CEimpact Podcast

Essential Review of OTC Cough and Cold Medications

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Cough and cold season brings a surge of questions about over-the-counter treatments, making it vital for pharmacists to stay sharp on the latest recommendations and safety considerations. This episode offers a review of common OTC medication options, including their efficacy, appropriate use, and potential interactions. Enhance your confidence in guiding patients through the maze of choices—tune in to this episode for a refresher!

THE GAMECHANGER: We are the medication experts. And really, even in this over-the-counter space, we have so much knowledge and there's so much we can do to help make sure our patients are walking away with a remedy that is safe for them, is hopefully effective for them. And that is the best fit for them.

HOST
Joshua Davis Kinsey, PharmD
VP, Education
CEimpact

GUEST
Kate Riddell, PharmD, MS
Pharmacist
Consultant
 
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CPE INFORMATION
Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:
1. Identify commonly used over-the-counter medications for cough and cold.
2. Describe key safety considerations, including contraindications and potential drug interactions, for OTC cough and cold medications.

0.05 CEU/0.5 Hr
UAN: 0107-0000-24-317-H01-P
Initial release date: 12/23/2024
Expiration date: 12/23/2025
Additional CPE details can be found here.

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Speaker 1:

Hey, ce Impact subscribers, Welcome to the Game Changers Clinical Conversations Podcast. I'm your host, josh Kinsey, and as always, I'm excited about our conversation today. Cough and cold season brings a surge of patient questions, making it essential for pharmacists to provide accurate guidance tailored to individual symptoms. Navigating misconceptions, monitoring for potential risks and ensuring the safe and effective use of OTC options are critical to delivering optimal patient care. It is so great to have Kate Rydell as my guest for this episode. We're going to dig into some of those misconceptions and we're going to navigate how pharmacists can and should be counseling and educating their patients on OTC cough and cold treatments. So welcome, kate, it's so great to have you.

Speaker 2:

Hi, josh, thank you so much for having me. I'm excited to be here.

Speaker 1:

Yeah, so before we jump in, I always like to introduce our guest speakers to our learners. So, kate, if you'll take just a couple minutes to introduce yourself, tell us a little bit about your practice site and why you're so passionate about pharmacy practice and OTC medicine.

Speaker 2:

So, yes, I'm a community pharmacist, I work at an independent pharmacy in Indiana and I'm also our CPSN, so the Community Pharmacy Enhanced Services Network managing network facilitator here in Indiana. So I've had the opportunity to work with lots of different independents and something that in both of these roles I've really gotten the chance to do is really see how much of an impact the community pharmacist can make for patients and just being accessible, being able to answer those questions and help guide patients to the right therapy. So yeah, so I'm excited to be here and kind of share a little bit about what I do in my day to day.

Speaker 1:

Well, we're excited for you to be here as well. Thanks again for taking out of time out of your busy schedule to join us, so it's great to have you. Let's go ahead and jump in. We're in the thick of cold season. I'm sure our pharmacists and our teams are getting lots and lots of questions from patients, so this should be a very timely episode and hopefully it's a nice refresher and maybe we'll give some people some tips and tricks that they didn't know about before. So let's jump in. I always like to set a foundational level for everyone. Let's just quickly review what are the common cough and cold symptoms that we're going to see in our patients.

Speaker 2:

Yeah, so a lot of these symptoms can include something like a fever. Some people get a lot of chills. They'll be fatigued, have malaise, they might feel really hot, usually due to that fever. They see productive cough or nonproductive cough, which we can talk about the differences of those here a little bit too, and some of those aches and pains as well.

Speaker 1:

Yeah, yeah. So, again, these are common things that your patients are going to have. One of the things, too, to point out is, you know, they're not always going to just hurry up to the counter and tell you that they're having these symptoms. You might just see someone struggling in the OTC aisle, you know, wondering what decision to make, and so that's another opportunity as well where we can, you know, step outside of that pharmacy area and really kind of focus on asking those the right questions. So okay, so one of the big things, one of the reasons we wanted to have this conversation now as well. There's been a recent update from the FDA. Kate, I'd like for you to talk a little bit about that. What is that? I have to be honest, I thought this happened a long time ago. It tells you how. I'm just not really in the know, I guess, on some things, but I really thought that phenylephrine had already been taken off the market, but apparently not.

Speaker 2:

Yeah, so I think you're not alone in that.

