Introduction
One of the primary roles of community pharmacists is the counter prescribing of OTC medicines. A number of factors have led to increasing demand for OTC products and concomitant advice from the community pharmacist. In deciding which medicine to use a pharmacist has to balance the efficacy and the safety of the medicine. The primary concern of pharmacists is safety (1,2). However safety is a perception and therefore different concepts of what makes an OTC medicine safe are likely to exist.

Method
Following 10 semi-structured interviews with community pharmacists various concepts of safety and efficacy were identified (2). These concepts were used as statements to produce a questionnaire, which, after piloting, was distributed by post to 500 randomly chosen community pharmacists. 10 of these statements on the questionnaire related to the safety of the product. Each pharmacist had to rate his or her level of agreement with each statement on a 5-point scale ranging from strongly agree to strongly disagree.

Results
After two reminders a 56.6% response rate was achieved. The highest level of consensus of agreement between respondents was 95.4% who agreed or strongly agreed with the statement "Due to the way they are sold, OTC products from the pharmacies are safer than the same product sold by a supermarket." The lowest consensus came from the statement "I would recommend a safer OTC product first, even if it was less effective." 32.9% of pharmacists agreed compared to 42.7% who disagreed. 60 pharmacists (21.2%) neither agreed nor disagreed with this statement. Most pharmacists agreed with statements that related to the way a product was sold, agreeing that giving advice and selling smaller quantities would improve the safety of the product. Only 13.1% of pharmacists agreed that effectiveness of the product is more important than safety.

Discussion
The results indicated that pharmacists do have differing concepts of what makes an OTC medicine safe. Most pharmacists consider that the way the OTC medicine is sold will contribute to safety of the product. The majority of pharmacists consider that the safety of the product is more important than the efficacy, which may be opposite to the view held by customers' (1).

Reference

1. Hassell K., et al. Advice provided in British community pharmacies: what people want and what they get. J Health Serv Res Policy, 1998,3,219-225
2. Smith I., Noyce PR., Weiss M.. Pharmacists' interpretation of "efficacy" and "safety" with regard to OTC medicines. 4^th Health Services Research and Pharmacy Practice Conference Abstracts, 1998.