Use Of Over-the-counter Medicines Research Articles

Preventing the Abuse and Misuse of Over-the-Counter Medicines: A Survey of Community Pharmacists in Finland

Background Over-the-counter (OTC) medicines intended for short-term use for self-care may be abused or misused. Aim To explore the experiences and perceptions of community pharmacists (dispensers, pharmacists, and pharmacy owners) of the use, abuse, and misuse of OTC medicines by pharmacy customers, and to identify their perceptions of the most appropriate methods to prevent inappropriate use of OTC medicines. Method A cross-sectional national online survey to community pharmacists in Finland. A previously validated structured questionnaire was modified. Three national pharmaceutical associations were contacted to help in recruitment of their members (n = 5594, calculated target sample size n = 360). Descriptive statistical analyses were conducted. Results In total, 442 responses were received. Most respondents strongly agreed (Md all = 5) that OTC medicines could be abused or misused; pharmacy owners were more likely to strongly agree than pharmacists (p = 0.012). Pharmacy owners were more likely to think that laxatives were liable for abuse than dispensers (p = 0.008), and that travel sickness medicines were liable for misuse than dispensers (p < 0.001) and pharmacists (p = 0.013). Patient counseling was the most commonly employed method to prevent the problem. Respondents perceived that providing training to staff about OTC medicines that can be abused (Md all = 5) was the most appropriate strategy to prevent OTC medicine abuse; pharmacy owners were more likely to strongly agree or agree of this (p = 0.005) than dispensers. Conclusion: Community pharmacists are aware of the liability of OTC medicines for the potential abuse and misuse. They employ various methods as advising and counseling the customer to support the rational use of OTC medicines.

Prevalence of Self-Medication Among Female University Students During Examinations: A Cross-Sectional Study in Saudi Arabia.

Introduction Those who practice self-care using over-the-counter (OTC) products believe that these medications are relatively safe. They can be used to treat mild illnesses that do not require medical consultation. However, improper self-medication using OTC medicines because of inadequate knowledge of their side effects and interactions can result in drug-related issues and even death. The current study was performed using the foundation year students of Princess Nourah Bint Abdul Rahman University (PNU) as subjects, to examine the use of OTC medicines during examination times. Methods This cross-sectional study was done on 213 (response rates 87.7%) foundation-year female students in the Health Colleges at PNU in Riyadh. Using a 26-item, self-administered, online questionnaire, data were collected. Results It was found that more than 50% of the students used OTC medicines habitually during exam periods. A majority (90.6%; p< 0.0001) of the students mentioned that the overuse of Panadol Extra was very safewhile 67.6% (p< 0.0001) of them declared that nonsteroidal anti-inflammatory drugs (NSAIDs) would not induce stomach ulcer formation. A higher percentage (67.6%; p<0.0001) of the students confirmed using OTC medicines during exam time for headache relief.A higher percentage (72.8%; p< 0.0001) of the students indicated that because the OTC medications were readily available and they believed these drugs were safe, they used sizable quantities during the time of the examinations. Furthermore, 69% (p< 0.0001) of the students confessed that because of a friend's recommendations, they started trying OTC medicine. Above 67% (p< 0.0001) stated that OTC medications are inexpensive and easily available in Saudi Arabia. Conclusion To conclude, the findings of this study reiterated the high usage of OTC medicines by female students during the time of examination, and the highest used were painkillers.

Prevalence and associated risk factors of self-medication with over-the-counter medicines among university students in the United Arab Emirates.

