Work System Barriers to Providing Safe Over-the-Counter (OTC) Medication Recommendations for Older Adults

Abstract

Background: Unsafe medication use represents a major public health concern, especially for older adults. OTC medications, those that can be purchased without a formal prescription or advice from a health care professional, are one contributor to unsafe use because of their perceived safety and accessibility. Despite the recognition of pharmacists’ ability to help patients make safe OTC medication choices, the prevalence of older adult misuse of OTC medications is well documented. Objective: To identify barriers to pharmacists providing safe OTC medication recommendations to older adults. Methods: Twenty-one retail pharmacists in three focus groups with questions developed using the critical incident technique. Analysis was guided by the Input-Performance-Output Model for Health Care Professional Performance. Results: Thematic analysis revealed barriers within all of the input categories of the work system model, including provider, patient, work system, organizational factors, and external environment. The results provide support that any intervention to improve safe OTC medication use in older adults should take into consideration the role of individual and interacting components of the work system.