Speaker 2:

I think a lot of us know that or you know the phenylephrine has not been proven to be effective for as a decongestant, so that is the big hot topic is the FDA is considering finally taking phenylephrine off of the shelves for OTC use.

Speaker 2:

I know personally there's not a lot of instances that I recommend phenylephrine because the data is just not there to show that it's effective as a decongestant. And another thing that I wanted to bring up is that phenylephrine is in a lot of those cold and flu products that have multiple different medications in them that your patients are seeking out, that one box, that one pill they can take that can hit everything, and a lot of times they either don't need everything that's in that multi-medication product or it has components and ingredients in it that may not be effective like the phenylephrine. Now I have heard some pushback on the FDA taking the phenylephrine off of the shelves because it is the only OTC oral decongestant product and there are patients out there that swear that it works for them. So you know, whereas it's not something I commonly recommend because the data is not there to support, it.

Speaker 2:

I know that there are some patients still that do feel like it works for them and there are some other contraindications to using the behind the counter Sudafed and so taking that one OTC option away I know has some people feeling maybe a little bit nervous about having good options.

Speaker 1:

Yeah, no, that's a great point. You know, again, I'm with you. It's been a while since I've been in practice, you know, behind the counter. But even then I was not recommending phenylephrine products because, like you said, the data was just not there, didn't show that it was actually effective. But that's a great counterpoint to maybe we should leave it, because there are patients who use it and say it works and it is an only option for them because maybe they can't take a pseudofedrin or whatever. So yeah, that's very interesting. Has there been any kind of normal way that the FDA does things? But is there going to be like an open discussion period, like what are we looking at, is it?

Speaker 1:

just make a decision.

Speaker 2:

So what I've looked into and this might not be all inclusive, but I think there is going to be some discussion back and forth and then, if the FDA does officially decide, okay, we need to get rid of phenylephrine, it's coming off the shelves They'll have to have about a year long grace period for all those multi medication products I was talking about that contain phenylephrine to figure out how to reformulate their combo product, because if we're taking phenylephrine by itself off the shelf, we'll have to take it off the shelf in those combo products, everything else, yeah.

Speaker 1:

So a lot of reformulations, repackaging, relabeling, a lot of considerations. Yeah, I could imagine that even being a two or three year process. So, yeah, okay, so no need to. If you are a phenylephrine user, no need to rush to shelves and buy everything that exists currently.

Speaker 2:

It's probably yeah, I think it's going to be there for a while yet.

Speaker 1:

It's going to be a little bit. Let's segue into some common misconceptions about OTC treatments. What are some common myths that we hear often? Or that patients come in and say, oh, so-and-so told me to do this Like. What are some of those things that we should either confirm or debunk, Because I want to be sure that we're giving accurate information to our patients?

Speaker 2:

Yeah, so I think the one that I see the most it goes back to those combo products is. I think a lot of patients feel like they need Advil, cold and flu, or DayQuil or NyQuil, and they need all of the different medications that are in those combo products. But a lot of times we're able to kind of narrow in on what is the main symptom and we are able to narrow it down to something that's maybe one product or maybe they're already taking something else. The example I'm thinking about is folks that take an antihistamine for allergies already. They might not necessarily need a combo product that has an antihistamine in it as well.

Speaker 1:

Great point.

Speaker 2:

So that's one of the things that I'm thinking about, also the kind of cough, I think. Another misconception I see is and I did say I was going to touch on the difference between nonproductive and and productive- coughs yeah please do, Is that all cough is bad, that we want to stop all cough.

Speaker 2:

But the thing is, if you have a productive cough and so what that means is you're actually coughing up substance. So when you cough, there's something green, you can feel mucus in your throat, something's going on there, versus the non-productive cough, which is the one that kind of hurts. It's really dry. You're not coughing anything up. I think a lot of patients think that we want to get rid of the cough no matter what. However, really, if you have a productive cough and you're coughing something up, we really don't want to suppress that cough. We want you to cough up whatever is stuck in there. We want you to cough up that excess mucus. So that's when I'm really recommending drinking a lot of water, letting that cough run its course. But then we're trying to support the pain you might be feeling from that sore throat from the cough, but we don't want to suppress that cough.

Speaker 1:

Right, right, because I mean we don't want the buildup of the fluid, because if patients are at high risk for pneumonia or fluid in the lungs and issues that can arise from that, so yeah, bronchitis, those are good yeah.

Speaker 2:

And then the other one that I wanted to mention is that a lot of these combo products also have Tylenol in them, so acetaminophen, and we've also we've got patients that might take that in other products I'm thinking about my chronic pain patients that are. You know they have their as needed hydrocodone, oxycodone, you know, percocet and or co-combinations, what I'm talking.