Proper self-medication with Over the Counter (OTC) medicines can benefit both the patient and the healthcare sector. Although OTC medications are considered relatively safe, their improper use can lead to serious health risks and implications. This study investigates the self-medication practices with OTC medicines among medical and non-medical students at different universities in the United Arab Emirates. A cross-sectional study was carried out over six months (January-June 2021). The desired confidence level was set at 95%, and the precision level was 0.03. A three-step cluster sample method was employed. A self-administered questionnaire that assessed predisposing, enabling and need factors associated with the use of OTC medicines was developed based on Andersen's behavioural model. A total of 2355 students completed the study questionnaire. The mean age was 20.94, and 76.3% were female. More than half of the participating students (57.5%) reported using OTC medicines during the past 90 days of conducting the study. A good proportion (67.8%) reported performing a high level of self-care. Student's perceived health (p<0.0001), educational background (p=0.003), use of left-over drugs (p=0.002), relies on informal sources for drug information (p=0.0001) and reading drugs information leaflets (p<0.0001) were all significantly associated with whether students sought medical advice or not. Many university students were observed that they never sought pharmacist advice when taking OTC medications. The likelihood of consulting a pharmacist when using an OTC medication was lower among medical students than non-medical students and among those who do not read the drug information leaflets. The proactive role that a pharmacist can play can have paramount importance in promoting the proper and safe use of OTC drugs.

Medicine use in children aged under 12 years-Population survey in Finland.

To study the prevalence of prescribed and over-the-counter (OTC) medicine use in children under 12 years of age in Finland and to examine factors associated with the medicine use. A nationwide population survey was carried out in Finland in spring 2018 with a random sample of children under 12 years (n= 8000). A response rate of 24% (n= 1921) was attained. The questionnaire was sent to the child's primary guardian. Current use of prescribed medicines and the use of OTC medicines in the preceding 2 days were the main outcome measures. Of all the children 19% had used prescribed medicines, 15% OTC medicines, and 31% either prescription or OTC medicines during the preceding 22 days. Children's health related factors were positively associated with prescribed medicine use including fairly good to poor health status, symptoms experienced, and illnesses diagnosed by a physician. The guardian's healthcare education and use of prescribed medicines were also associated with children's prescribed medicine use. Symptoms of illnesses and fairly good health status were found to be associated with childrens' use of OTC medicines. The use of medicines in children under 12 years of age is quite common in Finland. As expected, children's health-related factors were associated with medicine use. Also, guardians' healthcare education and the use of prescribed medicines were associated with children's prescription medicine use. Children's medicine use should be continuously monitored and investigated further to identify the reasons leading to appropriate and inappropriate medicine use in children.

Over-the-Counter Medicine Attitudes and Knowledge among University and College Students in Brunei Darussalam: Findings from the First National Survey.

Over-the-counter (OTC) medicine is defined as safe and effective for the general public to use, without seeking therapy from a health professional. As primary social media and internet users, university and college students are more likely to be exposed to unverified sources of health information. This study aims to assess the knowledge, attitudes, and behaviour of students at institutions of higher learning in Brunei with regard to the safe use of OTC medicines. A cross-sectional study was performed using a self-administered online questionnaire, adapted from the literature with additional information from the United States Food and Drug Administration (FDA) on the educational resources in understanding OTC medicine for consumers. The questionnaire consisted of 4 sections: demographic information, knowledge of OTC medicines, attitudes, and practice. Descriptive and inferential statistics were used for data analysis. A total of 335 students returned a completed questionnaire. The students had a mean knowledge score of 7.1 out of 9, with more than half (53.4%) having good knowledge (knowledge score > 7), and only a small percentage (5.7%) with poor knowledge. Almost all of the students (99.7%) had a positive attitude toward OTC medicine use. Few of the students practiced improper habits in terms of OTC medicine use, such as not reading the instructions or taking more than the recommended dose. Awareness of proper OTC medicine use among students in institutions of higher learning is necessary to prevent the rise of inappropriate user practices.

