Over the counter medications, a silent killer | By Dr Asif Maqsood Butt

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Over the counter medications, a silent killer


HEALTH is a state of complete physical, social and mental wellbeing and not merely the absence of a disease or infirmity.

We Asians are living with the history more than 100 years of ayurvedic and herbal medicines.

We are still strongly following them and have firm belief in these traditional ways of treatment. Certain incidences have put greater impact in our minds.

it is seen that if any of us are suffering with any condition or a disease, a majority deliberately or non-deliberately verifies a consultant’s or a qualified physician’s credibility as well as the medications with a medical store operating manager.

It is also seen that to purchase medicines that have not been prescribed by verified healthcare provider are raising critical concerns in Pakistan.

In the developed countries it is seen that the medicine sale and over the counter medicine are controlled and categorized efficaciously, it is a piece of cake to buy any sort of medicine in Pakistan.

Self-medication and the convenience to buy over-the-counter medicines as per the desire, there are many critical outcomes like addiction, withdrawal effects, resistance, chronicity & complications, adverse drug interactions, and hypersensitivities are common.

My personal observation is that this might be because of people’s affordability issue of doctors fee but contrary people might be ignoring the developing unseen complications and side effects that can produce disastrous effects.

But there are one more behaviour that is being observed; deliberate short listing of medicines, non-compliance and very low follow-up.

They shortened the course of medication or start hoping from one to another with the same kind of attitude (in case of non-relieved) rather ensuring compliance of treatment with appropriate follow up and sufficient time required the condition/disease to resolve/cure.

There were reportedly 70?000–80?000 unqualified quacks doing practice in different areas; in the most populous province of Punjab, involved in illegal medical practice and a vast majority of low income population visit to these quacks due to their low consultancy charges.

In most cases, Fake herbalists, homeopaths, and so-called traditional healers use steroids to provide rapid relief, this behaviour leads to misdiagnosis, serious medication errors, and spread of infections, resistance and masking of disease / underlying condition or illness.

According to WHO, if effective control measures against drug resistance are not ensured, this could lead to 10 million people’s death each year by 2050.

There are high numbers of deaths about 500,000 people, including women and children, die each year due to medication errors in Pakistan.

The occurrence of widely drug-resistant typhoid should be considered a warning of pushing back the world to the pre-antibiotic era due to overuse of antibiotics.

During the Covid-19 which had a severe mental distress pushed the people for certain precautionary measures, despite an extensive awareness campaign by the health ministry and allied departments were carried out.

Despite that the extensive and irrational use of antibiotics especially those which are spared for resistant typhoid; are being used at a very large quantity by the entire nation.

Similarly, the unnecessary and irrational use of antibiotics in self-limiting viral infections is causing antibiotic resistance, especially in children.

People prefer to take antibiotics over encountering a fever spike with prodromal symptoms which might be due to viral infection or seasonal allergy.

Patients could be at risk of developing serious complications during dengue virus outbreaks because of self-medication of non-steroidal anti-inflammatory drugs and aspirin, these medicines are used in rural areas for general fever and pain management. Unfortunately, Pakistan is lagging behind in various aspects.

By integrating public and private integrated model we can make our general physicians first line of defence for communicable & non-communicable diseases and to provide whole person care “holistic care”.

The suggested points are:

1. A family physician/general practitioner should be a 7-star doctor ie he should be a Leader, Researcher, good Communicator, and Manager, Care provider Altruistic and Empathetic & lifelong self-directed Learner.

2. The role of research can change the way of treating the patients dramatically.

3. They should act as a disease Screening Officer for the community instead of focusing more on treatment.

By this way they will be able to foresee the upcoming burden of diseases and can play a major role in prevention of many epidemics.

4. For timely and remedial measures by Health Department family physicians must be supported and given proper facilitation in a way that a software should be developed in which all the data regarding screenings & surveys and it must be interlinked with the health department at all levels.

An innovation project is under development by the author which shall be in a mature phase very soon. 5. Inculcating public health culture amongst family physicians/general practitioners that at least to start their private practice they must have at least a certificate of public health as they are more involved with the community problems.

However, the imposition of regulations regarding medicines of concern should be extended across the country.

Over-the-counter medicines should be classified uniformly across the country and should be monitored electronic database to minimize the irrational use of drugs.

All non-certified health care providers “quacks” practicing without appropriate permission must be dealt with irony hands and compact policies.

Sale of specialized medications should be linked with doctor/consultant prescriptions only.

GP’s are only being allowed to prescribe first aid medications and shall remain within the domain of primary care physician and they must do referral of complicated and serious cases to consultant after complete assessment.

Primarily, general public’s awareness about the associated complications and risks in over the counter medication as well as the importance of receiving medical treatment from certified medical practitioners should be bound with law & enforcement.

People must be educated, regarding the hazardous effects of treatment received from a quack and severity of complications associated with over the counter medications; could result into a painful memory for the whole life. May Allah bless us all with healthy life. Ameen

—The writer, RCGP (International Affiliate), Gold Medalist Innovation, is associated with Holy Family Hospital, Rawalpindi.