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Documents which entitle to a purchase of a discount ticket should be presented prior to the transaction. Museum visitors are obliged to present a valid ticket. The Museum building and the surrounding area are subject to the monitoring and recording of images. For more information on the data processing see the website: mnwr. Ticket offices remain open up to 30 minutes before the Museum closing time. Free admission days do not apply to temporary exhibitions. II General rules Visitors are obliged to follow instructions given by the Museum personnel and its security services. On entering the Museum, visitors and their luggage may be subject to electronic security checks aimed at identifying dangerous substances and objects. Visitors are fully financially liable for any damage or destruction caused to the Museum property. Parents or guardians bear full responsibility for under-age visitors. Prior to entering an exhibition visitors will be required to leave any bulky items such as large backpacks, bags, suitcases and umbrellas, as well as outdoor clothing in the Museum cloakroom or deposit boxes which are free of charge. Viewing is conducted on foot with the exception of persons with disabilities and adults accompanying a child in a pram. It is allowed to take photographs and make films only without the use of a flash or a tripod, and only for personal records. Professional photographic services are regulated by separate rules. The Museum kindly requests that visitors do not use their mobile phones when viewing exhibitions. Visitors should leave the Museum building by the official closing time.

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Official websites use. Share sensitive information only on official, secure websites. Background: The safety of pharmacotherapy for geriatric patients is an essential aspect of the demographic perspective in view of the increasing size of this population. The reasons for drug abuse are common in the geriatric population: musculoskeletal disorders, colds, inflammation and pain of various origins. The popularity of self-medication and the ability to easily access OTC drugs outside the pharmacy creates the danger of their misuse and the incidence of adverse drug reactions ADRs. The survey included respondents aged 50—90 years. The relationship between the prevalence of ADRs and the NOAs used, age, presence of chronic diseases, and place of purchasing and obtaining information about the mentioned drugs were evaluated. The results of the observations were statistically analyzed using Statistica Patients consumed the medications for intractable headaches, toothaches, fevers, colds and joint disorders. Respondents indicated the pharmacy as the main location for purchasing medications, and the physician as the source of information for selecting the therapy. ADRs were reported most frequently to the physician, and less frequently to the pharmacist and nurse. More than one-third of respondents indicated that the physician during the consultation did not take a medical history and did not ask about concomitant diseases. It is necessary to extend pharmaceutical care to geriatric patients that includes advice on adverse drug reactions, especially drug interactions. Due to the popularity of self-medication, and the availability of NOAs, long-term measures should be taken to increase the role of pharmacists in providing effective, safe health care to seniors. We are targeting pharmacists with this survey to draw attention to the problem of the prevalence of selling NOAs to geriatric patients. Pharmacists should educate seniors about the possibility of ADRs and approach patients with polypragmasy and polypharmacy with caution. Pharmaceutical care is an essential aspect in the treatment of geriatric patients, which can contribute to better results in their existing treatment and increase the safety of medication intake. Therefore, it is important to improve the development of pharmaceutical care in Poland in order to enhance patient outcomes. Keywords: pharmaceutical care, non-opioid analgesics, over-the-counter medications, geriatric, adverse drug reactions. Recent years have seen a steady increase in the elderly population. It is estimated that, by , the number of people over 60 years of age worldwide will reach two billion. In Poland, the elderly regularly take an average of seven medications, including more than five prescription drugs. These data do not differ from observations coming from other countries. As the number of drugs used increases, so does the risk of side effects, including interactions, especially at the metabolic stage \[ 5 , 6 \]. The geriatric population taking multiple medications is additionally more susceptible to TV commercials \[ 9 , 10 \]. Consequently, polytherapy often escalates into polypragmasy, meaning the medically unjustified, irrational consumption of more drugs. As a result, it is observed that patients take multiple analgesics, resulting in the synergism of their effects. The intensified effect of drugs leads to drug toxicity and the occurrence of adverse drug reactions. It has also been shown that about 7. Due to the widespread availability of these medications and the risks associated with their incorrect use, as well as the difficulty of contacting a physician, it is necessary to effectively implement and develop pharmaceutical care, especially for elderly patients. The purpose