Lekovi i nefarmakološke mere za ublažavanje simptoma infekcija respiratornog trakta u pedijatrijskoj populaciji

In the pediatric population, acute respiratory tract infections (RTIs) are the most common reason for seeking professional help from a physician or a pharmacist. Alleviation of symptoms is the only therapeutic measure in viral RTIs and is an adjunct to antibiotic therapy in bacterial RTIs. This article discusses pharmacologic and nonpharmacologic options for treating nasal congestion, cough, fever and sore throat in RTIs and clinical evidence on their efficacy and safety in the pediatric population. In general, clinical studies conducted in children for most of these drug groups are few or nonexistent, making it difficult to create evidence-based recommendations. Nasal decongestants, cough suppressants, mucolytics, expectorants, antipyretics/analgesics and sore throat local preparations are available in suitable pharmaceutical forms and strengths for the certain age. As many of them are over-the-counter (OTC) preparations, it is necessary to strictly take into account the age of the child in whom they may be used and dose properly. Multicomponent preparations carry the risk of taking unnecessary medications and of their side effects. The use of multiple OTC medicines is associated with the risk of an overdose of a component that may be present in different preparations. Appropriate non-pharmacological measures (e.g. oral hydration, nasal saline application or irrigation, honey) may be helpful and should be used whenever possible due to their safety.

Use of over-the-counter medicines by privately insured patients with common chronic conditions in South Africa

Abstract Objectives The study measured access to commonly used over-the-counter (OTC) medicines (OTCMs) by individuals who were insured for the management of chronic diseases and considered reasons for selection of the medicines in addition to mainstream drugs usually prescribed for treatment. Methods Data were extracted from a large corporate database. Eligible subjects were aged ≥40 years and registered for management of one of the prevalent non-communicable diseases. Utilization of aspirin, inhaled corticosteroids and bronchodilators was assessed. Key findings The study population included 12 108 controls and 4149 individuals with one of 11 common chronic conditions that were categorized as metabolic, respiratory, cardiovascular or glaucoma. There was high utilization of bronchodilators in the respiratory group, possibly indicative of poor control of the primary condition and moderate access to bronchodilators by controls, possibly self-medicating for an undiagnosed chronic condition. Aspirin was not only utilized for primary or secondary prevention in the cardiovascular and metabolic groups but also appeared to be used to treat glaucoma. Bronchodilators may also have been used to treat side effects of drugs used to treat hypertension. Conclusions Reasons for use of OTCMs in the treatment of a chronic condition include poor control, treatment of a side-effect of a drug used to treat the chronic condition and self-medication for an undiagnosed condition. To gain further insight, insurers should routinely analyse claims and develop performance-enhancing interventions.

The Practice of OTC Dispensing by Community Pharmacist in Nepal

Over the counter (OTC) medications are the group of drugs that can be sold without the prescription of a registered medical practitioner to the consumers. Pharmacists are the most accessible health care professionals to the patient for the treatment of their minor illness. To provide appropriate advice to the patient at the time of dispensing and over-the-counter (OTC) medication counselling, community pharmacists need access to current and reliable information about medicines. A descriptive study was conducted on fifty pharmacists present in the community pharmacy of Kathmandu and Lalitpur districts. Predesigned validated questionnaire consisting of 16 questions were taken for the collection of data. Qualification of pharmacists, numbers of consumer asking for OTC medication in a week, most commonly dispensed OTC medicines by pharmacists, common symptoms told by consumers and average working hour of community pharmacists were recorded. The approval from the concerned authorities was taken. The study was a community based descriptive study done for 3 months. The data of the study was analyzed by using SPSS version 18. Out of 50 Pharmacists, 27 were males and 23 were females. Most of the study populations were qualified as assistant pharmacy. 82% of Community Pharmacy encountered more than ten consumers in a week. Analgesics and antipyretics, drugs for gastritis, antiprotozoals and antihistamines were the most commonly dispensed drugs by the pharmacies. The most common symptoms enquired by patients/consumers were fever (92%), common cold (90%) and headache (86%) as reported by pharmacists respectively. Average working hours of community pharmacists were 67 hours per week. Few pharmacists knew the meaning of terms related to evidence-based health. Most respondents agreed that pharmacists have the necessary training to prescribe. There is increasing use of OTC medicines in Nepal. The study on community pharmacy practices regarding over the counter medicines can assist in evaluating pattern of use of OTC medicines by consumers thus help to reduce abuse and misuse of such medicines.

