Journal Article

Use of over-the-counter supplements, sleep aids and analgesic medicines in rheumatology: results of a cross-sectional survey

Soomro, Mehreen, Dixon, William G, Lyons, Stephanie, Jani, Meghna, Bravo, Ramiro, Lunt, Mark, McBeth, John

2024

Overview

Objectives Pain, fatigue and sleep disturbances are common symptoms in patients with rheumatic and musculoskeletal diseases (RMDs) that may prompt the use of over-the-counter (OTC) supplements, sleep aids and analgesics as self-management strategies. This study evaluated the prevalence of OTC supplements, sleep aids and pain relievers and the financial burden associated with their use in rheumatology. Methods A web-based survey developed with patients was administered in rheumatology clinics in an English hospital. Participants shared demographic information and detailed their use of OTC supplements, sleep aids and pain relief in the past week. The data were analysed using descriptive statistics and logistic regression models to identify influencing factors. Results A total of 876 people consented to participate in the survey. More than half of patients (54.5%) reported daily supplement intake, typically spending £10/month (interquartile range 5–20), ranging up to £200/month. The most commonly administered supplements were vitamin D, multivitamins, vitamin C, vitamin B/B complex and omega-3/-6 supplements, with multiple overlaps. Prescription, OTC or non-prescription pain relief use was reported by 82% of respondents, with sleep aids being used by 13%. Of the 327 patients who took NSAIDs, 165 (50.4%) also reported taking OTC supplements, while among the 131 patients using opioids (20.5%), 66 (50.3%) reported supplement use, some of which have documented interactions. Conclusion The use of OTC supplements, pain relief and sleep aids is common in patients with RMDs. Healthcare professionals should be encouraged to proactively ask about these during consultations, especially from a drug safety perspective, but also to provide timely, reliable advice about such strategies that may be sought by patients. Lay Summary What does this mean for patients? Living with musculoskeletal conditions often means coping with persistent pain, fatigue and sleep disturbances. To manage these symptoms, many people turn to over-the-counter (OTC) medications such as supplements, sleep aids and pain relievers, in addition to their prescribed medications. But how common is this practice and what are the implications for patients and healthcare providers? To understand this, we surveyed patients attending rheumatology clinics. The survey was designed with input from patients and asked participants about their use of these OTC products over the past week. The results revealed that using OTC products to manage symptoms is widespread. More than half of the patients surveyed reported take supplements daily, with vitamin D, multivitamins, vitamin C, B vitamins, omega-3/-6 and turmeric being the most popular. People often took multiple supplements with a financial cost up to £200/week. More than 80% of patients also used some form of pain relief, whether it was prescription, OTC/internet or borrowed from a family member. Concerningly, a considerable number of patients combined OTC supplements with prescription pain medications, including anti-inflammatories and opioids, despite potential interactions. This study highlights the importance of open communication between patients and healthcare providers about OTC product use. Healthcare professionals should proactively ask patients about these products during consultations, not only to ensure safety and manage potential drug interactions, but also to provide evidence-based advice and support patients in making informed decisions about their health.

• Publisher: Oxford University Press
• Subject: Alfacalcidol / Calcifediol / Care and treatment / Dietary supplements / Fatty acids / Health care industry / Health surveys / International economic relations / Opioids / Pain / Patient satisfaction / Rheumatology / Sleep / Sleep disorders / Strategic planning (Business) / Vitamin D