of this study was to analyze the safety of non-opioid analgesics used by the elderly and the importance of the pharmacist in optimizing pain management in geriatric patients. In this paper, we examine the most common adverse drug reactions associated with the use of NOAs and identify factors that intensify drug toxicity in elderly patients. We highlight the level of knowledge of older patients regarding pharmaceutical care and their willingness to access it. In the survey, we used a form consisting of 88 single- and multiple-choice questions to collect data from patients. The questionnaire included questions about the reasons for the use of pain medications, comorbidities, the use of dietary supplements, the source of purchasing and obtaining information about medications, and knowledge of reporting adverse drug reactions. Initially, we collected data using an online questionnaire, but due to the low online activity of people over 65, data were also collected at pharmacies. The study included people aged 50—90 years. For the study, participants with preserved cognitive ability taking medication on their own were eligible. The largest group Women were significantly more likely to report complaints of depression and neurosis Detailed data are shown in Table 1. Characteristics of the study group showing the relationship of the observed diseases to the gender of the respondents. Among the study group, cardiovascular disease, hypertension, diabetes, and renal failure were significantly more common among the subjects over 75 years of age. Obesity was significantly more common in the 61—75 age range. These relations are shown in Table 2. Characteristics of the study group showing the relationship of the observed diseases with the age of the respondents. The results of the observations were subjected to statistical analysis using Statistica The probability of correlation between variables was supported using count tables and multivariate tables. In the case of expected counts of less than 5, the chi-square test with Yates correction was applied additionally. Observations showed that NOAs were used most often for headache and toothache The most commonly used were paracetamol, ibuprofen, acetylsalicylic acid ASA , ketoprofen and diclofenac. Most often—several times a week—respondents took ibuprofen, and less often, nimesulide, acetylsalicylic acid, paracetamol, ketoprofen and naproxen. Less than once a week, respondents used paracetamol, ASA, ketoprofen, diclofenac, naproxen and metamizole. The prevalence of non-opioid analgesic use among the elderly is shown in Figure 2. With topical skin application, ADRs included local skin reactions, which were significantly more common in respondents aged 61—75 years 5. NOA users in the 50—60 age range Dietary supplements were used by Respondents who did not check the expiration date of the drug before taking it were significantly more likely to observe gastrointestinal bleeding after using ASA The vast majority of respondents Taking medications was significantly more often forgotten by men Women were more likely to skip a dose they did not take, while men took it when they remembered it. Respondents sipping medication with a beverage other than water A self-reported survey shows that many patients did not receive a proper medical interview and advice. As many as It is worrying that, despite the concerns, a significant proportion of patients did not ask for medical advice from a pharmacist. Paracetamol was used by Gastrointestinal bleeding Of the respondents with peptic ulcer disease, Ibuprofen was used by Regular smokers were more likely to report gastrointestinal bleeding 7. Gastrointestinal bleeding was significantly more common in those who did not check the expiration date of the drug before taking it Gastrointestinal disorders, gastric ulcers, duodenal ulcers and allergic reactions were most frequently reported. In ADRs occurred significantly more often in those who were unaware of the existence of the same active ingredients under different brand names. In this group, The survey showed that a small percentage of respondents used ASA in the prevention of heart disease. The use of ketoprofen was declared by It was used most often by people aged 50— Reported ADRs associated with ketoprofen therapy included gastrointestinal disorders, gastrointestinal bleeding, gastric ulcers, duodenal ulcers, allergic reactions, and renal dysfunction. Respondents taking two NOA drugs 9. Diclofenac was taken by only The 76—year-olds were the least likely to use it. ADRs were reported by The most common were gastrointestinal disorders, indicated by Aging is a gradual and irreversible pathophysiological process that manifests as a decline in tissue and cell function, and with a significant increase in the risk of various diseases associated with aging neurodegenerative diseases, cardiovascular diseases, metabolic diseases, musculoskeletal diseases and immune diseases \[ 20 \]. The increase in morbidity promotes large geriatric syndromes \[ 21 \]. Multimorbidity is associated with a high number and type of multi-drug therapies in general populations, often administered by multiple specialists \[ 22 \]. Furthermore, the elderly use OTC medications and dietary supplements purchased on their own \[ 23 \]. We have shown that older patients take multiple drugs simultaneously, leading to a synergistic effect. Consequently, toxicity and the risk of ADRs increases. Similar results were