivalence included factorial analysis and the calculation of validity and reliability estimates. As with the original questionnaire, principal component analysis identified 4 components, however, in 2 of them there were differences regarding included items. One question was removed from this analysis due to its sample inadequacy. Medication knowledge was correlated with medication regimen complexity r = -.22, p = .046. Medication knowledge of antihypertensives was correlated with their adherence r = .70, p < .001, and blood pressure control rb = .46, p = .029. The adapted version revealed functional equivalence, therefore it can be used in the Brazilian context.

Determination of medication adherence and related factors among people living with HIV/AIDS in a Turkish university hospital

Background/aim: Widespread use of antiretroviral treatment (ART) has led to decrease in the incidence of HIV/AIDS-related mortality. Besides the availability of ART, medication adherence is essential for treatment success. There is a scarcity of data reported from Turkey regarding ART adherence among people living with HIV/AIDS (PLWHA). Therefore, this study was undertaken to determine medication adherence and related factors among PLWHA in Turkey. Materials and methods: The sample consisted of 158 PLWHA, who were being followed up at Infectious Diseases Outpatient Clinic of Hacettepe University Hospital. Data were collected using an individual questionnaire and the Turkish version of the Morisky Medication Adherence Scale. Results: The median patient age was 38 years, 80.4% were male, and 51.3% were married. The median duration of both HIV infection and ART was 3 years. Sixty-one percent used two drug regimens. Sixty-one percent were highly adherent to ART while 37.9% were moderately adherent. The absence/presence of social support resources, disease duration, ART duration, and being informed about the ART regimen were statistically associated with medication adherence. Conclusion: Our results suggest that medication adherence is excellent among Turkish PLWHA. Interventions, including effective social support, and continuous counseling about ART, might further boost the adherence of PLWHA

Willingness to Change Medications Linked to Increased Fall Risk: A Comparison between Age Groups.

OBJECTIVE: To describe and compare two age groups' knowledge of medications linked to falls and willingness to change these medications to reduce their fall risk. METHOD: We analyzed data from community-dwelling adults age 55 and older (n = 1812): 855 adults aged 55 to 64 years and 957 older adults (65 and older) who participated in the 2016 summer wave of the ConsumerStyles survey, an annual Web-based survey. The data are weighted to match the US Current Population Survey proportions on nine US Census Bureau demographic characteristics. MEASUREMENTS: Survey respondents were asked about medication use, knowledge of side effects, their willingness to change their medications to reduce fall risk, communication in the previous year about fall risk with their healthcare provider, and their comfort in discussing fall risk with their healthcare provider. All data were weighted to match the 2016 population estimates. Descriptive statistics and χ2 (p ≤ .05) were used to identify differences between the two age groups. RESULTS: About one-fifth of all respondents reported using at least one class of medication that increases fall risk. Older adults were less likely to report using medications for mood or sadness, less likely to report knowing the side effects of pain medications, and more willing to change their sleep medications compared with their younger counterparts. Among all respondents using these medication classes, less than one-third knew the potential fall-related side effects. However, most of them expressed willingness to change their medication if advised by their healthcare provider. CONCLUSION: Most older adults were unaware of potential fall risks associated with medications prescribed to address pain, difficulty sleeping, mood or sadness, and anxiety- or nervousness-related health issues. However, most were willing to change their medication if recommended by a healthcare provider. J Am Geriatr Soc 67:527-533, 2019.

Warnings for drug-drug interactions in consumer medication information provided by community pharmacies.

OBJECTIVES: In 2006, the U.S. Food and Drug Administration (FDA) issued a draft guidance for pharmacies to provide consumer medication information (CMI) to patients receiving prescription medications. The objective of this study was to evaluate CMI leaflets provided by community pharmacies for accuracy and completeness regarding drug-drug interactions (DDIs). METHODS: CMI leaflets were obtained for 3 commonly prescribed medications (azithromycin, ciprofloxacin, and simvastatin) from 14 community pharmacies that are part of 6 chain organizations that operate in southern Arizona. Three to 4 salient interacting medications for each leaflet medication were identified with the use of 2 well recognized drug compendia. The content of the DDI information in the leaflets was evaluated for completeness. The font size and reading level of each leaflet were assessed as well. RESULTS: The CMI provided by 14 pharmacies appeared to be produced by 2 information vendors, Wolters Kluwer and First Databank. This was evident based on the identical wording and attribution (e.g., copyright statements) on the leaflets. The CMI from First Databank mentioned 5 of the 11 previously identified interactions with the target medications, although 1 chain in this group chose not to print the DDI section at all and as a result scored 0. The CMI developed by Wolters Kluwer mentioned only 2 of the 11 identified DDIs. The average reading grade level for First Databank leaflets was 10.6 (SD 2.87), and the reading level for the CMI from Wolters Kluwer was 5.0 (SD 1.02). The font sizes varied from 8 to 12 points; FDA recommends that the information be printed in 12-point size or larger. CONCLUSION: Community pharmacies appear to be distributing CMI leaflets with limited warnings about serious and well known DDIs. The results of this study suggest that consumers are not being informed through the CMI about important known DDIs.