Speaker 1:

It has Tylenol in it, but if you'll, a few patients that you know take Extent, Extra Strength acetaminophen around the clock already or even or take it for migraines, and they take the ones labeled migraines and they don't even realize that that's what they're taking Right.

Speaker 2:

Like Excedrin. Also, your menstrual leaf products like Midol and Pamprin, also tend to have acetaminophen in it. So there's a lot, and our OTC recommendation for acetaminophen is like 3000 milligrams a day max to really reduce your risk of potential liver complications.

Speaker 1:

Sure.

Speaker 2:

However, depending on what medications you're already taking, you could you could hit that really close to that.

Speaker 1:

Yeah, yeah, that's a great point as well. And again, another reason to maybe shy away from those combo multi products that you know maybe you don't need the additional tylenol or the acetaminophen. Or maybe you know if you don't have a sore throat or there's nothing else hurting, then let's get one without that product in it.

Speaker 2:

So yeah, you're already taking your antihistamine you know, things like that or a lot of these combo products. I have dextromethorphan on it, which is a good cough suppressant. However, if you have that productive cough, I really don't want to suppress that.

Speaker 1:

Sure, yeah, and you know a lot of people, I think, may refer to a productive cough as a wet cough. I've heard that before as well. Wet cough where you actually kind of hear the fluid or the, the croupiness that comes up. So yeah, so again, great points. Just to kind of set the stage again. Productive coughs are not a bad thing. So we really don't need to suppress those, we don't want to get rid of those. That's actually helping get rid of some of that fluid build up. So yeah, great points. Thanks, kate. So any other common myths or misunderstandings, maybe natural remedies? I'm going to lead you on this one.

Speaker 2:

Anything to put on the path on that.

Speaker 2:

Yes, and I have actually seen an uptick in interest in natural remedies or approaches to cold symptom management that maybe don't involve traditional medications, and so there's some things here. I think the biggest hurdle with some natural remedies and like herbal products is just the lack of data around some of these products Like, for example, one that I know is really popular is elderberry syrup, and so you know, looking into the data, there's some studies that suggested that the use of elderberry can really reduce your flu severity and duration. However, there was a larger study that came out more recently that didn't really see any difference between using elderberry and placebo.

Speaker 2:

So, there's just not conclusive data. Same thing with the zinc too is that you know. The studies really go back and forth. I think. Another thing is we do know that taking a little bit more vitamin C and maybe combining that with vitamin D and zinc can be really helpful for cold symptom management and just immune boosting in general. However, you got to start that before you've got the cold. So you've got the cold, you've got the flu symptoms already. Bumping up your vitamin C, zinc et cetera isn't going to do as much for you and giving you that immune boosting effect as it would have if you had started that earlier on.

Speaker 1:

So it's more preventative than it is, yeah exactly.

Speaker 2:

I feel like these things are more preventative. However, again, like especially with the elderberry and the zinc, for example, the data really goes back and forth on whether or not that's really helping with reducing the duration of your symptoms.

Speaker 1:

Sure, yeah, no, it makes sense. Okay, so let's jump into for the next few minutes. We always like to set our pharmacists up who are listening for success. What are some recommendations? What are some of the things they should be doing? Questions they should be asking. You know, should they be again, as I mentioned earlier, looking for confused patients in the OTC aisle and then asking open-ended questions? It's like what are some of the things we need?

Speaker 2:

to identify in order to make good recommendations. Yeah, absolutely so. We've definitely talked about some of them. But I think, yes, looking for those patients that look a little confused in the aisle, I think Just asking, hey, can I help you find something, goes a really long way. I feel like a lot of folks don't want to necessarily come and bother us. They know we're busy and they want to respect that, but at the same time, if we kind of open that door, we notice they're looking for something like they're more likely to be like you know what? Yes, I'm trying to. I'm looking for DayQuil, and then that's a great place for us to step in and be like kind of ask more questions as far as like why they're looking for DayQuil.

Speaker 2:

So, asking about those symptoms and those open-ended questions. Great point, Shout out to my professors in pharmacy school. The open-ended questions will forever be drilled in me that we need to do those, but asking what are the symptoms? So that gets back into is it the wet, as you said, josh Koff, or is it dry? Are we having? Do they have a fever? Do they have chills? Um, are they congested or maybe not really? Um, how long have you been?