obtained by Weiner et al. According to their observations, the most popular drug in the elderly population was also paracetamol The reasons for their use were headache and migraine Rule et al. Thus, the data are universal, and the scale of the problem is very similar regardless of nationality. The risks associated with the use of the aforementioned drugs include primarily adverse reactions. It has been found that people die annually in Poland due to chronic use of non-steroidal anti-inflammatory drugs. Fialova et al. Our study found that the geriatric population showed an increased incidence of gastrointestinal bleeding and gastrointestinal disorders associated with paracetamol use, especially several times a week. ADRs occurred significantly more often in individuals who were unaware of the presence of acetylsalicylic acid in preparations under various brand names. Among respondents taking ASA regularly, gastrointestinal bleeding was more common when combined with paracetamol, and gastric or duodenal ulcers were reported when it was combined with other analgesics. Most common ADRs associated with taking ketoprofen included allergic reactions and renal impairment. The risk of gastrointestinal disorders increased in patients taking dietary supplements. Polypharmacy is observed in about Morphological and functional changes in the body of the elderly can cause changes in pharmacokinetics, pharmacodynamics and ultimate response to the therapy used \[ 29 \]. Pharmacokinetic changes include decreased renal and hepatic clearance and increased volume of distribution of fat-soluble drugs hence increased elimination half-life. Pharmacodynamic changes typically include increased sensitivity to several classes of drugs, such as anticoagulants, cardiovascular drugs and psychotropic drugs. It is therefore necessary to take measures to improve the efficacy and safety of geriatric treatment, especially regarding the NOAs so often used in this age group \[ 30 \]. Older patients declare that the problem is that font used in such leaflets is too small and that these contain unclear formulations regarding the use of drugs \[ 28 \]. Observations of people in New South Wales, Australia, showed that Some, however, were unable to recognize the discomforts associated with taking the drug \[ 31 \]. Vega-Moralesab et al. Importantly, our results revealed that The data show that although patients mainly get their medications from the pharmacy, they relatively rarely feel the need to educate themselves and talk to a pharmacist about possible drug interactions and ADRs. Raynor et al. Unfortunately, the results of a study by Chlebowska et al. It has been shown that less than half of patients visiting pharmacies declare that they receive proper information from professional staff regarding the storage and use of medicines. Despite the development of pharmaceutical care worldwide, the level of care in Poland in this regard is much lower. However, a study by Merks et al. This is important because it is estimated that 1 in 10 elderly people experience ADRs leading to hospitalization or during a hospital stay, and pharmacist involvement could prevent these events \[ 36 \]. Since the pharmacist is one of the most accessible healthcare professionals, this can relieve the burden on physicians and optimize the medication management process within the healthcare team \[ 36 \]. They play a key role as an advisor when determining therapy in self-medication with OTC products \[ 38 \]. The limitations of the survey used in the current work include the use of an electronic survey, which may have been a difficulty in the case of older people, both because they are less skilled in this area and have less access to mobile devices and the Internet. Hence, a smaller-than-planned number of people was included in the observation. The original assumption of using a paper-based survey had to change due to security concerns related to the COVID pandemic restrictions. There is a need to involve them in the process of coordinating the medications taken by seniors. With the lack of an adequate number of geriatricians in the Polish health care system and the incidence of adverse drug reactions—especially NOAs—increasing with age, the need for patient education and pharmacotherapy analysis performed by pharmacists through drug review cannot be overestimated. The potential of pharmacists should be tapped into, as they are the most accessible group of health care professionals to patients. The survey showed that despite easy access to pharmacists, few seniors take advantage of the opportunity to educate themselves about the medications they are taking. It is therefore important to emphasize the importance of the role of pharmaceutical care, as through medication reviews, the number of ADRs that occur can be reduced in the future, and the safety and effectiveness of pharmacotherapy for geriatric patients can be increased. Conceptualization, K. K-B; writing—review and editing, K. All authors have read and agreed to the published version of the manuscript. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Find articles by Natalia Sauer. Find articles by Laura Jonderko. Laura Jonderko : Visualization. Roger E Thomas : Academic Editor. Open in a new tab. Click here for additional data file. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Depression, neurosis. Cardiovascular diseases. Kidney failure.

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