Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Primary Care
Published in: BMC Primary Care 1/2021

01-12-2021 | Paracetamol | Research

Pharmacist’s recommendations of over-the-counter treatments for the common cold - analysis of prospective cases in Poland

Authors: Malgorzata Pietrusiewicz, Paulina Natalia Kopa-Stojak, Rafal Pawliczak

Published in: BMC Primary Care | Issue 1/2021

Login to get access

Abstract

Background

Common cold is a frequent illness in northern hemisphere between late autumn and early spring. Patients suffering from it frequently turn to pharmacists instead of physicians in order to receive medical advice and treatment. We studied its treatment advised by pharmacists in Poland, as well as evidence for the efficacy of their recommendations by utilizing a self-developed questionnaire and a study of existing literature.

Methods

The data were collected by 27 pharmacists who worked in four large network community pharmacies in Lodz, Poland. The study took place from December 2019 to February 2020. Data were recorded only if the patient asked for pharmacy counselling for over-the counter (OTC) products due to common cold self-diagnosis and a product was sold. Pharmacists’ recommendations were compared with the results of a literature review of best evidence to determine appropriateness of the pharmacists’ decisions.

Results

In four out of five cases the pharmacists recommended products contained paracetamol. In addition, in one out of three patient encounters they advised nasal decongestant, inosines and/or OTC mucolytics. There was a significant relationship between fever and recommendation frequency of some analgesics, inosines, mucolytics and sore throat products (OR > 1, p < 0.05); rhinorrhea and recommendation frequency of paracetamol, inosines, anti-histamines and alpha-mimetics (OR > 1, p < 0.05); cough and recommendation frequency of paracetamol, inosines, mucolytics and sore throat products (OR > 1, p < 0.05); and fatigue and recommendation frequency of paracetamol, acetylsalicylic acid, inosines and sore throat products (OR > 1, p < 0.05). The pharmacist recommendations were based on patients’ symptoms, product price, pharmaceutical company promotion and the financial incentive. In many cases their recommendations were not in line with current best practice recommendations.

Conclusions

Our study suggests that the most common rationale for pharmacist recommendation on anti-common cold treatment was to take a “shotgun” approach. Pharmacists commonly made recommendations for products that lack strong evidence for efficacy (i.e. anti-viral agents) and are potentially unnecessary, based on presentation of the symptom. Reasons for this situation include lack of training, lack of time to evaluate the patient, lack of awareness of evidence as well as drug company marketing and financial incentives (i.e. fulfilling sale plans and target sale bonuses).