Prevalence and pattern of misuse of over-the-counter drugs among teachers in public and private secondary schools in Benin City, Nigeria

Purpose: Misuse of over-the-counter (OTC) medicines can result in several harms ranging from mild to very severe conditions. The study assessed the prevalence and pattern of misuse of OTC medicines among secondary school teachers, for improved safety measures. Methods: A descriptive cross-sectional study was conducted, using a multistage sampling technique. A self-administered, structured, researcher-developed questionnaire on OTC medicine use was used for data collection after face validity and pre-test. OTC medicines misuse was assessed with reference to the recommended dose, among 300 respondents. Analysis of data was done using IBM SPSS version 21.0. P ≤ 0.05 Results: A total of 300 respondents participated in the study and the majority were 25-40 years of age, 120 (40.0%). Females constituted 186 (62.0%) of the population. Vitamin supplements were predominantly misused 110 (36.7%) at varying degrees, followed by Analgesics 104 (34.7%), Cough mixtures 41 (13.7%) and Ointments 7 (2.3%) respectively. More than half of the respondents (62.3%) misused their OTC medicines at varying degrees; Always 6 (2.0%), Sometimes 145 (48.3%) and rarely 36 (12.0%). The majority of the respondents misused OTC drugs because they did not think it mattered 91 (48.7%). Other reasons were; recommended dose not effective 84 (44.9%) and the need for faster onset of action 9 (4.8%). The prevalence of misuse was 187 (62.3%). Conclusion: There was high prevalence and widespread misuse of various OTC medicines by the teachers at varying degrees, with vitamin supplements being most misused. Teachers should have routine OTC drug information through workshops organized by health-related agencies, since they possess the ability to influence the larger society. Keywords: Over-the-counter (OTC) medicines, misuse, school teachers, prevalence

Over-the-counter medicines, economic conditions, and citizens most in need in Greece: Is it a challenge for primary care research?

IntroductionRecent austerity experiences in Greece suggest a plausible link between extensive use of over-the-counter (OTC) medicines and socio-economic peculiarities of life. CommentaryDuring the economic crisis in Greece, accessibility to healthcare services has been impacted, particularly for people with low income. However, this fact has not been systematically analyzed in conjunction with an observed increase in use of OTC medicines. Gaining a better understanding of the reasons leading to self-care may help to answer additional questions. Further research is needed to assess the gap between self-care and medically assisted care/treatment by designing pilot monitoring actions and focusing on behaviours related to OTC medicine use. Primary care can offer more collaboration between primary care physicians, community pharmacists, patients, and their families. ImplicationsIt is crucial to create a multimodal research plan to gain a better understanding of motivational reasons that eventually lead to increasing use of OTC medicines. Efforts should be made to develop data collection techniques that will elicit information from various social groups that focus on changeable behaviours and perceived needs in relation to medicine consumption.

A Pilot Evaluation of I'M HAPPY: An Interactive Module to Halt Abuse of Prescriptions in Preteens and Youth.

Objective: The purpose of this project was to create a web-accessible drug education program that would positively impact student knowledge and perceptions. Materials and Methods: An interactive computer module (Interactive Module to Halt Abuse of Prescriptions in Preteens and Youth [I'M HAPPY]) was created using a combination of e-learning and animation software. The module used narrated illustrations, animations, and games to explain what over-the-counter (OTC) and prescription drugs are, how they are used correctly, and what risks they carry. Animated drug refusal scenarios with user-determined outcomes were also incorporated. Sixth-grade students were asked to complete the module online and were given a 14-question pretest and posttest on the definitions, adverse effects, and proper use of OTC and prescription medicines. They were also asked to rank the perceived helpfulness of several drug refusal strategies. Student opinions about the computer module itself were collected on the posttest. Results: Students (n = 34) scored better on quiz questions following the module. They also showed increased favorability toward three of four drug refusal strategies after completing the module, with a greater proportion ranking these strategies "Very Helpful." Most students indicated they learned new things from the module (79%) and found it enjoyable (88%) and easy to use (97%). Conclusion: The I'M HAPPY program improved student knowledge of OTC and prescription drugs and enhanced perceptions of the helpfulness of certain drug refusal strategies. The computer module was considered enjoyable and easy to use, and can be easily disseminated to any student or classroom having internet access.

