For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Over-the-counter artificial tears effective for dry eye syndrome
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Over-the-counter artificial tears effective for dry eye syndrome
How effective are over-the-counter (OTC) artificial tear drops in the treatment of dry eye syndrome?
Comparing between classes of OTC artificial tears, and compared with no treatment or placebo, OTC artificial tears were effective at treating dry eye syndrome, and were generally safe, although not without side effects (blurred vision, ocular discomfort and foreign body sensation). Polyacrylic acid-based artificial tears (0.2%) were consistently more effective at treating dry eye syndrome than 1.4% polyvinyl alcohol-based artificial tears in 2 trials comparing these products (175 participants). All other included artificial tears produced contradictory between-group results or found no between-group differences.
The overall completeness of the included trials was limited by factors such as being short-term, incomplete investigator masking, industry support bias and incomplete data reporting. Thus, the overall quality of the evidence is low.
OTC artificial tears, historically, have been first-line treatment for dry eye syndrome and dry eye-related conditions like contact lens discomfort, yet, currently, little is known regarding the overall efficacy of individual commercially available artificial tears.
Pucker AD et al. Over the counter (OTC) artificial tear drops for dry eye syndrome. Cochrane Reviews, 2016, Issue 2. Art. No.: CD009729.DOI: 10.1002/14651858. CD009729.pub2. This review contains 43 studies involving 3497 participants.
Cochrane Systematic Reviews for primary care practitioners
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