Introduction

Due to deregulation of products and an increasing trend for self-medication among consumers, over-the-counter (OTC) medicines are widely used. Previous research has, however, demonstrated that such products can be misused/ abused.¹ The aim of this study was to investigate the general public's opinion and perceptions of OTC medicines, with a focus on their knowledge and opinion of the misuse/abuse of such preparations.

Methods

Data were collected using a survey which was administered to 1000 members of the public in 8 urban centres in Northern Ireland, using a structured interview technique. This survey was based on an instrument that had been used in a previous public survey.² The questionnaire was divided into four sections addressing: (a) attitudes towards community pharmacy and patients' contact with pharmacies, (b) attitudes towards the use of OTC medicines, (c) views on OTC medicines in terms of safety, potency and effectiveness, (d) knowledge and opinion of inappropriate use of OTC medicines. Data were coded and entered into a custom designed SPSS^© database for analysis. Chi square and Fisher exact tests were used to test any significant differences between groups.

Results

74.6% of participants (417 males and 583 females) reported visiting a pharmacy at least once a month, with 11.3% of participants visiting the pharmacy primarily to purchase OTC medicines. Almost 75% of the public stated they always followed the directions on the product. Males were more likely to increase the dose of the preparation if it did not work within the recommended period of time, while females were more likely to decrease the dose or stop the product (P<0.05). More than 80.0% (n=848) of the interviewees thought that OTC products could be abused, with painkillers being the most frequently mentioned category (n=501). Almost one third of participants (29.8%) had personally encountered at least one case of OTC abuse. Their experience of OTC abuse ranged from being 'addicted' to an OTC medicine (27.2%), using the product all the time for no legitimate reason, using the product for a 'rush' (18.8%), mixing the product with alcohol or soft drinks (9.7%) or using laxatives to lose weight (6.4%). From those who had personally encountered at least one case of OTC abuse, almost one quarter of participants (n= 104; 26.2%) thought that nothing could be done since these products are sold over-the-counter, 16.6% suggested prescription-only status for these medicines, while 10.8% (n=43) said that healthcare professionals should intervene to prevent OTC misuse/abuse.

Discussion

This survey revealed that the general public had a high level of awareness of the abuse potential of OTC medicines. These findings indicate that pharmacists should be proactive in the management of inappropriate OTC drug use.

References:

1. Hughes GF, McElnay JC, Hughes CM, McKenna P. Abuse /misuse of non-prescription drugs. Pharmacy World and Science 1999; 21(6): 251-55

2. Bell HM, McElnay JC, Hughes CM. Societal Perspectives on the Role of the Community Pharmacist and Community-based Pharmaceutical Services. Journal of Social and Administrative Pharmacy 2000; 17(2) 119-128