INTERNATIONAL REPORTS

Home Medication Cabinets and Self-Medication:

A Source of Potential Health Threats?

Leen De Bolle, Els Mehuys, Els Adriaens, Jean-Paul Remon, Luc Van Bortel, and Thierry Christiaens

n the past 3 decades, 2 major trends in

I the consumption of medicines have
surfaced. First, there has been a tremen-
BACKGROUND: Data regarding the contents of home medication cabinets
(HMCs), the management of leftover medications, and the inclination of patients
dous rise in available treatments as a re- toward self-initiated treatment using nonprescription drugs are scarce.
sult of extended medical knowledge. OBJECTIVE: To evaluate the nature and safety of medication storage and intended
This has led to an increased quantity of self-medication in a general population.
available over-the-counter (OTC) as well METHODS: A cross-sectional study was conducted in 72 Belgian community
as prescribed drugs. The second trend is pharmacies. Pharmacy customers (N = 288, aged 18–80 y) were visited in their
growing public interest in health and homes by pharmacy students. The HMCs were inventoried and the participants
health products, driven by easier access were interviewed.
to health-related information and by RESULTS: A mean of 31 ± 17 (range 6–136) drug packages were identified per
drug advertising (in Europe, for nonpre- 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
scription drugs only). Both of these fac-
categories of registered medicines were nonopioid analgesics (7.2%), nonsteroidal
tors can be expected to affect an individ- antiinflammatory drugs (NSAIDs) (6.9%), nasal decongestants (3.5%) and
ual’s management of medicines and per- antinausea agents (3.2%). Despite their high prevalence, NSAIDs and non-opioid
spective of self-care and may raise analgesics did not predominate among the most frequently used drugs, whereas
concern, especially in the context of a 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
growing elderly population.
package insert was missing for 18%. Self-initiated treatment was considered for
Drugs are often stored for long peri- 56% of all drugs (over-the-counter drugs, 74%; prescription drugs, 21%).
ods at the patient’s home, and leftover Indication, dosage, or treatment duration was misjudged by only 5.2% of the
medication may later be considered for participants, but consulting the package insert was allowed. The tendency toward
self-medication, especially when only self-treatment decreased with age and with increasing number of medications
manufacturers’ standard package sizes taken daily (p = 0.002).
are used and drug repackaging to tai- CONCLUSIONS: We found large amounts of drugs per household, with a high
prevalence of analgesics and NSAIDs. Self-medication, although generally
lored amounts is not allowed (as in Bel-
acceptable in terms of indication and dosage, was commonly practiced, also with
gium). The readability of package inserts prescription drugs. Taking into account that younger people showed a significantly
(ie, drug information for patients provid- higher intention of self-medication, a sustained awareness of the risks of self-
ed by the manufacturer and enclosed in medication is warranted for the future.
the drug package) is suboptimal,1 and KEY WORDS: Belgium, home medication, self-treatment.

Ann Pharmacother 2008;42:572-9.

Published Online, 25 Mar 2008, www.theannals.com, DOI 10.1345/aph.1K533
Author information provided at the end of the
text.