136. Medicines and Me: Hands-On Health Literacy Lessons for Adolescents

Adolescents are prone to errors in self-administering medicines, and they have serious misunderstandings about potential risks or adverse effects of over-the-counter (OTC) medicines. This project created six hands-on lessons for use by secondary school teachers to increase their students’ understanding of the safe use of OTC medicines, with focus on how to safely administer the correct dose of medicine, and how medicines are developed and tested.

Over-the-counter medicines: Global perspective and Indian scenario.

Patients often approach a pharmacist instead of visiting a doctor for minor ailments such as cough, cold, allergies, pain, fever, acidity, diarrhea, and skin-related conditions. Purchase of specific medicines over the counter is legally recognized in most countries. 'Over-the-Counter (OTC) Medicines' means drugs which are legally allowed to be sold by pharmacists without need for a prescription. The term does not have a legal definition in India. Technically, drugs are OTC unless they are specifically stated as prescription only drugs. OTC drugs allow faster and cheaper access to healthcare; however, their misuse and adverse health effects cause concerns. This article describes concept of OTC medicines and practices in India against the background of globally prevalent regulations and practices. A recognized category of OTC medicines by law, patient awareness programs, and support of pharmacists and pharmaceutical companies are required to optimize the use of OTC medicines in India.

Knowledge and Practice Regarding Over the Counter Medicines among Adults

Self-medication can be defined as obtaining and consuming one (or more) drug(s) without the advice of a physician either for diagnosis, prescription or surveillance of treatment. The use of over the counter medicines are increasing day by day. Low cost and easy availability make these medicines to reach the hands of community quickly. The present study was intended to assess the knowledge and practices regarding over the counter medicines among adults and determine the association between knowledge and socio demographic variables. Across sectional survey was adopted and 100 adults were selected randomly from a rural ward in Thiruvananthapuram district. The result revealed that 39% of the adults had good knowledge, 43% had average knowledge and only 18% had poor knowledge. A statistically significant association was found between knowledge regarding Over the Counter (OTC) medicines with age (p=0.034) and monthly family income (p=0.002). The practice regarding OTC medicines revealed that majority (92%) of the adults were using OTC medications for various conditions like fever, pain, respiratory and gastric problems and 31% of the adults were taking more than one medicines without prescription and 85% of the subjects took medicines shown in advertisement without consulting a doctor and 90% of the subjects checked expiry date while purchasing medicines from the shop and 92% of the subjects discarded the medicines after the date of expiry. It can be concluded that knowledge regarding the use of OTC medicine was less among adults and public awareness through mass media can help to reduce the use of OTC medicines among people.

Pharmacotherapy Literacy and Parental Practice in Use of Over-the-Counter Pediatric Medicines.

