gms | German Medical Science

Introduction: Self medication with medicines which have a certain potential for Adverse Drug Reactions or risks if not used properly is a challenge for the pharmacists who provide these medicines to their patients. To ensure patient as well as drug safety pharmacists have to identify patients who are under increased risk when using these medicines and refer them to their physician if necessary. In addition, councelling activities by pharmacists also include the evaluation of possible interactions with other medicines. This statement also refers to the recent OTC-switch of the proton pump inhibitors (PPIs) Omeprazol and Pantoprazol. Patients at risk with a long history of gastrointestinal complaints or events of gastrointestinal bleeding have to be monitored closely. Therefore, pharmacists were asked to interview patients who came into the pharmacy to buy either Omeprazol or Pantoprazol according to an interview guideline. In addition, they were asked to document the advice that they have given to their patients in a questionnaire including a self test related to gastrointestinal disorders.

Methods: Data were collected in public pharmacies in Germany using a self developed questionnaire which was checked for completeness and plausibility. Correlation analysis will be used to assess how many patients are under risk when using Omeprazol or Pantoprazol with out proper professional advice.

Results: So far, 642 questionnaires have been received from 242 pharmacies in different parts of Germany, in total 800 are expected. Preliminary results indicate that

1.

patients having stomach complaints early start self medication with PPIs even if the frequency of complaints is only once per day or week.

2.

approximately 50% of the patients who use PPIs do not have signs of stomach complaints on a regular base

3.

for approximately 54% of the patients the self test indicated that there were serious signs of gastrointestinal disorders which required a referral to a physician.

4.

more than 50% of the patients who use PPIs take at least one additional medicine that may increase the risk of gastrointestional bleeding.

Discussion and conclusion: The results clearly indicate that there is a substantial safety risk in cases where PPI are used without proper professional advice. To support the counselling of pharmacists a guideline to be integrated into the pharmacy software should be developed and introduced to make sure that patients at increased risk can be identified and treated accordingly.