572 n The Annals of Pharmacotherapy n 2008 April, Volume 42 www.theannals.com

package inserts are thought to be read by only one-third of 7. frequency of use: daily, weekly, monthly, or less ac-
patients.2 Finally, even when instructions on use are given cording to the patient;
by healthcare professionals at the time of prescription or 8. legal status: prescription or OTC;
delivery, this information may have faded from memory 9. indication according to the interviewee;
when self-initiated treatment is started.3,4 10. intended for self-medication: yes or no;
The amount of structured data available on the contents 11. daily dosage when self-medicated; and
of home medication cabinets (HMCs) and on medication 12. duration of treatment when self-medicated (until
management by the general population is limited. Reports disappearance of symptoms or an exact number of
published so far have focused on specific drug classes (eg, days).
antibiotics),5,6 or on selected subsets of patients.7-10 Several Interviewees were allowed to consult the package insert
studies have addressed the inclination toward self-initiated if it was present. Since the early 1990s, registered drugs in
treatment in the general population but were primarily fo- Europe have both a patient and a scientific package insert.
cused on drug misuse or presented data gathered from de- Whereas the former is enclosed in the drug package, the
veloping countries that cannot easily be extrapolated to latter is available only to healthcare professionals (eg, on
Western countries.11,12 We aimed to identify the content of the Internet). Self-medication was defined as the use of a
HMCs in a population not predefined, with special atten- drug on one’s own initiative, regardless of whether it was
tion to safety aspects and intended self-medication. originally prescribed by a physician. Some of these param-
eters did not apply to compounded medications (ie, drugs
Methods prepared at a community pharmacy), medical aids, food
supplements (vitamins, minerals, amino acids, and other
This cross-sectional study was performed by 72 fifth- unclassified products such as glucosamine), and comple-
year pharmacy students from the University of Ghent, Bel- mentary medicines (homeopathy and phytotherapy or
gium, as part of an obligatory 6-month community phar- herbal remedies), which were also included in the registra-
macy training finalizing their studies, between July and tion. Further data management and analysis, such as recod-
September 2005. The community pharmacies are located ing branded names to Anatomical Therapeutic Chemical
in diverse areas of Flanders (the Dutch-speaking northern (ATC) codes (using a database kindly provided by the Bel-
part of Belgium, 6.1 million inhabitants). To reach differ- gian Pharmacist Organization), reviewing legal status, and
ent types of pharmacy visitors, each student sequentially scoring the appropriateness of self-medication features,
recruited 4 persons entering the pharmacy starting at 2 dif- was performed by academic staff.
ferent time points of the day; refusals were listed anony- This study was approved by the Ethics Committee of
mously. Inclusion criteria were age between 18 and 80
the Ghent University Hospital. The patients’ identities
years, sufficient knowledge of the Dutch language, and ac-
could not be linked to the collected data as they were dealt
ceptance to being visited and interviewed. Prior to their
with on separate forms. Statistical data analysis was per-
consent, participants were informed about the purpose of
formed using SPSS 14.0 for Windows (SPSS Inc., Chicago,
the visit.
IL) software. Correlations between categorical variables
In addition to recording demographic characteristics
were investigated using Pearson (for nominal data) and
such as age, sex, family composition, education level, and
Spearman’s Rho (for ordinal data) χ2 tests. Post-hoc tests to
living environment (village; city <100,000 inhabitants; city
identify the determinant cells were done, using 1.96 as the
≥100,000 inhabitants), students were asked to describe the
critical value for the standardized residual. The dependency
condition of drug supplies at the interviewee’s home by in-
of continuous variables on categorical parameters was inves-
specting the HMC and conducting a structured interview.
tigated using univariate analysis of variance. The equality of
This involved describing the storage conditions of medica-
error variances was checked using the Levene’s test (signifi-
tion (centralized, cool and dry location, accessibility by
cance level 0.01) and the normal distribution of residuals
children or demented patients, appropriate storage temper-
was ascertained using the Kolmogorov-Smirnov Test (sig-
ature) and making a detailed inventory of all drugs present.
nificance level 0.01). A p value less than 0.05 was consid-
This inventory addressed the following parameters for
ered significant throughout the analyses.
each branded drug:
1. name and dosage;
2. number of package units; Results
3. number of expired units; DEMOGRAPHIC DATA
4. number of units stored in the original package;
5. number of units accompanied by a package insert; Of 556 sequentially recruited pharmacy visitors, 288
6. actual user: interviewee, family member, multiple (response rate 52%) matched the inclusion criteria and
family members, or animal; agreed to participate (Table 1). An overrepresentation of

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L De Bolle et al.