Trial registration

The study was a non-interventional, observational research trial. The study registration was not required.
Appendix
Available only for authorised users
Literature
1.
2.
3.
Irwin RS, Baumann MH, Bolser DC, Boulet L-P, Braman SS, Brightling CE, et al. Diagnosis and management of cough executive summary. Chest. 2006;129(1 Suppl):1S-23S.PubMedCrossRef
4.
5.
Raal A, Volmer D, Sõukand R, Hratkevitš S, Kalle R. Complementary treatment of the common cold and flu with medicinal plants – results from two samples of pharmacy customers in Estonia. PLoS One. 2013;8:e58642.PubMedPubMedCentralCrossRef
6.
Mináriková D, Fazekaš T, Minárik P, Jurišová E. Assessment of patient counselling on the common cold treatment at Slovak community pharmacies using mystery shopping. Saudi Pharm J. 2019;27:574–83.PubMedPubMedCentralCrossRef
7.
Montgomery AT, Kettis Lindblad Å, Eddby P, Söderlund E, Tully MP, Kälvemark SS. Counselling behaviour and content in a pharmaceutical care service in Swedish community pharmacies. Pharm World Sci. 2010;32:455–63.PubMedCrossRef
8.
Assemi M, Torres NM, Tsourounis C, Kroon LA, McCart GM. Assessment of an online consumer “ask your pharmacist” service. Ann Pharmacother. 2002;36:787–92.PubMedCrossRef
9.
Waszyk-Nowaczyk M, Simon M. Znaczenie porady farmaceuty w procesie samoleczenia się pacjentów; 2009. p. 3.
10.
Kokane JV, Pawan S. Avhad. Role of pharmacist in health care system. J Community Health Manag. 2016;3:37–40.
11.
Villako P, Volmer D, Raal A. Factors influencing purchase of and counselling about prescription and OTC medicines at community pharmacies in Tallinn. Estonia Acta Pol Pharm. 2012;69(2):335–40.PubMed
12.
Elhoseeny TA, Ibrahem SZ, Abo el Ela AM. Opinion of community pharmacists on use of nonprescription medications in Alexandria, Egypt. J Egypt Public Health Assoc. 2013;88:79–84.PubMedCrossRef
13.
Klimek L, Schumacher H, Schütt T, Gräter H, Mueck T, Michel MC. Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms. Int J Clin Pract. 2017;71:e12907.CrossRef
14.
Picon PD, Costa MB, da Veiga PR, Fendt LCC, Suksteris ML, Saccilotto IC, et al. Symptomatic treatment of the common cold with a fixed-dose combination of paracetamol, chlorphenamine and phenylephrine: a randomized, placebo-controlled trial. BMC Infect Dis. 2013;13:556.PubMedPubMedCentralCrossRef
15.
Maggini S, Beveridge S, Suter M. A combination of high-dose vitamin C plus zinc for the common cold. J Int Med Res. 2012;40:28–42.PubMedCrossRef
16.
17.
Salisbury-Afshar E. Oral antihistamine/decongestant/analgesic combinations for the common cold. Am Fam Physician. 2012;86:812–3.PubMed
18.
19.
Kim K-I, Hong M, Park Y-C, Lee B-J, Kim K, Kang BK, et al. Herbal medicines (Eunkyosan and Samsoeum) for treating the common cold: a protocol for a randomized, placebo-controlled, multicenter clinical trial. Integr Med Res. 2020;9:48–53.PubMedPubMedCentralCrossRef
20.
Mousa HA-L. Prevention and treatment of influenza, influenza-like illness, and common cold by herbal, complementary, and natural therapies. J Evid-Based Complement Altern Med. 2017;22:166–74.CrossRef
21.
Yakoot M, Salem A. Efficacy and safety of a multiherbal formula with vitamin C and zinc (Immumax) in the management of the common cold. Int J Gen Med. 2011;4:45–51.
22.
Ikuta K, Hashimoto K, Kaneko H, Mori S, Ohashi K, Suzutani T. Anti-viral and anti-bacterial activities of an extract of blackcurrants ( Ribes nigrum L. ): anti-microbial activity of blackcurrants. Microbiol Immunol. 2012;56:805–9.PubMedCrossRef
23.
Nantz MP, Rowe CA, Muller C, Creasy R, Colee J, Khoo C, et al. Consumption of cranberry polyphenols enhances human γδ-T cell proliferation and reduces the number of symptoms associated with colds and influenza: a randomized, placebo-controlled intervention study. Nutr J. 2013;12:161.PubMedPubMedCentralCrossRef
24.
Di Pierro F, Rapacioli G, Ferrara T, Togni S. Use of a standardized extract from Echinacea angustifolia (Polinacea) for the prevention of respiratory tract infections. Altern Med Rev J Clin Ther. 2012;17:36–41.
25.
Moyad MA, Robinson LE, Zawada ET, Kittelsrud JM, Chen D-G, Reeves SG, et al. Effects of a modified yeast supplement on cold/flu symptoms. Urol Nurs. 2008;28:50–5.PubMed
26.
27.
28.
29.
30.
31.
32.
33.
Simasek M, Blandino D. Treatment of the common cold. Am Fam Physician. 2007;75:515–20.PubMed
34.
35.
36.
37.
