Use of over-the-counter medicines by privately insured patients with common chronic conditions in South Africa

Objectives The study measured access to commonly used over-the-counter (OTC) medicines (OTCMs) by individuals who were insured for the management of chronic diseases and considered reasons for selection of the medicines in addition to mainstream drugs usually prescribed for treatment. Methods Data were extracted from a large corporate database. Eligible subjects were aged >= 40 years and registered for management of one of the prevalent non-communicable diseases. Utilization of aspirin, inhaled corticosteroids and bronchodilators was assessed. Key findings The study population included 12 108 controls and 4149 individuals with one of 11 common chronic conditions that were categorized as metabolic, respiratory, cardiovascular or glaucoma. There was high utilization of bronchodilators in the respiratory group, possibly indicative of poor control of the primary condition and moderate access to bronchodilators by controls, possibly self-medicating for an undiagnosed chronic condition. Aspirin was not only utilized for primary or secondary prevention in the cardiovascular and metabolic groups but also appeared to be used to treat glaucoma. Bronchodilators may also have been used to treat side effects of drugs used to treat hypertension. Conclusions Reasons for use of OTCMs in the treatment of a chronic condition include poor control, treatment of a side-effect of a drug used to treat the chronic condition and self-medication for an undiagnosed condition. To gain further insight, insurers should routinely analyse claims and develop performance-enhancing interventions.