families with children and an underrepresentation of sin- medications were veterinary drugs; therefore, these data
gles was observed among pharmacy visitors when com- were not included in the analysis. Of all different medica-
pared with statistics for the Belgian population, and the ed- tions encountered, prescription drugs accounted for 34%,
ucation level was higher than the Belgian average.13 An 65% were OTC products, and 1% were compounded med-
equal topographic spread was reached, with 39.9% of re- ications (either prescription or OTC). In the majority of
spondents living in villages, 31.2% in smaller cities, and cases, the supply of each brand-name drug was one pack-
28.8% in larger cities. Higher age was found to be signifi- age (92%). However, storage of multiple package units
cantly associated with a lower education level (p < 0.001). was noted significantly more often with prescription drugs
than with OTC products (p < 0.001). Of all registered
GENERAL ASPECTS OF THE HOME MEDICINE CABINET medications, 91% were found in the original container and
82% were accompanied by a package insert. Twenty-one
A large majority (92.4%) of the participants kept their percent of all packages had passed the expiration date; pre-
drugs in one central spot and chose a cool and dry place scription drugs and drugs for which the indication was
for storage (89.5%). However, in 14.6% of the households, known to the interviewee were less likely to be expired
at least one medication needing refrigeration was not than OTC products (p < 0.001) or unknown medication (p
stored in the refrigerator. When evaluating the accessibility < 0.001), respectively. Not unexpectedly, an inverse corre-
by unauthorized family members, such as children or per- lation was found between frequency of use and the passing
sons with dementia, the pharmacy students found that of expiration dates (p < 0.001).
drugs were not kept in safe storage in 33.0% of house- The most frequently encountered categories of regis-
holds, irrespective of the family composition. tered medicines (classified according to the third level of
the ATC Classification) are listed in Table 2. The greatest
CONTENTS OF THE HOME MEDICINE CABINET percentage of drugs were nonopioid analgesics, mainly
simple preparations of acetaminophen (59%) and aspirin
A total of 8890 drug containers were listed, correspond- (20%). These were followed by the NSAIDs, with ibupro-
ing to a mean number of 31 ± 17 (range 6–136) packages fen (39%), diclofenac (18%), piroxicam (15%), and
per respondent. On average, 32% of these medications naproxen (10%) the main constituents. Common cold
were used by multiple members of the family, 37% were treatments such as nasal decongestants (topical or sys-
used by the interviewee, and 30% were intended for use by temic), expectorants, cough suppressants (34% dex-
another member of the family. Approximately 1% of the tromethorphan, 27% codeine derivatives), and throat
preparations were found to be commonly present in Bel-
gian home pharmacies. Domperidone was the most fre-
quently seen antinausea agent (78%), followed by meto-
Table 1. Demographic Characteristics clopramide (21%). Nonregistered products, such as com-
plementary medicines (homeopathy or phytotherapy),
Study
Participants, % Belgian medical aids (health-related nonregistered products such as
Parameter (N = 288) Population, %a test materials, certain antiseptics, physiological sodium so-
Sex lutions, and wound management products), food supple-
men 24.0 48.9 ments, and compounded medications represented 6%, 3%,
women 76.0 51.1
Age, y
3%, and 1% of the inventoried goods, respectively.
<25 9.7 29.3
25–40 18.4 20.6 INTENDED SELF-MEDICATION
41–55 29.5 21.9
56–70 21.2 15.7
We found that 56% of all drugs identified (OTC 74%,
>70 21.2 12.5
Family type prescription 21%) were considered to be used for self-
single (no children) 21.9 38.5 treatment. The tendency toward self-initiated treatment de-
family with children 47.9 40.1
creased with age from 60% among people aged 18– 40
family without children 30.2 21.4
Education levelb years, to 57%, 48%, and 36% among respondents aged
no high school diploma 30.5 44.0 41–55 years, 56–70 years, and over 70 years, respectively (p
high school graduate 27.8 32.4 = 0.002). The percentage of drugs used on the participant’s
college degree 41.7 23.6
initiative decreased from 58% in those taking 0–2 drugs dai-
a
Data for 2005.13 ly to 50% and 33% in people taking 3–5 drugs and 6 or more
b
No high school diploma = secondary school unfinished; high school
graduate = finished secondary school; college degree = succeeded
drugs every day, respectively (p = 0.002). This indicated that
in any type of higher (tertiary) education. the number of drugs taken daily was negatively correlated
with the intention to self-treat, irrespective of age.

