Home medication cabinets and self-medication: a source of potential health threats?

Abstract

Background: Data regarding the contents of home medication cabinets (HMCs), the management of leftover medications, and the inclination of patients toward self-initiated treatment using nonprescription drugs are scarce.

Objective: To evaluate the nature and safety of medication storage and intended self-medication in a general population.

Methods: A cross-sectional study was conducted in 72 Belgian community pharmacies. Pharmacy customers (N = 288, aged 18-80 y) were visited in their homes by pharmacy students. The HMCs were inventoried and the participants were interviewed.

Results: A mean of 31 +/- 17 (range 6-136) drug packages were identified per household; in one-third of the cases, the packages were not stored safely. Prescription drugs accounted for 34% of the total. The most frequently encountered categories of registered medicines were nonopioid analgesics (7.2%), nonsteroidal antiinflammatory drugs (NSAIDs) (6.9%), nasal decongestants (3.5%) and antinausea agents (3.2%). Despite their high prevalence, NSAIDs and non-opioid analgesics did not predominate among the most frequently used drugs, whereas food supplements were used daily in 23.3% of households. Twenty-one percent of the drugs were expired, 9% were not stored in the original container, and the package insert was missing for 18%. Self-initiated treatment was considered for 56% of all drugs (over-the-counter drugs, 74%; prescription drugs, 21%). Indication, dosage, or treatment duration was misjudged by only 5.2% of the participants, but consulting the package insert was allowed. The tendency toward self-treatment decreased with age and with increasing number of medications taken daily (p = 0.002).

Conclusions: We found large amounts of drugs per household, with a high prevalence of analgesics and NSAIDs. Self-medication, although generally acceptable in terms of indication and dosage, was commonly practiced, also with prescription drugs. Taking into account that younger people showed a significantly higher intention of self-medication, a sustained awareness of the risks of self-medication is warranted for the future.