Developing a latent class analysis model to identify at-risk populations among people using medicine without prescription

ABSTRACT

Introduction

There exist limited strategies to address the issue of topical medication without prescription (MWP) use.

Material and methods

A survey with pre-coded questionnaires was conducted with 210 patients following up in the dermatology clinic of a tertiary care center. The knowledge and attitude scores were regressed against demographics and exploratory practice questions, and latent class analysis was carried out to check any particular set of characteristics associated with study subpopulations.

Results

Forty-seven (22%) participants were found using topical antimicrobial containing MWP. Participants with good knowledge score had 3.41 (95% C.I. = 1.68–7.33), 2.99 (1.37–6.73), and 2.49 (1.26–5.15) times association with opting of distance as the prime reason for availing topical MWP, habit of always reading the accompanying drug leaflet, and understanding that OTC topical medication may change the effect of the already prescribed drugs. Participants with good attitude score showed 2.76 (1.50–5.13) times association with limiting the use of steroid containing topical MWP. Latent class analysis identified one subset of participants having lesser knowledge and attitude scores and quoted financial reasons for the procurement of MWP; however, it was found to have greater income as compared to remaining participants.

Conclusion

The strategy to identify the target patient audience so as to deliver patient education intervention programs, regarding safe and effective use of MWP was built.

KEYWORDS:

• Medication without prescription
• over the counter drugs
• dermatology
• latent class analysis
• pharmacy practice

Article highlights

1. Topical medication without prescription (MWP) use, especially antimicrobials, is a serious threat with rising levels of resistance.

2. Topical MWP use is an area of interest to the dermatologist community but the appropriate strategy to address this problem was neither identified nor tried on a pilot run basis.

3. A round table meeting is needed between dermatology clinicians, regulatory, and the patient population representatives to understand the quality and availability of medicines over the counters as well as the changes in laws required to control the situation.

4. A simple, easy, cheaper tool is developed here in present study to address the hotspots of topical MWP use which can be tried in other settings

5. Clinical Pharmacology discipline has to attain this call to develop variety of pharmacoepidemiological tools to help their clinician colleagues in building the quality of patient management.

Acknowledgments

Authors would like to acknowledge Prof Samir Malhotra for his valuable comments in improving the manuscript. Authors would also like to thank all study participants from the dermatology outpatient clinic patients for their participation in the study.

Author contributions

A. N. Patil: Contributed to conception, data check, execution of the entire study; P. kumar-M: data analysis along with data extraction; N. Hedge and A. K. Kakkar: Important intellectual content, literature review, and final approval; R. Mahajan and K. S: Manuscript writing and important intellectual content All authors critically revised the content.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.