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 Home Medication Cabinets and Self-Medication

High rates of self-medication were observed for some inated among the non-daily used drugs, next to alternative
frequently encountered categories that consist mainly of remedies (homeopathy and phytotherapy). The average
prescription drugs, such as NSAIDs, drugs for gastric ulcer number of personal medications used daily was noted to
and gastroesophageal reflux disease, corticosteroids for increase with age from 1.3 and 1.9 drugs in the younger
topical use, opioid analgesics, anxiolytics, and hypnotics groups (18– 40 and 41–55 y, respectively) to 4.6 and 6.5
(Table 2). The most popular self-administered substances drugs per day in the older age groups (56 –70 and >70 y,
within each of these categories (regardless of their legal respectively; p < 0.001) and was independent of the educa-
status) were (1) ibuprofen, piroxicam, and diclofenac; (2) tion level. These chronic medications in the elderly popu-
alginic acid and ranitidine; (3) hydrocortisone and be- lation mainly consisted of cardiovascular and psycholeptic
tamethasone; (4) codeine-containing analgesics and tra- drugs. Reflux disease treatments appeared among the regu-
madol; (5) lorazepam and diazepam; and (6) herbal reme- larly used drugs in participants older than 40 years of age.
dies (mainly valerian), lormetazepam, and zolpidem. A to-
tal of 164 packages of antibiotics (ATC category J01: INTERVIEWEES’ KNOWLEDGE OF THEIR DRUGS
antibacterials for systemic use) were encountered in 99
households visited and were intended to be used without The interviewees’ knowledge of the content of their
consulting a physician by 3.8% (11/288) of respondents. HMC was investigated in terms of indication, dosage (both
under- and overdosage), and duration of treatment. The
ACTUAL FREQUENCY OF USE
question was restricted to medicines intended for the per-
son (or for multiple family members) and used on his/her
Interviewees were asked to score their medications on a own initiative. Overall, 5.2% of these drugs were mis-
scale of actual usage frequency, ranging from daily to judged for one or more of these criteria after consultation
monthly (or less) use. Table 3 shows the most frequently of the package insert or otherwise. Table 4 shows the rates
occurring drugs within each frequency of use category and of erroneous answers per ATC category. Although nasal
per age group. Food supplements were said to be used dai- decongestants and nonopioid analgesics appeared on all 3
ly (by any member of the family) by 23.3% of all respon- shortlists as a result of their high prevalence, their scores
dents, whereas NSAIDs and nonopioid analgesics predom- were near the average of 3.6%, 2.0%, and 1.7% incorrect

Table 2. Major Constituents of the Home Medication Cabinet

Intended Self-
Medication Use, %b
Occurrence,
ATC-7 % of total OTC, Owner’s Age, y
Code Category Description (N = 8158) %a 18–55 ≥56 Total

N02 Analgesics 8.6 83.8 85.3 73.4 80.4

N02A opioidc 1.3 0.0 37.0 32.1 34.6
N02B nonopioid 7.2 100.0 93.1 83.8 89.4
M01 Antiinflammatory and antirheumatic productsd 6.9 23.3 47.4 37.2 44.0
R01 Nasal preparations 5.5 83.6 75.6 66.1 72.9
R05 Cough and cold preparationse 5.3 83.6 68.6 61.5 66.7
A03 Drugs for functional gastrointestinal disorders 4.7 78.9 76.3 68.7 74.0
A07 Antidiarrheals, intestinal antiinflammatory/antiinfective agents 3.8 96.5 85.1 80.4 83.5
D08 Antiseptics and disinfectants 3.1 100.0 93.2 83.0 89.1
R02 Throat preparations 2.7 93.8 93.1 90.8 92.4
A02 Drugs for acid-related disorders 2.7 50.7 57.1 50.0 53.4
N05 Psycholepticsf 2.6 10.2 36.8 23.4 28.9
M02 Topical products for joint and muscular pain 2.6 98.6 85.2 72.1 79.9
D06 Antibiotics and chemotherapeutics for dermatological use 2.1 85.8 70.3 60.0 66.3
J01 Antibacterials for systemic use 2.0 0.6 9.4 5.2 7.9
R06 Antihistamines for systemic use 2.0 67.5 58.4 32.4 52.5

ATC = Anatomical Therapeutic Chemical; NSAIDs = nonsteroidal antiinflammatory drugs; OTC = over-the-counter.
a
Percentage of drugs (within ATC category) available without prescription.
b
Percentage of drugs (within ATC category), intended to be used for self-medication.
c
Opioid analgesics: tramadol either alone or in combinations (ATC codes N02AX02 and N02AX52, 48%), codeine-containing combinations (ATC
code N02AA59, 46%), and tilidine (ATC code N02AX01, 6%).
d
565/566 (99.8%) were NSAIDs.
e
Expectorants and cough suppressants, alone and in combination.
f
Antipsychotics, anxiolytics, and sedatives and hypnotics (including registered herbal remedies).