Speaker 1:

knows, do you have, you know, pain in the ear?

Speaker 2:

you know like yeah, yeah exactly what are the actual symptoms we're looking to treat. Then you know how long have they had these symptoms. Have they tried anything else, so that maybe they've already had DayQuil but they didn't recognize it because it was, you know, another pharmacy chain's version of DayQuil. But they've actually tried that already. So, asking some of those questions, and then, especially if we're looking at, potentially, a product that has acetaminophen in it, or if we're looking to recommend, like behind the counter, sudafed, I'm asking a few more questions about the different kinds of medications they're on.

Speaker 2:

I want to identify if we've got that risk of going over our threshold on acetaminophen. I want to know like especially if we're looking at Sudafed, for example, is this patient on blood pressure medications? Are they maybe taking like a TCA? Amitriptyline is the one that comes to mind.

Speaker 2:

Are there different medications they're on that are going to either, like, increase their blood pressure with this combination of Sudafed, increase heart rate. You know things? Are they taking other medications essentially that we wouldn't traditionally recommend that they take Sudafed with? So those are some of the things that I'm looking for to make sure that we can make the most sound recommendation and a lot of times it doesn't end up being a combo product.

Speaker 2:

It ends up being the one thing that they need, or we're able to recommend something that doesn't have one of the ingredients that would potentially cause a problem for this patient with their current therapies.

Speaker 1:

Yeah, that's great. So let's go ahead and talk about some of the other drug-drug interactions. So I know you briefly mentioned pseudofedrine. Obviously we know that that can increase heart rate and that can affect patients who have heart issues or blood pressure or whatever. What are some of the other things that we're looking out for? Obviously, our diabetic patients is a big part of our population, so a lot of our products, especially if they're liquid, are going to have a lot of sugar content. So what are some of the other things heart issues or whatnot that we're looking for?

Speaker 2:

Yes, I love that you brought up the liquid products with our patients that have diabetes, because a lot of those do contain sugar, and so that's a huge consideration for us to look at. So a lot of times I don't always recommend the liquids, especially in adults. Most adults want a tablet anyways, but if you are looking at liquids, that's a great consideration too. We talked a little bit about with Sudafed. We know that that can increase the high blood pressure cost of heart regularities. The ones that I briefly had mentioned and this is not inclusive these are just some key ones.

Speaker 2:

I was thinking of what I see the most often.

Speaker 1:

Yeah, of course.

Speaker 2:

You know TCA, so amitriptyline is the one I see the most often. That, can you know, increase that blood pressure in combination with Sudafed, as well as cause a regular heartbeat. I'm thinking about our patients that are already on blood pressure medications. So you know, if they're on blood pressure medications and then we put them on Sudafed, the effect of their blood pressure medications can essentially be counteracted, and so we don't want to necessarily do that either. Another thing it's not a drug but caffeine use. So for patients that you know, you might think of just coffee and tea, but there is OTC caffeine tablets. We've got some patients that maybe have an energy drink every day, and some of those can have up to 200 milligrams of caffeine in them.

Speaker 1:

A lot of the teas are caffeinated as well. Right, and a lot of people, when they're sick, they want a warm tea. Something else to maybe point out?

Speaker 2:

Yes, so you know increasing heart rate, increasing blood pressure, and then putting Sudafed on top of that. So you know thinking about that too, because the teas are not always. It's a little harder sometimes to figure out if they're caffeine free or how much caffeine is in them. So those are some considerations, too, that I want to take note of. And then another medication to note is Phentiramine. So it's a weight loss medication, but for patients that are on that one, they might not necessarily if that's like the only thing they're taking, they might not necessarily think that it could interact with any over-the-counters.

Speaker 2:

I think you talked about misconceptions, but I think a lot of patients think, oh, if it's over-the-counter, I don't have to worry about it with any of my other medications. Yeah, and especially in my patients that only take one or two medications. They really they're not worried about drug interactions, but this is one, for example, that you know it can also increase that blood pressure and cause rhythm.

Speaker 1:

Combination together with pseudoephedrine could be way too much stress on the heart. Yeah, yeah, okay, great. So I think we've gone into most everything as far as drug-drug interactions that I wanted to touch on the possibility of getting too much acetaminophen, so watching out for that as well, since it's in so many of those combo products. We've touched on some of the natural remedies. I want to go down this path a little bit more. You'd mentioned something in the space before we started recording and I really want you to touch on that, because where our patients are getting their information is so super important.

