Children's over‐the‐counter medicines pharmacoepidemiological (COPE) study

Objective To quantify the extent and types of minor ailments in children that were presented at community pharmacies and the types of over‐the‐counter (OTC) medicines purchased in response to these ailments. Method Data on all requests and sales of OTC medicines for children (aged 16 years and under) and consultations for minor ailments in children were recorded in eight community pharmacies for one week every month over a 12‐month period. Participants were members of the public who consulted the pharmacists or other pharmacy staff in the community pharmacies. Key findings A total of 976 consultations was recorded with 61.5% requesting an OTC medicine by name and 38.5% by symptom presentation. An average of 10.2 consultations was made per pharmacy per week. Requests for treatment were usually made within five days of symptom occurrence (86%). Most of the consultations were made by mothers (75%), although 17% were by fathers. The most commonly purchased OTC medicine was paracetamol. There were five requests for aspirin and one was for a 2‐year old child. A total of 62 cases (6%) was referred back to the child's primary care physician (general practitioner). Conclusions Symptoms related to cough and cold were the most common problems in children presenting to community pharmacies for treatment. Paracetamol was the most widely used OTC medicine in children. Pharmacy staff do question the request for OTC medicines such as aspirin, to ensure its safe use. Community pharmacies play an important role as the first port of call for advice on minor ailments in children and have an opportunity to provide health promotion to carers of children.     

Adolescents and media coverage of over‐the‐counter and complementary medicines

Focus groups were conducted with adolescents to explore their knowledge and opinions of complementary and alternative medicine and over‐the‐counter medicines Adolescents are more focused on staying well rather than on treating illness; thus, they are aware of herbal products they see as relevant to staying healthy Pharmacists need to be aware of the messages teens receive through the media that appeal to their sense of well‐being and concerns about their appearance Pharmacists should also be prepared to respond to adolescents' questions about herbal products     

Discussing side effects of over‐the‐counter medicines: impact of adding percentage data

Objectives Discussing side effects with patients continues to be a difficult area of practice. Questions arise as to how many should be mentioned and which ones. The way such information is presented can affect drug‐taking decisions. This study examined how over‐the‐counter (OTC) medicine users are influenced by numerical risk estimates of side effects. Methods As part of a larger study on patient decision‐making, 30 participants aged over 50 years were asked to consider three OTC headache medicines. They responded to one of two headache scenarios, one with symptoms described as mild but common and the other severe but rare. Participants made their selection based on drug efficacy and side effects, at first not linked to occurrence rates and then with this information provided. Key findings Average age was 66.6 years and the majority were female. Most were currently using some form of drug therapy. Drug choices differed in relation to mild versus severe headache scenarios. A stronger preference for drug X (50% effective and two side effects) was evident when the headaches were mild, shifting to a more effective agent (but with more side effects) when more severe. Addition of occurrence rates to the side effects had the greatest effect within the severe headache scenario, where more participants opted for the most effective agent (drug Z at 100% effective but six side effects) upon seeing the numbers. Overall, however, most kept the same drug in spite of the numerical information. Conclusions Inclusion of numerical data for side effects did not negatively influence potential OTC medicine users. For most, effectiveness and side effects were the concern before receiving the percentages, while effectiveness became more important when the frequency data seemed to instil a sense of reassurance.     

Patients' experiences of over‐the‐counter treatments for irritable bowel syndrome

Little evidence is available on the benefit of many OTC medicines used for irritable bowel syndrome and more research is needed to enable community pharmacists and their support staff to make evidence‐based recommendations It is feasible to conduct multi‐centre community pharmacy‐based studies on OTC medicine use Patients perceived significant relief of their symptoms when taking either OTC mebeverine or peppermint oil EC Patients who used mebeverine reported a slightly greater, though not statistically significant, improvement in symptoms than those who purchased peppermint oil‐containing products     

Supply of over‐the‐counter weight‐loss products from community pharmacies

Objectives The aim was to ascertain the availability of over‐the‐counter (OTC) weight‐loss products from community pharmacies and other retail outlets in a large conurbation, and to determine the knowledge and practices of pharmacy staff in the supply of OTC weight‐loss products. Method The setting was one primary care trust in England. We used a cross‐sectional survey of 123 community pharmacies, 12 health stores and 64 supermarkets, plus telephone interview of the pharmacists. Key findings Over two‐thirds of community pharmacies (69%) and health stores (67%) but few supermarkets (8%) stocked one or more OTC weight‐loss products. In total, 73 different products were available from pharmacies, most of which (50) were claimed by manufacturers to be appetite suppressants. Seventy‐eight pharmacists were interviewed, of whom 57 stocked OTC weight‐loss products. Of these 57, only two claimed to undertake any measurements before supplying the products and 33 had no supporting materials/information about the products, although 38 claimed to provide advice. None of the 57 pharmacists had undertaken any specific training in relation to weight loss. Only 44% of all those interviewed considered OTC weight‐loss products to be useful, with even fewer (35%) considering them to be safe. Conclusions Community pharmacies are a major distributor of OTC weight‐loss products, despite the lack of evidence of their efficacy and concerns about their safety. Many pharmacists had limited knowledge of the products, placed few restrictions on their supply and viewed training in weight loss as unnecessary. Pharmacists should consider the appropriateness of supplying these products and utilize the opportunities presented to support weight reduction by more effective means.     

A cross‐media analysis of educational information content of advertisements for over‐the‐counter medicines in a Nigerian urban setting

Objective To analyse the educational information content of adverts for over‐the‐counter (OTC) medicines on radio, television and billboards in a Nigerian urban setting.     

Using suitability profiles to better inform consumers' choice of commonly used over‐the‐counter analgesics

Objective To quantify the impact of labelled contraindications, precautions and warnings for use on the population that may take commonly used over‐the‐counter (OTC) analgesics. Setting Primary care: data were collected from a general practitioner database in Australia. Methods Patient data were audited retrospectively (n = 107553) to determine the number of patients with contraindications, warnings or precautions to the use of OTC paracetamol and the non‐steroidal anti‐inflammatory drugs aspirin and ibuprofen. The primary outcome measure was the suitability rate (i.e. the proportion of patients with no contraindications, warnings or precautions) of these commonly used analgesics. Key findings In this Australian dataset, the proportions of patients who had no contraindications, warnings or precautions to the use of paracetamol or ibuprofen were 98.1 and 76.9%, respectively (P = 0.0001); 83.4% of patients had no contraindications, warnings or precautions to the use of aspirin (P = 0.005 compared with paracetamol). Conclusion Of the three OTC analgesics examined, paracetamol is suitable for use by a larger proportion of the general population without the need to seek medical advice.