The aim of this study was to assess the public\'s opinions and expectations of self-medication consultations in German community pharmacies with special emphasis on the acceptance of guideline-recommended consultation. In a cross-sectional study in the city centre of Leipzig, Germany, we conducted a questionnaire-based survey administered via an interview with passers-by from June to September 2018. The structured questionnaire contained questions assessing (I) previous experience with self-medication consultations, (II) possible reasons for declining self-medication consultations, (III) the attitude towards information gathering and (IV) expectations of self-medication consultations. (I) 92% of the 963 respondents stated they were generally satisfied with self-medication consultations in community pharmacies. Around one-fifth of all respondents claimed that they would like to be asked more health-related questions (22%) and receive more information on non-prescription drugs (20%). (II) Privacy issues (39%) and reluctance to talk about some medical conditions (43%) were the most frequent reasons for declining self-medication consultation. (III) Respondents understood the need for answering guideline-recommended questions (85-96%) and did not mind being asked these questions (70-96%). (IV) Most of the respondents expected to be counselled even if they did not ask for it directly (69%). Pharmacies were further expected to recommend the best drug, even if it was not what the customer initially intended to buy (87%). However, more than half of the respondents would consider counselling as unimportant if they knew exactly which medication they wanted to buy (56%) or if they had used the non-prescription drug before (70%). The majority also expected to receive guideline-recommended drug information (each item at least 52%). Thus, our study shows that respondents were mostly in line with the required standards of self-medication counselling guidelines. Customers expect high-quality counselling on self-medication. These findings support pharmaceutical staff\'s understanding of customers\' barriers and expectations during self-medication consultations.

Self-medication should always be temporary. Self-medication can be used to relief or treat many symptoms and conditions. In general self-medication is safe when used properly. However all medicines may cause adverse events or have interactions with other drugs. It is important to consider all used drugs and other self-medication products when new drugs are added to the medication list. Persons using the drugs as well as health care personnel should be aware of benefits and harms of drugs.The guideline has recommendations for 10 symptoms that are typically treated with self-medication.

An anaphylactic reaction due to a Hymenoptera sting is a clinical emergency, and patients, their caregivers as well as all healthcare professionals should be familiar with its recognition and acute management. This consensus report has been prepared by a European expert panel of the EAACI Interest Group of Insect Venom Hypersensitivity. It is targeted at allergists, clinical immunologists, internal medicine specialists, pediatricians, general practitioners, emergency department doctors, and any other healthcare professional involved. The aim was to report the scientific evidence on self-medication of anaphylactic reactions due to Hymenoptera stings, to inform healthcare staff about appropriate patient self-management of sting reactions, to propose indications for the prescription of an adrenaline auto-injector (AAI), and to discuss other forms of medication. First-line treatment for Hymenoptera sting anaphylaxis is intramuscular adrenaline. Prescription of AAIs is mandatory in the case of venom-allergic patients who suffer from mast cell diseases or with an elevated baseline serum tryptase level and in untreated patients with a history of a systemic reaction involving at least two different organ systems. AAI prescription should also be considered in other specific situations before, during, and after stopping venom immunotherapy.

BACKGROUND: Periodontitis prevalence remains high. Peri-implantitis is an emerging public health issue. Such a high burden of disease and its social, oral and systemic consequences are compelling reasons for increased attention towards prevention for individuals, professionals and public health officials.
METHODS: Sixteen systematic reviews and meta-reviews formed the basis for workshop discussions. Deliberations resulted in four consensus reports.
RESULTS: This workshop calls for renewed emphasis on the prevention of periodontitis and peri-implantitis. A critical element is the recognition that prevention needs to be tailored to the individual\'s needs through diagnosis and risk profiling. Discussions identified critical aspects that may help in the large-scale implementation of preventive programs: (i) a need to communicate to the public the critical importance of gingival bleeding as an early sign of disease, (ii) the need for universal implementation of periodontal screening by the oral health care team, (iii) the role of the oral health team in health promotion and primary and secondary prevention, (iv) understanding the limitations of self-medication with oral health care products without a diagnosis of the underlying condition, and (v) access to appropriate and effective professional preventive care.
CONCLUSIONS: The workshop provided specific recommendations for individuals, the oral health team and public health officials. Their implementation in different countries requires adaptation to respective specific national oral health care models.