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L De Bolle et al.

answers for the respective criteria (with the exception of known indication, had passed the expiration date. Yet, ex-
decongestants with regard to treatment duration). Patients cept for tetracycline,15 reports about expired drugs causing
failed to know the indication of corticosteroids and an- harmful effects (other than reduced activity) are very
tibacterials for topical use in 30% and 21% of cases, re- scarce. When asked about the indication and dosage of the
spectively. Topical chemotherapeutics (ie, acyclovir and drugs they would consider using on their own initiative, re-
penciclovir for herpes labialis) were underdosed in 18% of spondents gave roughly correct answers in almost 95% of
cases, and although counts were low, the treatment time the cases. However, it is unclear whether patients would
suggested by the patient for systemic antiinfectives was consult the package insert in real-life circumstances as
too short in more than half of the cases (5/9). well. Also, the fundamental intention for self-treatment
may have been underrated, as people might have wanted to
Discussion avoid further questions on dosage and treatment duration.
We found that topically applied drugs such as nasal decon-
Numerous drug utilization reviews have been published gestants and dermatologic corticosteroids were often mis-
in recent years. Few of them discriminate, however, be- understood. Although misuse of these drugs may rarely lead
tween prescribed and self-initiated use of drugs, and even to severe outcomes, the frequency of their adverse effects, es-
fewer provide documentation on the general intention to pecially after prolonged use, may be underestimated16,17;
self-medicate or on the nature and size of drug reserves at pharmacists should draw the patient’s attention to their cor-
people’s homes.7,10,14 This study aimed to describe the con- rect use. Another reassuring aspect of the results was the de-
tent of HMCs in the broadest sense and included data on creasing tendency toward self-initiated treatment with higher
both prescription and nonprescription drugs, as well as numbers of medication taken daily, suggesting that people
complementary remedies, from respondents of all age cat- are, to some extent, aware of the risks of combining multiple
egories. We also investigated which of these drugs were drugs, as stated also by Indermitte et al.18 On the other hand,
considered for self-medication. An additional strength of if the younger generations maintain their higher propensity
this study is that data were recorded during a home visit toward self-care, this effect may be cancelled out, resulting in
and by people well aware of the subject. an increased risk of drug interactions.
Overall, the picture drawn from this survey is not alarm- We found high amounts of drugs per household, the
ing. The storage conditions of the drug supplies were satis- most frequently encountered categories being nonprescrip-
factory in most of the family homes visited. In one-third of tion drugs (eg, nonopioid analgesics) and NSAIDs, which
the cases, drug storage could be considered unsafe, but is in accordance with previous findings.7 Although
whether this actually posed a safety issue in the given cir- NSAIDs are considered safe when used for short periods
cumstances was not further investigated. Furthermore, 1 in of time and at lower doses, their high prevalence and actu-
5 medications, especially OTC products and drugs of un- al use rates, in addition to the fact that they are commonly

Table 3. Categorization of Drugsa

Frequency of Useb
Owner’s
Age (y) Daily Weekly Monthly or Less

18–40 n = 88 n = 17 n = 397
sex hormones (15.9%); food supplements nasal preparations (29.4%); food cough and cold preparations (8.8%);
(15.9%) supplements (29.4%) analgesics (8.6%); NSAIDs (8.3%)
41–55 n = 147 n = 26 n = 464
β-blocking agents (8.8%); sex hormones drugs for acid-related disorders (11.5%); NSAIDs (10.3%); analgesics (7.1%); nasal
(8.2%); psycholeptics (7.5%); analgesics (11.5%) preparations (6.7%)
psychoanaleptics (7.5%); food
supplements (7.5%)
>55 n = 647 n = 96 n = 815
psycholeptics (7.4%); β-blocking agents analgesics (11.5%); drugs for acid- analgesics (9.3%); NSAIDs (7.4%); homeo-
(7.0%); food supplements (6.5%); related disorders (9.4%); NSAIDs pathy/phytotherapy (5.5%)
antithrombotic agentsc (6.3%); drugs (6.3%); psycholeptics (6.3%)
acting on the renin–angiotensin system
(6.3%); lipid-modifying agents (6.3%)

ATC = Anatomical Therapeutic Chemical; NSAIDs = nonsteroidal antiinflammatory drugs.

a
Analysis restricted to medications used by the interviewee (N = 2770); the most frequently occurring classes of drugs (ATC, 2nd level) are men-
tioned for each category.
b
Numbers represent the total amount of drug packages found in the specified frequency category (daily, weekly, monthly or less) and age group. Per-
centages represent the occurrence of each type of drug within that category.
c
Includes low-dose aspirin.