Satisfaction with medical support in women with endometriosis.

Endometriosis affects various aspects of women's lives. We searched for predictors for patient satisfaction with medical support (PSwMS) in women with endometriosis. The study was designed as a multi-centre retrospective cohort study. We approached women with histologically confirmed endometriosis from 2010 until 2016, comparing women satisfied to women dissatisfied with medical support. We analysed data on characteristics of endometriosis, PSwMS and the influence of disease characteristics on PSwMS. Information on satisfaction with medical support was collected through a standardized questionnaire. After exclusion of 73 women because of inchoately filled in questionnaires, data from 498 women was evaluated. Altogether, it was observed that 54.6% (n = 272) of the study participants were satisfied with medical support and 45.4% (n = 226) were not. Feeling adequately informed by the time of diagnosis (p < 0.001), taking women's mental troubles seriously (p < 0.001) and supporting women in handling their pain (p < 0.001) were significantly associated with satisfaction. We found adequate information to be the most distinctive indicator for PSwMS. Further, acknowledging psychological distress and supporting women in handling their symptoms rather than to alleviate them, positively affect PSwMS. To achieve PSwMS, healthcare providers have to give adequate information on endometriosis and its management.

Use of Self-Medication with Homeopathy in Germany: Results of an Online Questionnaire Survey.

BACKGROUND: Little is known about self-medication with homeopathic drugs in Germany. The aim of this study was to gain information about users, sources of information and the selection process of the drugs. METHODS: An online questionnaire survey among users of self-medication with homeopathy was conducted via social media and email newsletters. RESULTS: A total of 665 users who responded to the questionnaire were included. Most of the respondents were women (92%) in their mid-forties with high educational status. In total, 43% of the participants reported a household member working in the health sector. Books (65%) and Internet (47%) were the most common sources of information. Consultations in pharmacies - with a mean duration of 10 min - were likely to be used (60%). Homeopathic drugs were mainly used in the potency D12 (55%), for a duration of 5 days, 3 times daily, with 5 globules. Homeopathic drugs were mainly used due to good therapeutic experiences in the past (82%). Indications for use were acute diseases (91%), particularly colds (86%), as well as chronic diseases (51%) and prevention (47%). The selection of a homeopathic drug took the participants 25 min on average. CONCLUSION: Homeopathic self-medication is understood by users as a resource to regain, maintain, and promote health. Further research about the quality and applicability of information for homeopathic self-medication is necessary.

Patient satisfaction with information on oral anticancer agent use.

Adequate information on oral anticancer agent (OACA) use is an essential element of optimal cancer care. The present study aimed to get insight into the experiences of patients with information on OACA treatment and their characteristics regarding information dissatisfaction. Patients of four Dutch university hospitals using OACA participated in this observational study and completed the Satisfaction with Information about Medicines Scale (SIMS), EORTC Quality of Life Questionnaire-C30, Brief Illness Perception Questionnaire, and Beliefs about Medicines Questionnaire-Specific. Logistic regression analyses were used to determine factors associated with dissatisfaction with information. Patients (n = 208) using capecitabine (35%), lenalidomide (15%), imatinib (14%), temozolomide (12%), sunitinib (11%), thalidomide (5%), dasatinib (4%), erlotinib (2%), and nilotinib (2%) participated. Information on the following SIMS-items was inadequate: how OACA elicit their effect, how long it takes before treatment works, how to conclude that treatment is effective, the risk of side effects and its management, interference with sex life, drowsiness, interference with other medication and alcohol and what to do in case of a missed dose. Younger age, hematological malignancy, dyspnoea, positive perception of consequences of the cancer, low perception of treatment control, and indifferent attitude towards OACA were associated with dissatisfaction with information. In conclusion, a considerable number of patients would have appreciated receiving more information on specific issues relating to the consequences of OACA treatment such as the effects and side effects of OACA and the interference of treatment with various aspects of their daily life. Oncologists, hematologists, lung-oncologists and pharmacists may reconsider the provision of information on OACA treatment.