Background and objectives: Pharmaceutical literacy skills of parents are crucial for appropriate and safe medication use in pre-school children (ages 1–7 years). A recent study on pharmacotherapy literacy from Serbia showed that one in five parents have difficulty understanding common information about the use of medicines. Because antipyretics are considered to be the most frequently used group of over-the-counter (OTC) medications during the pre-school period, we aimed to: (i) examine parental practice and expectations in antipyretic medication use, and (ii) analyze associations of parental practice and expectations related to socio-economic status and pharmacotherapy literacy. Materials and methods: A cross-sectional survey using a self- report validated specific instrument was conducted with the parents of pre-school children in kindergartens in Belgrade, Serbia. Pharmacotherapy literacy refers to the knowledge and personal skills needed to meet the complex demands of medicine use in both healthcare and non-healthcare settings. A comprehensive literature review, expert-focus group consultation, and pre-testing were employed in 4-item multiple-choice test development to explore practice and expectations related to the use of OTC pediatric antipyretic medicines. Results: The final analytical cohort was comprised of 813 participants, the majority (63.3%) chose a medicine based on a physician’s suggestion and only 15.4% of parents reported they would follow the advice of a pharmacist. More than a half of parents (54.1%) would need advice about antipyretic medicine from a pharmacist, firstly in a simpler language. Parents satisfied with the information given by a pharmacist had higher pharmacotherapy literacy, compared to parents with lower levels (OR–0.718, 95%CI (0.597–0.865), p < 0.001). Men had a higher expectation of pharmacists to explain medicine use in a simpler language (OR–1.630, 95%CI (1.063–2.501), p = 0.025), as well as parents with three or more children (OR–2.527, 95%CI (1.43–4.459), p = 0.001). Parents with higher knowledge about medicine use were less likely to ask for simpler information (OR–0,707; 95%CI (0,583–0,856), p < 0,001). Conclusions: Our main finding is that practice in antipyretic OTC medicine use was associated with levels of parental pharmacotherapy literacy. The expectations of pharmacists were higher among parents with lower levels of pharmacotherapy literacy, who expected more information in a simpler and more precise language. This study highlighted the need for pharmacists to identify risks in parental practice and to provide information about medicines to parents of pre-school children in a simpler and more appropriate way.

Strategies to foster an adequate compromise of the pharmacist with respect to over the counter medicines’ advertisement.

The advertisement has a great influence on the public and, in over the counter medicines (OTC), it can generate health risks on the population if it is misregulated. The aim of this work is to analyze and disclose strategic viable actions emerged from a forum debate during an online course for fostering the pharmacist’s compromise related to OTC advertisement. Methods: A content analysis was carried on, grouping by themes and categories the opinions of community pharmacists participating in a forum debate about OTC advertisement. Two audiovisual advertisement pieces were analyzed as triggers of discussion. Results: Sixty-five professionals participated in 3 groups of debate, and 103 opinions were collected. Among individual strategies, to guarantee the attention by a pharmacist was highlighted when health conditions or the use of medicines are consulted about. Other strategies include denouncing to the ANMAT the advertisements that do not comply with the norms, procuring a better regulation and assuming a critical posture. Within the collective strategies, including pharmacists in the evaluation committee of advertisement of ANMAT and furthering norms to reassess the role of the pharmacist and the community pharmacy in minor illnesses were stressed. Conclusion: The contribution of the community pharmacists allows disposing a set of professional strategies, both individuals and collectives, to promote a rational use of OTC for the patients and the community.

Interventions to enhance effective communication during over-the-counter consultations in the community pharmacy setting: A systematic review.

