Nonprescription medication purchases and the role of pharmacists as healthcare workers in self-medication in Istanbul.

BACKGROUND: In Turkey, some drugs can be purchased from pharmacists without a prescription and there is no legal classification corresponding to the international term "over-the-counter drugs". The purpose of this study was to identify these non-prescribed drugs and to define the role of pharmacists in their sale and their use in primary healthcare. MATERIAL/METHODS: This cross-sectional study was carried out in Istanbul between December 1, 2003, and August 31, 2004. Seventy-three of the 901 pharmacies in two districts of Istanbul were chosen with systematic sampling, and information concerning drug sales and pharmacists' behavior regarding primary healthcare services was collected by observations as well as by interviews with the pharmacists. RESULTS: The study demonstrated that 41% of the drugs sold were non-prescribed. In pharmacies remote from healthcare institutions, remote from district centers, and in the summer seasons, the rates of non-prescribed drug sales were higher than those of prescribed drugs (Chi(2)=10.5, d.f.=1, p=0.001; Chi(2)=62.8, d.f.=1, p=0.0001; Chi(2)=23.4, d.f.=1, p=0.0001). The pharmacists stated that aside from drug sales, consumers visited them to consult about drugs, to get information on their health status, and to learn about family planning (78.1%, 72.1%, and 72.6% of the pharmacists, respectively). CONCLUSIONS: Extensive sale of non-prescribed drugs as a response to public demand, including those used for serious illnesses, has been observed in private pharmacies in Istanbul. The role of pharmacies and pharmacists in primary healthcare should be discussed more thoroughly and redefined on a legal basis.

Effect of pharmacist-led patient education on adherence to tuberculosis treatment.

PURPOSE: The purpose of this study was to assess the effect of a clinical pharmacist-directed patient education program on the therapy adherence of first-time tuberculosis (TB) patients and to identify the major pharmaceutical care needs and issues of first-time TB and multidrug-resistant (MDR)-TB patients. METHODS: In the first part of the study, first-time TB patients were randomized either to the No EDU group (n = 58) where patients received routine medical and nursing care or to the EDU group (n = 56) where patients were also provided with clinical pharmacist-directed patient education. The patient's adherence to treatment was evaluated by attendance at scheduled visits, medication counting, and urine analysis for the presence of isoniazid metabolites. In the second part of the study, the pharmaceutical care needs and issues were determined for first-time TB patients and for MDR-TB patients (n = 40). RESULTS: The adherence of patients who received pharmacist-directed patient education was greater than that of patients who did not. The attendance at scheduled visits and urine analysis for the presence of isoniazid metabolites yielded better results in respect to adherence for the EDU group (p < 0.05), while medication counting did not differ between the two groups. The major pharmaceutical care needs of first-time TB patients were for pain control, nutrient replacement, appropriate prescribing, respiratory control, and diabetic control. Similar findings were recorded for MDR-TB patients. CONCLUSION: Patients' adherence to TB treatment improved when a pharmacist provided patient education on medication use and addressed patients' pharmaceutical care issues.

Response Frequency as a Function of Remote Associational Ability, Type of Verbal Stimulus, and Serial Position of Response.

This study investigated predictions from Mednick's remote associates theory as to unusualness of response in a word association task as a function of remote associational ability (high or low scores on the RAT), the nature of the verbal stimulus (flat or steep hierarchy words), and the serial position of the response. Ss were Ohio high school students. Although high RAT scorers gave significantly less unusual responses overall than did low RAT scorers, results were interpreted as generally supportive of the theory. Low RAT scorers moved more rapidly to less frequent responses than did high RAT scorers, later responses were more infrequent than earlier responses in the sample tested, and while word-type did not in itself determine unusualness of response, it did interact with the other variables in a manner consistent with the theory.