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Due to the removal of many pharmaceuticals from the prescription requirement, self-medication implies an increasing responsibility for pharmacists towards their patients. The application of evidence-based guidelines could be a responsible basis for consulting in pharmacies. Evidence-based guidelines represent the systematically accumulated and evaluated facts (the evidence) of desired and undesired effects of pharmaceuticals in the population. We wanted to find out which interest pharmaceutical professionals have in evidence-based guidelines and which are the exact requirements on their content, deducted from public pharmacies everyday demands. With this purpose, three surveys were conducted between March and August 2012, in which 365, 350, and 486 pharmaceutical professionals participated respectively. The results show that pharmacy staff is very interested in evidence based guidelines. Furthermore, they suggest that the pharmacy staff feel safe with the self-diagnosis of the customer, with the consideration of limits of self-medication, as well as with the selection of the--according to own assessment--appropriate active substance. For the selection of the correct active substance, the following criteria are named: self-security in the counselling, first-hand experiences as well as the wish of the customer. At the same time, it is striking that the most frequent critique the pharmacy staff gets from pharmacy customers is the lack of effectiveness of the selected medication. With that in mind, it is possible that not the appropriate medication was selected, and the chosen criteria as selection method should be replaced by an evidence-based decision. Secondly, the results show that in up to 52% of the cases, depending on the indications, the participating consultants felt less certain to uncertain with regards to possible interactions or contraindications. Also in this context, it is desirable to prepare the existing data in such a practical way, that the pharmacies are able to apply them directly.

OBJECTIVE: It is important that self-medication customers with potentially serious diseases are correctly referred from pharmacies to physicians. The aim of this study was to determine the appropriateness of pharmacy practitioners in referring customers suffering from dyspepsia to a general practitioner (GP).
METHODS: Practitioners in 12 pharmacies, supported by clinical guidelines and training, recorded information regarding the dyspeptic customers they referred to a physician on a data collection card. The card was sent to a GP participating in the study, who did a regular medical history of the referred customer over the phone and assessed whether the referral was appropriate or not.
RESULTS: Out of 133 referred customers with dyspepsia, 132 completed the study. The GPs found that 119 (90%) needed a medical examination and/or prescription drugs and thus assessed these referrals as appropriate. In three cases (2%) the referral was doubtful and in ten cases (8%) not adequate, as the symptoms were more likely to come from an irritable bowel syndrome than dyspepsia.
CONCLUSIONS: The results confirm the role of pharmacy practitioners as important members of the primary health care team. Provided with the appropriate referral guidelines and training, they are in a position to operate as \'filters\', promoting the adequate use of other primary care services.

In the UK, there has been a rapid increase in the reclassification of prescription only medicines (POMs) to pharmacy only (P) and general sales list (GSL) status. This means that community pharmacy staff have a greater range of non-prescription medicines to recommend for the treatment of minor illness. Strategies are needed to promote good professional practice in the supply of non-prescription medicines. Guidelines have been shown to promote quality of care in other health care settings. In this article, we present evidence based guidelines for the treatment of vulvovaginal candidiasis using non-prescription anti-fungal medicines.

This survey of 162 households in the city of Bouaké, Côte d\'Ivoire was undertaken to study the behavior of the population in diagnosing and treating malaria. Findings indicate that awareness of symptoms and ability to evaluate the severity of malaria is high. In most cases, mild malaria is treated at home. In case of presumptive diagnosis of malaria, 87.6% of households undertake self-treatment, 9.3% seek institutional healthcare, 1.2% go to traditional healers, and 1.9% use traditional remedies. The most frequent drug for primary treatment is chloroquine (68.3%) which is generally obtained from pharmacies (98.8%). However, proper dosages are rarely used. If primary treatment fails, behavior is complex depending on the estimated severity of disease. Although many causes of malaria are mentioned, most people implicate mosquitoes (75.6%). In 95.1% of households surveyed, chloroquine prophylaxis was used for newborns. Most households (89.5%) practice mosquito bite protection but use of mosquito nets is low (4.9%). These results showing the preference for family-based management suggest that informational campaigns are needed to promote effective and consistent home treatment. Education is also needed to increase knowledge about mosquito nets and insecticides.

There is currently worldwide concern about the problems of antimicrobial resistance. A number of important bodies such as the World Health Organisation and the British House of Lords have identified the reasons for the emergence of resistance to antimicrobial agents and the preventive measures which need to be urgently implemented to curb the spread of resistant organisms. The reasons for the emergence of resistant organisms are not difficult to find. During the past half-century, since the discovery of penicillin by Fleming, people in both the developing and the developed world have accepted antimicrobial agents as a fundamental right, not only to demand at the first sign of a trivial infection but also to self prescribe with readily available, cheap antimicrobial agents. Such unbridled abuse of antimicrobial agents not only in man but also in animals could lead down a slippery slope to an era where the microbe may rule supreme once again. Indeed some authorities are forecasting a \'post-antibiotic era\' (as opposed to the pre-antibiotic era before the discovery of penicillin) in the foreseeable future when many infectious diseases will once again be almost impossible to treat.