Background

The UK Government increasingly encourages self-care for management of minor ailments. However, despite growth in the over-the-counter (OTC) medicines market, self-care remains an under-researched area. A literature review of over-the-counter analgesics use and pilot pharmacovigilance work with OTC ibuprofen, has identified a need for a better understanding of the patterns of use of these medicines to determine the extent of problem use.

Objectives

1. Estimate the prevalence of current or recent use of non-prescribed analgesics.

2. Describe relationships between non-prescribed analgesic use and demographic characteristics.

3. Describe reasons for use and patterns of use of non-prescribed analgesics.

4. Determine the source of supply of non-prescribed analgesics.

5. Begin to explore patients' attitudes towards the risks and benefits of using analgesics.

Methods

This was a descriptive, cross-sectional, self-completed postal questionnaire survey. Three slightly different survey forms were piloted on three separate random samples of 100 individuals selected from the Scottish electoral roll. The form was revised in response to the pilot, and a final version of the questionnaire was mailed to 3000 individuals randomly selected from the Scottish electoral roll. Two reminders were sent.

The data collected included: Demography (age, gender, education, lifestyle, relevant medical history etc.); Use of non-prescription analgesics during the previous two weeks (preparation name, source of preparation, reason and pattern of use); Use of other non-prescribed medicines (preparation name, source of preparation); Use of prescription medicines (preparation name, reason for use); Attitudes towards analgesics; Attitudes towards medicines in general. Chi square tests were used to test for associations between variables.

Results

The response rate to the postal questionnaire was 56%. Forty-one percent of respondents reported having used a non-prescription analgesic in the previous two weeks, a higher prevalence than has been reported elsewhere. The most commonly used analgesics were paracetamol (49%) and ibuprofen (27%). The most common reason for using a non-prescribed analgesic was headache/migraine. Thirteen percent of those using non-prescription analgesics used them continuously while 35% used them regularly. Of those using non-prescription analgesics, 40% usually obtained them from a community pharmacy while 33% used a supermarket.

Users of non-prescription analgesics were more likely to be: younger (p<0.01); female (p<0.01); married or living with a partner (p<0.05); educated to a higher level (p<0.01); users of alcohol (p<0.01); in good or very good health (p<0.01); eligible to pay for their prescriptions (p<0.01); living in a less deprived area (p<0.05).

Most respondents thought that analgesics obtained from general stores were as safe and as effective as those obtained from a pharmacy. Prescription analgesics were perceived to be as safe as those obtained from pharmacies, but opinion was divided on their relative effectiveness; prescription analgesics were perceived to be more effective than those obtained from general stores, but opinion was divided on their relative safety.

Conclusions

Preliminary results suggest that non-prescribed analgesics are used to treat chronic conditions. Further analysis on the appropriateness of use of OTC analgesics is ongoing and will be presented at the conference. Future research will compare attitudes to OTC and prescription analgesics.