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 Home Medication Cabinets and Self-Medication

considered for self-medication, may be reasons for worry.19 Still, our findings agree with those of other European and
Other sources of concern are sedatives and opioid anal- North American reports, which describe a widespread use
gesics, which not only were highly prevalent in the older of vitamins and minerals.24,25 The few surveys that describe
age groups, but would often be considered for self-medica- population-based levels of use of homeopathic and herbal
tion as well. Finally, systemic antibiotics were found in remedies mention similar low percentages.26,27
one-third of the households visited. The large majority of We chose the atypical approach of performing home
participants stated that they should not be used without visits to meticulously record the contents of HMCs rather
consulting a physician, which suggests that the awareness than relying on self-reported data. As this type of sampling
among the Belgian public (as in other Northern and West- would hardly have been practicable through random digit
ern European countries) about the risks of an uncontrolled dialing, pharmacy visitors were chosen as a study popula-
use of antimicrobial drugs is reasonably high.20,21 Never- tion. Although diverse in nature, they may not be represen-
theless, one should be aware of socially desirable respons- tative of the entire population, as illustrated by the higher
es in this matter,22 and further efforts should be made to re- occurrence of households with children and higher educat-
duce leftover or standby antibiotics by prescribing tailored ed people among our respondents.13 As interviewees were
quantities. Indeed, a large-scale study by European surveil- aware of the purpose of the visit, they may have skewed
lance groups demonstrated a consistent association be- the results by cleaning their HMC before the interview, al-
tween prescribed use and self-medication with antibiotics though the frequent occurrence of expired drugs argues
left over from previous therapy.23 against this possibility. This, together with the possible
A smaller portion of the HMC consisted of food supple- higher tendency to give socially desirable responses when
ments, which were reported to be taken daily by one-fifth directly questioned by a healthcare professional, may have
of the respondents, and homeopathic and herbal remedies, produced a more flattering image of the contents of the
which were seen to be used mainly sporadically. Compar- HMCs, the frequency of actual use, and the degree of intend-
ing studies is not a straightforward task for methodological ed self-medication. This kind of bias, however, is inherent to
reasons (eg, definitions of natural medicines may vary). this type of study. Finally, the results presented here may be
influenced by a regional context: European patients face
more restrictions in obtaining medicines through higher rates
of prescription-only drugs and through the existence of a
Table 4. Participants’ Understanding of Indication, Dosage,
pharmacy monopoly on drug dispensing in half of the mem-
and Duration of Treatmenta
ber states. Also, they are less exposed to drug advertising.
Incorrect
Answers,
Nevertheless, we believe that these limitations do not com-
Criterion ATC-7 Category %b (n) promise the generalizability of our data.
Indication D06A antibiotics (topical) 30.0 (6)
D07A corticosteroids (topical) 20.7 (6) Conclusions
A03B belladonna derivatives 14.9 (7)
(ie, butyl scopolamine)
R01A nasal decongestants (topical) 5.8 (9)
This evaluation of HMCs in a general population de-
N02B nonopioid analgesics 1.4 (6) scribes high average amounts of drugs, with a high preva-
Total for all ATC categories 3.6 (115) lence of analgesics and NSAIDs. The regular lack of a safe
Daily dose D06B chemotherapeutics (topical) 17.8 (13)
R05F cough suppressants and 13.8 (4)
storage space for medicines and the frequent occurrence of
expectorants drug containers without a package insert raise concern. Al-
R06A antihistamines (systemic) 8.2 (4) though the intention for self-treatment was mostly accept-
M01A nonsteroidal antiinflammatory drugs 6.0 (11)
R01B nasal decongestants (systemic) 6.0 (5)
able in terms of indication and dosage, high rates of in-
R01A nasal decongestants (topical) 2.6 (4) tended self-medication with prescription drugs and a sig-
N02B nonopioid analgesics 0.7 (3) nificantly higher intention to self-medicate by younger
Total for all ATC categories 2.0 (55)
Treatment G01A antiinfectives (gynecological) 75.0 (3)
people represent potential health threats.
duration J01X antibacterials (mainly nitrofuran 40.0 (2)
derivatives) (systemic) Leen De Bolle MSPharm PhD, Postdoctoral Researcher, Faculty of
R01A nasal decongestants (topical) 11.5 (18) Pharmaceutical Sciences, Ghent University, Ghent, Belgium
N02B nonopioid analgesics 0.7 (3) Els Mehuys MSPharm PhD, Postdoctoral Researcher, Faculty of
Total for all ATC categories 1.7 (47) Pharmaceutical Sciences, Ghent University
Els Adriaens MS PhD, Postdoctoral Researcher, Faculty of Phar-
ATC = Anatomical Therapeutic Chemical. maceutical Sciences, Ghent University
a
Analysis restricted to drugs intended for interviewee or for multiple
Jean-Paul Remon MSPharm PhD, Professor of Pharmaceutical
members of the family and used on the interviewee’s initiative (n =
Technology, Faculty of Pharmaceutical Sciences, Ghent University
3507). Drug categories that represented at least 5% of the total of in-
correct answers for each criterion are shown. Luc Van Bortel MD PhD, Professor of Clinical Pharmacology, Hey-
b
Percentage incorrectly used items within the specified ATC category. mans Institute of Pharmacology, Faculty of Medicine and Health Sci-
ences, Ghent University

