Objectives
To investigate the variations in over the counter supply of selected medicines between patients living in an affluent locality compared with those living in a deprived locality. To investigate patients' perceptions of current systems of self care and primary care.

Design
Study of selected over the counter medication using quantitative data analysis, structured questionnaire survey and semi structured qualitative analysis. Patients living in a most affluent locality (n=106) and most deprived locality (n=110) of Glasgow, who used one pharmacy in each respective locality were included. Selected over the counter medicines' supplies from combined wholesaler database for 1998 and 1999, and information from patients on purchased and prescribed medicines.

Results
Selected medicines for general pain relief, treatment of indigestion, head lice and vaginal candidiasis were supplied to pharmacies 4.2 times (indigestion) to 8.0 times (head lice) more per thousand head of population in the deprived area than the affluent area in the two years surveyed (1998 and 1999). The survey pharmacies served populations representative of local socio-economic characteristics, with 93% patients living in each defined locality. The survey recruitment showed three times more supplies on OTC than prescribed in the affluent area (76% vs 27%). Of those purchasing a selected medicine, 63% (SE 9%) of patients sampled (n=30) in the deprived area and 44% (SE 6%) of those (n=81) in the affluent area were taking concurrent prescribed medication. Similar patterns of use within the treatment indications were seen in affluent and deprived areas, for general pain relief (70% in affluent area, 71% in deprived area), treatment of indigestion (28% in affluent area, 22% in deprived area) and head lice (1% in affluent area, 3% in deprived area), and vaginal candidiasis (1% in affluent area, 4% in deprived area). Most (88%) of all those surveyed in the affluent area, and 89% of those in the deprived area, were recurrent users of the selected medicine. Most selected medicines used for the first time, were for indigestion in the affluent area, but were for pain relief in the deprived area. Qualitative investigation showed trust and confidence in the pharmacist to be key requirements for patients. Patients expressed a need for selective information on their medicines, and more flexible systems of medicines' supply. Patients in both samples expressed similar views and expectations.

Conclusions
The pattern of medicines available for OTC use indicates considerably higher use in the more socially deprived locality. Consumption of medicines commonly purchased in the pharmacy survey showed that patients in deprived areas were less likely to purchase OTCs, but those who did purchase them were more often on prescribed medication. Individual patients' views and expectations of their medicines and their pharmacy service did not reveal differences associated with living in a deprived area. Current treatment of morbidity available from prescription data is incomplete, and the inclusion of OTC data in local health care needs assessment is recommended.