Easy access to effective over-the-counter (OTC) treatments allows self-management of some conditions, however inappropriate or incorrect supply or use of OTC medicines can cause harm. Pharmacy personnel should support consumers in their health-seeking behaviour by utilising effective communication skills underpinned by clinical knowledge. To identify interventions targeted towards improving communication between consumers and pharmacy personnel during OTC consultations in the community pharmacy setting. Systematic review and narrative analysis. Databases searched were MEDLINE, EMBASE, Psycinfo, Cochrane Central Register and Cochrane Database of Systematic Reviews for literature published between 2000 and 30 October 2014, as well as reference lists of included articles. The search was re-run on 18 January 2016 and 25 September 2017 to maximise the currency. Two reviewers independently screened retrieved articles for inclusion, assessed study quality and extracted data. Full publications of intervention studies were included. Participants were community pharmacy personnel and/or consumers involved in OTC consultations. Interventions which aimed to improve communication during OTC consultations in the community pharmacy setting were included if they involved a direct measurable communication outcome. Studies reporting attitudes and measures not quantifiable were excluded. The protocol was published on Prospero Database of Systematic Reviews. Of 4978 records identified, 11 studies met inclusion criteria. Interventions evaluated were: face-to-face training sessions (n = 10); role-plays (n = 9); a software decision making program (n = 1); and simulated patient (SP) visits followed by immediate feedback (n = 1). Outcomes were measured using: SP methodology (n = 10) and a survey (n = 1), with most (n = 10) reporting a level of improvement in some communication behaviours. Empirical evaluation of interventions using active learning techniques such as face-to-face training with role-play can improve some communication skills. However interventions that are not fully described limit the ability for replication and/or generalisability. This review identified interventions targeting pharmacy personnel. Future interventions to improve communication should consider the consumer's role in OTC consultations.

Attitudes Toward and Use of Over-The-Counter Medications among Teenagers: Evidence from an Italian Study

&lt;p&gt;In recent years, the consumption of Over-The-Counter (OTC) drugs has increased. Previous studies have pointed out that the OTC medications are misused and abused by teenagers, who often show poor knowledge of the toxicity of these drugs.&lt;/p&gt;&lt;p&gt;The paper aims to analyze the use of OTCs by teenagers and the factors that influence their consumption.&lt;/p&gt;&lt;p&gt;This paper is based on quantitative data. A web-based survey was administered to the students of an Italian high school. The questionnaire included queries on the knowledge, attitudes and practices of the students with regard to OTCs. Since teenagers are influenced by their families, their approach to healthcare was also investigated.&lt;/p&gt;&lt;p&gt;An exploratory factor analysis was conducted in order to determine the key factors influencing their attitudes toward the use of medications. Finally, a cluster analysis was run in order to identify different behavioral segments.&lt;/p&gt;&lt;p&gt;Results show that four factors (tradition, social communication, self-management, and caution) influence the attitudes and behaviors of teenagers toward OTC medicines. The research also highlighted that attitudes toward the use of OTC medicines varied among the respondents, who were grouped into three different clusters: their presence implies the need for targeted educational programs, involving teenagers and their families.&lt;/p&gt;

Misuse of prescription and over-the-counter medicines in South London nightclubs

Objectives. There is currently little research on the extent of prescription and over-the-counter (OTC) medicines misuse in the United Kingdom. The objectives of this study were to determine the prevalence of OTC/prescription medicine misuse in the South London nightclub community and to look at the sources of supply. Methods. Individuals attending nightclubs in South London catering for, but not exclusively for, men who have sex with men (MSM) were surveyed about their use of recreational drugs, prescription, and OTC medicines and where they obtained these medications. Results. In total, 313 individuals were surveyed: 282 (90.1%) were male and 248 (79.2%) were MSM; 113 (36.1%) had misused at least one medicine in their lifetime and were more likely to have lifetime use of a recreational drug (OR 9.74, 95% CI 1.27–74.44). Diazepam (25.2%) and Z-drugs (zolpidem, zopiclone, zaleplon) (16.3%) were the most commonly misused medicines. The sources were friends (32.9%), dealers (15.7%), primary care doctors (13.7%), Internet purchases (10.9%), and overseas (7.3%). Conclusion. OTC and prescription medicines misuse is common among nightclub attendees in South London with these medicines coming from numerous sources. Further work is needed to determine the extent of this problem and the various forms of drug diversion.

Pharmaceutical counseling: Between evidence-based medicine and profits.