Eccles R, Martensson K, Chen SC. Effects of intranasal xylometazoline, alone or in combination with ipratropium, in patients with common cold. Curr Med Res Opin. 2010;26:889–99.PubMedCrossRef
38.
39.
De Sutter AI, Saraswat A, van Driel ML. Antihistamines for the common cold. Cochrane Database Syst Rev. 2015;11:CD009345.
40.
41.
42.
43.
44.
45.
van Driel ML, Scheire S, Deckx L, Gevaert P, De Sutter A. What treatments are effective for common cold in adults and children? BMJ. 2018:363.
46.
Ruohola A, Waris M, Allander T, Ziegler T, Heikkinen T, Ruuskanen O. Viral etiology of common cold in children, Finland. Emerg Infect Dis. 2009;15:344–6.PubMedPubMedCentralCrossRef
47.
48.
Albrecht HH, Dicpinigaitis PV, Guenin EP. Role of guaifenesin in the management of chronic bronchitis and upper respiratory tract infections. Multidiscip Respir Med. 2017;12:31.PubMedPubMedCentralCrossRef
49.
Kiran MD, Vakharia MP, Pawaskar LJ, Sheikh SN. Efficacy and safety of a fixed dose combination of paracetamol, chlorpheniramine maleate and phenylephrine in treatment of common cold: a phase IV, open-labelled, multi-centric study. Int J Basic Clin Pharmacol. 2018;8:34.CrossRef
50.
Sur DKC, Plesa ML. Chronic nonallergic rhinitis. Am Fam Physician. 2018;98:171–6.PubMed
51.
DeGeorge KC, Ring DJ, Dalrymple SN. Treatment of the common cold. Am Fam Physician. 2019;100:281–9.PubMed
52.
Quidel S, Gómez E, Bravo-Soto G, Ortigoza Á. What are the effects of vitamin C on the duration and severity of the common cold? Medwave. 2018;18:e7260.CrossRef
53.
Allan GM, Arroll B. Prevention and treatment of the common cold: making sense of the evidence. Can Med Assoc J. 2014;186:190–9.CrossRef
54.
55.
Waldman RH, Ganguly R. Therapeutic efficacy of inosiplex (Isoprinosine) in rhinovirus infection. Ann N Y Acad Sci. 1977;284:153–60.PubMedCrossRef
56.
57.
Unuvar E, Tamay Z, Yıldız I, Toprak S, Kılıc A, Aydın S, et al. Effectiveness of erdosteine, a second generation mucolytic agent, in children with acute rhinosinusitis: a randomized, placebo controlled, double-blinded clinical study. Acta Paediatr. 2010;99:585–9.PubMedCrossRef
58.
Padma L. Current drugs for the treatment of dry cough. J Assoc Physicians India. 2013;61:9–13.PubMed
59.
Malesker MA, Callahan-Lyon P, Ireland B, Irwin RS, Adams TM, Altman KW, et al. Pharmacologic and nonpharmacologic treatment for acute cough associated with the common cold: CHEST expert panel report. CHEST. 2017;152:1021–37.PubMedPubMedCentralCrossRef
60.
Ghaibi S, Ipema H, Gabay M. ASHP guidelines on the Pharmacist’s role in providing drug information. Am J Health Syst Pharm. 2015;72:573–7.PubMedCrossRef
61.
Grebenar D, Nham E, Likic R. Factors influencing pharmacists’ over-the-counter drug recommendations. Postgrad Med J. 2020;96:144.PubMedCrossRef
62.
63.
Eccles R. Efficacy and safety of over-the-counter analgesics in the treatment of common cold and flu. J Clin Pharm Ther. 2006;31:309–19.PubMedCrossRef
64.
Allen PJ, Simenson S. Management of Common Cold Symptoms with over-the-counter medications: clearing the confusion. Postgrad Med. 2013;125:73–81.CrossRef
Metadata
Title
Pharmacist’s recommendations of over-the-counter treatments for the common cold - analysis of prospective cases in Poland
Authors
Malgorzata Pietrusiewicz
Paulina Natalia Kopa-Stojak
Rafal Pawliczak
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2021
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-021-01561-2

Other articles of this Issue 1/2021

BMC Primary Care 1/2021 Go to the issue

Research article

Feedback of patient survey on medication improves the management of polypharmacy: a pilot trial

Research

Effects of the dementia care toolbox on personnel’s self-reported confidence in patient care: a CRT in general practices

Research

The impacts of the COVID-19 pandemic on the mental health and residency training of family medicine residents: findings from a nationwide cross-sectional survey in Turkey

Research Article

Primary care physician volume and quality of care for older adults with dementia: a retrospective cohort study

Research

Factors affecting statin uptake among people living with HIV: primary care provider perspectives

Research article

The developing family doctor system: evidence from the progress of the family doctor signing service from a longitudinal survey (2013–2016) in Pudong New Area, Shanghai