Speaker 1:

So I'll let you kind of talk about that again, but tell us about how important it is to ask those questions, to understand where they're getting the information, because it may not always be accurate.

Speaker 2:

Yes, I see more and more of our patients are looking to social media for information and do not always be accurate. Yes, I see more and more of our patients are looking to social media for information and, do not get me wrong, there's some great information on social media. I was telling Josh earlier there's an OBGYN I follow on TikTok and she's great, really informative. However, our patients are maybe not always getting their information from sources that are credible on social media and we have to recognize that they might be coming to us with questions or we can ask questions to help them kind of debunk maybe what they've seen on social media.

Speaker 2:

And so I saw an article actually earlier today that was talking about the TikTok craze of fermented garlic and honey for colds, and I've seen this everywhere on my own social media feeds and I did have a patient ask me about it, and so in the example here, there's been a lot of videos about how garlic has these antimicrobial properties and honey can be really good for cold and symptom management.

Speaker 2:

And so, whereas there is some research to suggest that garlic by itself does have those antimicrobial properties and, can you know, decrease cold and flu severity, that's not to say that there isn't any interactions or things that you would potentially need to look out for with garlic, for example, garlic interacts with warfarin and tacrolimus and those are medications that, if patients are on them, it's a pretty serious condition that they have, and so you know you wouldn't want to be saying that it's OK for them to do their at home garlic remedy and it's not going to interfere with any of their medications if they were on one of those, for example.

Speaker 2:

The other thing with honey is what I've seen is a lot of you know moms on social media saying this is a great natural remedy for your kids. You can give them honey and garlic, but the American Academy of Pediatrics doesn't recommend that you give honey to infants under age one, and the reason for that is because of an increased risk of infant botulism, and so that's not something that's getting communicated in those social media posts that I've seen, and so we really, really, if moms or parents are coming to you with this saying, hey, what do you think about this? That's a really important point for them, because the honey could be dangerous for their child if they're under one and don't have that more mature digestive system yet.

Speaker 1:

Yeah, that's great. I feel like there should be huge red signs around all honey in the stores that say don't feed to anyone under the age of one, because I do not think that that is widely known and accepted by patients. So yeah, those are all great points and, again, things that our pharmacists and they can find out these things with open-ended questions we can really get to the root cause of what symptoms are we trying to treat? What have you heard? What were you looking for over the counter? You know why are you looking for that? And just really kind of getting to the root of everything.

Speaker 2:

I think it's really important for us to to be understanding of where our patients are getting their information from and just help fill in the blanks. It's not going to be helpful to them for, like, oh my gosh, you cannot use social media Like that's a terrible place to get your information, like now we've turned them off. They don't want to listen to what we have to say They'll never come back to us again.

Speaker 2:

Yeah right, exactly, and like we want to be that trusted professional, we want them to come and be like hey, we saw this, but I'd really like your input, or you know is missing. Like I, I want them to come to me with those questions so I just wanted to make sure I added that in too, because we might not agree with where they're getting their information.

Speaker 1:

It's not going to help the conversation if we belittle them for using those sources of media exactly meet them where they're at and fill in the gaps you're exactly right and I think it's important to reiterate to them. It's okay if you're getting ideas or new remedies or whatnot from online, but just always ask us, ask the trusted professional who has the knowledge to help you determine whether or not it's legit or if it's not.

Speaker 2:

Yes, exactly.

Speaker 1:

Yeah, that's great. So, along those lines, are there any other education points or any other things that our pharmacists can be doing with our patients in the aisle? You had mentioned how, not only finding out if they've taken a previous product or because they may not remember or may not realize that it was the same thing that they're looking for here in a different brand or generic or whatever but also let's touch on really briefly why is it important to know about the duration of their symptoms, like, why is that something that we want to know about?

Speaker 2:

So yeah, I'm glad that you circled back on that. Yeah, so if they have had symptoms for more than a week and they've tried they've, you know, tried one or two things. Nothing is helping that's really when we want to refer them to see a doctor, another provider that can maybe look into if it's bacterial I know we mentioned that earlier and if it's something where you're going to need an antibiotic to clear up what you've got going on, because if really you're not seeing any symptom improvement and you've thrown some different OTC options or even some natural remedies that way and you're not seeing improvement after a week, it's likely something that OTC meds are not going to be able to cover.

