Diuretics misuse: A cross-sectional study to explore community pharmacist’s perceptions of diuretics use and misuse

Abstract

This study aims to explore the perceptions and observations of community pharmacists regarding diuretic use and misuse in Jordan and their understanding of their expected role in patient education about proper use and misuse. A cross-sectional study was conducted using an online self-administered survey distributed to community pharmacies in various locations in Jordan. Descriptive and correlation analyses are used in data evaluation. A total of 112 respondents (female 61.05% and male 38.95%) completed the survey. Community pharmacists (56.76%) confirmed that individuals without health problems misuse diuretics and 81.82% confirmed that patients are not interested in seeking medical advice before buying a diuretic. Congestive heart failure followed by ascites edema was the main reason for dispensing diuretics with and without a prescription in community pharmacies. Moreover, elderly patients mostly misuse diuretics, and patients with chronic diseases misuse prescribed diuretics, besides using them for weight and fluid loss. Furosemide was the safest diuretic and the most misused diuretic due to its low cost and availability as a locally manufactured drug within the market. For all diuretics, fatigue and electrolyte disturbances were the most reported adverse events. A low rate of dispensing spironolactone in poly cystic ovary syndrome management was reported. Since 82.88% of the participants acknowledged that diuretics are prescription-only drugs, and 87.27% confirmed that diuretics are dispensed without a prescription, most community pharmacists (97.1%) stressed the importance of educating patients about diuretics and their side effects, as well as the necessity for patients to consult their physicians. In conclusion, diuretic misuse was observed among patients in Jordan, and community pharmacists are responsible for increasing public awareness about diuretic misuse. Still, enforcing a prescription-only policy of diuretic dispensing is crucial in restricting diuretic misuse.