The number of pharmacies, which produce drug formulations locally, has recently considerably reduced in Russia. Pharmacies mainly operate as retailers of industrially manufactured drugs.Pharmaceutical consultation of customers at pharmacies aimed at responsible self-medication is the most popular and accessible feature of pharmaceutical care. In Russia there is a significant list of medicines approved for sale in pharmacies on a non-prescription basis that is specified in the product label. In this regard, the role of pharmacists in public health in Russia increases. Pharmacist, working directly with population, is an important figure for the rational use of medicines. This type of work requires high level of professional training and appropriate ethics. To explore the current status of pharmaceutical counseling in Russia. Situation analysis, surveys of pharmacists. Our experience in the system of postgraduate professional education, the results of the survey of pharmacists, and the long-term dialogue with pharmacists allowed us to identify several unresolved issues in the work of a pharmacist selling non-prescription drugs.Lack of differentiation in the functions of a pharmacist with a higher education and pharmaceutical technologist: In production/industrial pharmacy technicians are engaged in manufacturing of pharmaceutical formulations. However, due to the loss of production functions technologists had to move away from production laboratories of apothecaries to the sales area. Currently, the apothecary's assignment to receive prescriptions and dispense medications can be fulfilled by either a pharmacist or a pharmaceutical technician. It significantly discerns the pharmacy from the medical organization with clearly delineated functions of doctors and nurses. Russian regulations should consider the level of education required for high-quality pharmaceutical counseling.Contradiction between the pharmacist's special functions and trade procedure with the lack of pharmaceutical counseling standards: Article 1.1 "Code of Ethics of the pharmaceutical worker of Russia" states: "The main task of the professional activity of the pharmaceutical worker - protection of human health", Article 1.3 states that a pharmaceutical worker must take professional decisions solely in the interests of a patient [1]. However, the pharmacy is a trade organization, thus as a retailer the pharmacy is directly interested in making profits and increasing sales of pharmaceutical products, including non-prescription medicines. Moreover, while the clinical medicine is monitored for unjustified prescribing and measures are being taken to prevent polypharmacy, for a pharmacist the growing sales of over-the-counter drugs, active promotion of dietary supplements, homeopathic medicines, medical devices, and, consequently, an increase of financial indicators (particularly "average purchase size") - all are characteristics of success [2].Rational use of over-the-counter medicines requires introduction of pharmaceutical counseling standards (pharmaceutical care) according to symptoms - major reasons to visit a pharmacy as part of responsible self-medication (cold, sore throat, headache, diarrhea, etc.). Standards of pharmaceutical counseling should be objective, reliable and up-to-date and contain recommendations for the rational use of over-the-counter drugs as well as indications requiring treatment to the doctor. Standardization of pharmaceutical counseling in terms of Evidence-based Pharmacy would enhance the efficiency, safety and cost-effectiveness of over-the-counter medicines.Currently, the lack of clinical component in the higher pharmaceutical education and the lack of approved standards of pharmaceutical counseling lead to the introduction of cross-selling technologies (which are broadly applied in other areas of trade, for example, the offer of a boot-polish during the sale of shoes) to the pharmaceutical practice [2, 3]. However, drugs belong to a special group of products, proper selection of which requires special education, and the consumer is not always able to evaluate the quality of the recommendations. Marketing cross-selling recommendations are aimed at promotion of the over-the-counter medicines for customers buying prescription drugs. For example, business coaches recommend the pharmacists to make additional offers: with the purchase of physician-prescribed antibiotics - offer of vitamins, with prescribed nonsteroidal anti-inflammatory drugs - commercially available ointment with non-steroidal topical formulation ("to enhance the effect") and others. These recommendations do not agree with evidence-based medicine and lead to inefficient use of over-the-counter drugs and unjustified financial expenses. Thus, to ensure the rational use of medicines permitted for free (non-prescription) dispensing at the pharmacies, pharmaceutical information needs standardization on the basis of evidence-based medicine as well as standardization of the pharmaceutical counseling service. The development of practical recommendations on the rational use of over-the counter medicines by doctors and pharmacists with further adoption at the state level, the recommendation of most secure, efficient and cost-effective over-the-counter medications during pharmaceutical counseling in pharmacies will contribute to the restoration and preservation of public health.