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L De Bolle et al.

Thierry Christiaens MD PhD, Professor of General Practice, De- 19. Lewis JD, Kimmel SE, Localio AR, et al. Risk of serious upper gastroin-
partment of General Practice and Primary Health Care and Hey- testinal toxicity with over-the-counter nonaspirin nonsteroidal anti-in-
mans Institute of Pharmacology, Faculty of Medicine and Health Sci- flammatory drugs. Gastroenterology 2005;129:1865-74.
ences, Ghent University 20. Grigoryan L, Haaijer-Rysjamp FM, Burgerhof JG, et al. Self-medication
Reprints: Prof. Dr. Christiaens, Department of General Practice with antimicrobial drugs in Europe. Emerg Infect Dis 2006;12:452-9.
and Primary Health Care, Ghent University Hospital, De Pintelaan
21. McNulty CA, Boyle P, Nichols T, Clappison DP, Davey P. Antimicrobial
185, B-9000 Gent, Belgium, fax 329 240 49 67, thierry.christiaens@
ugent.be drugs in the home, United Kingdom. Emerg Infect Dis 2006;12:1523-6.
22. Gordon SM, Mosure DJ, Lewis J, Brown S, McNagny SE, Schmid GP.
This work was presented, in part, as a poster at the 35th European Prevalence of self-medication with antibiotics among patients attending
Symposium on Clinical Pharmacy (Vienna, Austria, 2006) and at the a clinic for treatment of sexually transmitted diseases. Clin Infect Dis
8th Congress of the European Association for Clinical Pharmacol-
1993;17:462-5.
ogy and Therapeutics (Amsterdam, Netherlands, 2007).
23. Grigoryan L, Burgerhof JG, Haaijer-Ruskamp FM, et al. Is self-medica-
This work could not have been accomplished without the pharmacy students who tion with antibiotics in Europe driven by prescribed use? J Antimicrob
graduated in 2006 from Ghent University and their pharmacy supervisors. Their Chemother 2007;59:152-6.
help in collecting these data was invaluable. We also thank the Belgian Pharmacist 24. Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Re-
Organization for willingly providing a database containing the names, ATC classifi-
cation, and legal status of all registered drugs in Belgium.
cent patterns of medication use in the ambulatory adult population of the
United States: the Slone survey. JAMA 2002;287:337- 44.
25. Messerer M, Johansson SE, Wolk A. Use of dietary supplements and
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Croat Med J 2005;46:74-80. INTRODUCCIÓN: Los datos sobre el contenido de los botiquines caseros
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counter medication use in an older rural community: the MoVIES Pro- medicamentos y la automedicación intencionada en una población general.
ject. J Am Geriatr Soc 1997;45:158-65. MÉTODOS: Estudio transversal en 72 farmacias comunitarias belgas. Los
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2003;37:731-7. DOI 10.1345/aph.1C310 se entrevistó a los participantes.
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(6.9%), decongestivos nasales (3.5%), y procinéticos (3.2%). A pesar de
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predominaban entre los medicamentos más utilizados, mientras que los
14. Muller R. [Epidemiology of drug use in Switzerland]. Soz Praventivmed suplementos de la dieta eran usados diariamente en el 23.3% de los
1982;27:334-5. hogares. El veinte por ciento de los medicamentos estaban caducados,
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1963;184:111-3. los medicamentos disponibles (74% de los que no necesitan receta y 21%
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of use. Expert Opin Drug Saf 2006;5:783-90. consultarlas en el envase. La tendencia hacia la automedicación disminuía
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578 n The Annals of Pharmacotherapy n 2008 April, Volume 42 www.theannals.com