Speaker 1:

Yeah, that's great, that's great, yeah. And I think again it's important to ask those questions because also dig deeper, don't just be like, oh, you've been treating it for two weeks, you need to go to the doctor. Like what have they been treating it with? So ask those questions first. Have they just been taking a zinc lozenge? Then, you know, maybe we could try a few other OTCs.

Speaker 2:

Yeah, exactly, exactly, you know from assist discretion, but in general you know, once we're at that week, or even two weeks if they've tried something, you know really at that point we want to be encouraging them to see somebody and kind of make sure it's not something bigger.

Speaker 1:

Yeah, yes, exactly, yeah, make sure it's nothing bigger.

Speaker 2:

Yeah, yes, exactly yeah that's great, okay, awesome.

Speaker 1:

Well, anything else, we're almost out of time. Is there any other supportive care tips or tricks for our pharmacists, anything else that we didn't go down the path of, that you want to be sure you share with our pharmacists and listeners?

Speaker 2:

Yeah, I mean I think I mentioned this a little bit too that folks are looking for some more natural things that they can do as well, and so you know, one thing is this time of year, especially if you're in an area that experience has cold weather, you're everything's a lot more dry inside, and so just adding that moisture back into the air with the use of a humidifier is something that can really help with congestive symptoms.

Speaker 2:

You know, a lot of times that congestion can come from the fact that just the air is just really dry. Also, there are products like the saline nose drops that you can use to kind of help break that up a little bit, and those are safer in kids too, since there's no active, you know, drug ingredients. And so those are some other and even just the hot beverage I know we talked a little bit about teas and caffeine, so maybe leaning towards something that's non-caffeinated, but that hot tea can really help soothe like a sore throat and those are some more natural recommendations that are more supportive, that you can always offer to patients too.

Speaker 1:

Yeah, that's great. And you opened another door that I want to be sure we go fully into.

Speaker 2:

Let's go through all the doors.

Speaker 1:

Yeah, so it's the nasal sprays and drops. So, obviously saline is very safe for the whole range of the human population. It doesn't affect anything. It is pretty effective in ways that it works with those symptoms. But we all know that some of those other products do have issues. Let's talk a little bit about what some of those issues are and why we need to watch out for those.

Speaker 2:

Yeah, so there are nasal decongestants fluticasome so otherwise you might know it, as Flonase is the one that I see most often. We've got patients that get that as a prescription. It's also available over the counter, and you can use that for a few days. The biggest thing with that one, though, is after a few days use usually like three to five if you keep using it you might actually experience some rebound congestion, and so that's not really what we're looking for. So that's one of the big things that I make sure you know I can recommend to patients. It's nice because it's a top, it's topical, you know it's at the site of the congestion, so there's fewer drug interactions in that way, but prolonged use can cause that rebound congestion.

Speaker 1:

Yeah, yeah. So we want to, we want to, we want to stay away from the just continuous application of those products because we might actually just be making the problem worse.

Speaker 1:

So that's great. Well, we are out of time. Kate, this has been so great. Thank you so much. One thing I always like to do at the end of the episode to wrap it up, is kind of have our guest speaker give us a summary of what the game changer is. What is the take home here? What do we want to leave our listeners with today?

Speaker 2:

Yeah, I think the game changer is that we are the medication experts, and really even in this over-the-counter space we have so much knowledge and there's so much we can do to help make sure our patients are walking away with a remedy that is safe for them, is hopefully effective for them and that is the best fit for them.

Speaker 2:

And sometimes those combination products, too, can be really expensive, and so, if they're really not warranted, we can also help with the cost savings dynamic, as well as just making sure they're not taking more medications that really aren't warranted, and so we have a wealth of knowledge in that area and just making patients feel comfortable and helping ask those questions to guide them in the right direction, as well as you know adding in those supportive measures, or you know being able to acknowledge and fill in the gaps on, maybe, where they get some of their information from. You know, there's a lot of places where we can make a huge difference, even in the over-the-counter space, and so I just encourage everyone listening today to feel empowered by the knowledge that they have to make that difference.

Speaker 1:

We always. We always tell our listeners you are the, you have the clinical knowledge, you are the expert. So just be confident in your discussions with patients and your recommendations. So this is great. Thank you so much, kate, for joining us. I've taken time out of your busy schedule. It was so nice to have you.

Speaker 2:

Of course. Thank you so much for having me.

Speaker 1:

Yeah, definitely. If you're a CE plan subscriber, be sure to claim your CE credit for this episode of Game Changers by logging in at CEimpactcom. And, as always, have a great week and keep learning. I can't wait to dig into another game-changing topic with you all next week.