 Home Medication Cabinets and Self-Medication

y dosificación, era comúnmente practicada, incluso con medicamentos RESULTATS: En moyenne 31 (fourchette 6–136, écart ± 17) boîtes de
de prescripción. Teniendo en cuenta que los más jóvenes mostraron una médicaments étaient présentes par foyer, et n’étaient pas stockées de
tendencia a la automedicación significativamente mayor, es previsible façon sécurisée dans un tiers des cas. Les médicaments de prescription
que los riesgos de la automedicación supongan un problema en el futuro. représentaient 34% du total. Les catégories de spécialités médicamenteuses
le plus souvent rencontrées étaient les analgésiques non opaciés (7.2%),
Traducido por Juan del Arco les AINS (6.9%), les décongestionnants nasaux (3.5 %), et les laxatifs
(3.2%). Malgré leur prévalence élevée, les AINS et les analgésiques non
opiacés ne prédominaient pas parmi les médicaments les plus fréquemment
Armoires à Pharmacie Familiale et Automédication:
utilisés, alors que les compléments alimentaires étaient utilisés
une Source de Dangers potentiels Pour la Santé? quotidiennement dans 23.3% des foyers. Vingt pour cent des
L De Bolle, E Mehuys, E Adriaens, J-P Remon, L Van Bortel, et T Christiaens médicaments étaient périmés, 9% n’étaient pas conservés dans le
conditionnement d’origine et la notice était absente pour 18%. L’auto-
Ann Pharmacother 2008;42:572-9. initiation de traitement était considérée pour 56% de tous les médicaments
(médicaments sans ordonnance: 74%, et médicaments de prescription:
21%). Les indications, posologies et durées de traitement étaient mal
RÉSUMÉ
évaluées dans seulement 5.2% des cas, mais il était autorisé de se reférer
RAPPEL: Les données sur les contenus des armoires à pharmacie familiale à la notice. La tendance à l’automédication diminuait avec l’âge et avec
(APF), sur la gestion des médicaments non utilisés et sur l’inclination l’augmentation du nombre de médicaments pris chaque jour (p = 0.002).
des patients envers l’auto-initiation de traitements à partir de médicaments CONCLUSIONS: Nous avons trouvé d’importantes quantités de médicaments
de prescription (ou non) sont limitées. par foyer, avec une forte prévalence d’analgésiques et d’AINS.
OBJECTIFS: Evaluer la nature et la sécurité du stockage des médicaments L’automédication, bien que généralement acceptable en termes
et de l’automédication délibérée dans la population générale. d’indications et de posologies, était couramment pratiquée, y compris
METHODES: Enquête dans 72 pharmacies de ville en Belgique. Des usagers avec des médicaments de prescription. Compte-tenu du fait que les plus
des pharmacies (n = 288, âge 18–80 ans) ont été visités à leur domicile jeunes montraient une disposition plus forte à l’automédication, des
par des étudiants en pharmacie. Les APF ont été inventoriées et les avertissements réguliers sur les risques de l’automédication sont
participants interrogés. nécessaires pour l’avenir.
Traduit par Michel Le Duff

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