Pharmacy students’ use and views on over-the-counter (OTC) medicines: a questionnaire study

BackgroundDown-scheduling one or more triptans to Schedule 3 (Pharmacist Only Medicine) from Schedule 4 (Prescription Only Medicine) has been debated in Australia for a decade. This study aimed to evaluate the perspectives and readiness of Western Australian (WA) community pharmacists to manage migraine including over-the-counter (OTC) provision of triptans.MethodsData were collected using a self-administered paper-based questionnaire, posted to a random sample of 178 metropolitan and 97 regional pharmacies in WA. Respondent pharmacists were surveyed regarding: knowledge of optimal migraine treatment as per current guidelines, resources required to appropriately recommend triptans and attitudes and perspective toward down-scheduling. Data were analysed using descriptive statistics and multivariate regression analysis. Pharmacist/pharmacy characteristics influencing readiness were evaluated by assigning respondents a score based on responses to Likert scale questions. These questions were assigned to five domains based on an implementation model and these scores were used in a general linear model to identify demographic characteristics associated with readiness across each domain.ResultsA total of 114 of the 275 pharmacies returned useable questionnaires (response rate: 41.5%). The two most commonly recommended first line OTC agents were a combined paracetamol/non-steroidal anti-inflammatory drugs and aspirin (44/104; 42.3% and 22/104; 21.2%, respectively) which provided context to the respondents’ knowledge of optimal migraine treatment. Responses to questions in relation to triptans and the warning signs requiring referral were in line with current guidelines, demonstrating respondents’ knowledge in these areas. Nevertheless, most respondents demonstrated uncertainty in relation to the pathogenesis of migraine. If triptans were available OTC, 66/107 (61.7%) would recommend them first-line. The majority (107/113; 94.7%) agreed that down-scheduling would improve timely access to effective migraine medication and 105/113 (92.9%) agreed that if triptans were down-scheduled, pharmacists may be better able to assist people in the treatment of migraine. Most respondents agreed that additional training and resources, including a guideline for OTC supply of triptans and the management of first-time and repeat migraine would be necessary if triptans were down-scheduled. No single demographic characteristic influenced readiness across all five domains.DiscussionPharmacists were knowledgeable regarding triptans and recognised symptoms requiring referral; migraine knowledge could be improved. Pharmacists supported down-scheduling of one or more triptans in Australia, however they highlighted a need for further training and resources to support migraine diagnosis and provision of OTC triptans. Professional pharmacy bodies should consider these findings when recommending drugs suitable for down-scheduling for pharmacist recommendation.

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Section: Discussionmentioning

confidence: 99%

Managing migraine with over-the-counter provision of triptans: the perspectives and readiness of Western Australian community pharmacists

Booth¹,

Parsons²,

Sunderland³

et al. 2019

PeerJ

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“…Data were collected by means of a self-completed paper-based questionnaire which was developed with reference to relevant publications [22][23][24][25][26][27][28][29][30] including the previous study [34] and the electronic medicines compendium (eMC) [36]. To maximize the response rate [37], the questionnaire was quite short and divided into four discrete sections to ensure it was easy to follow.…”

Section: Methodsmentioning

confidence: 99%

“…Other studies have investigated self-care education provision across ten Canadian pharmacy schools [31] and approaches used to teach pharmacy students about OTC medicines in Iran [32] and across the globe [33]. Limited research has been conducted to determine UK-based pharmacy students' self-medication practice or to glean pharmacy students' opinions on a breadth of related areas (evidence-based practice and decision-making, the importance of pharmacist-led OTC consultations given other new roles, confidence with deregulations and restrictions imposed by manufacturers) [34]. Two authors of this paper conducted previous work with 154 UK pharmacy students [34] over five years ago, however, this was before (i) pertinent deregulations such as ulipristal acetate (emergency contraception with no specific age limit) and sildenafil (for erectile dysfunction) (ii) reclassifications of diclofenac and domperidone back to POM status and the deepening opioid crisis, (iii) new additional roles for pharmacists such as vaccination services and (iv) the launch of new General Pharmaceutical Council (GPhC) standards for pharmacy education which will result in an autonomous independent prescribing qualification for pharmacists at the point of registration [35].…”

Section: Introductionmentioning

confidence: 99%

Future Pharmacists’ Opinions on the Facilitation of Self-Care with Over-the-Counter Products and Whether This Should Remain a Core Role

et al. 2021

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Background: The aim was to investigate pharmacy students’ views on the role of the pharmacist in facilitating self-care with over-the-counter (OTC) medicines, particularly in light of new roles, and establish personal practice. Methods: Final year pharmacy students at Queen’s University Belfast were invited to participate. Data were collected via a pre-piloted questionnaire, distributed at a compulsory class (only non-identifiable data were requested). Descriptive statistics were performed, and non-parametric tests were employed for inferential statistical analysis (responses by gender). Results: The response rate was 87.6% (78/89); 34.6% (27/78) males and 65.4% (51/78) females. Over a third [34.6% (27/78)] reported using OTC medicines about once a month. All appreciated the importance of an evidence-based approach to optimize patient care. Most [(96.2% (75/78)] deemed OTC consultations should remain a fundamental responsibility of pharmacists and 69.2% (54/78) thought OTC consultations have the potential to be as complex as independent pharmacist prescribing. Females felt more confident recommending OTC emergency contraception than males (p = 0.002 for levonorgestrel and p = 0.011 for ulipristal acetate). Many [61.5% (48/78)] considered more medicines should not be deregulated from prescription-only status. Conclusions: Data from this single institution suggests that enabling self-medication is an important part of practice but there were confidence issues around deregulations.

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“…It was reported that whilst strategies to enable safe supply of reclassified medicines were necessary, the risk assessment tools, including comprehensive questionnaires for the supply of sumatriptan, were regarded as a barrier (Paudyal et al, 2013). Another study explored pharmacy students' perspectives on OTC medicines, including triptans, and identified that restrictive product licences and manufacturers' restrictions a barrier to self-care (Hanna et al, 2016)." Whilst this study focuses on the management of migraine with OTC provision of triptans, the questionnaire and study protocol may be adapted to assess pharmacists' readiness for downscheduling of other medicines, and in the management of other medical conditions, for example antibiotics for urinary tract infection, combined oral contraceptives for contraception and 5phosphodiesterase inhibitors for erectile dysfunction.…”

Section: Manuscript To Be Reviewedmentioning

confidence: 99%

Peer Review #3 of "Managing migraine with over-the-counter provision of triptans: the perspectives and readiness of Western Australian community pharmacists (v0.1)"

Edwards¹

2019

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Background. Down-scheduling one or more triptans to Schedule 3 (Pharmacist Only Medicine) from Schedule 4 (Prescription Only Medicine) has been debated in Australia for a decade. This study aimed to evaluate the perspectives and readiness of Western Australian (WA) community pharmacists to manage migraine including over-the-counter (OTC) provision of triptans. Methods. Data were collected using a self-administered paper-based questionnaire, posted to a random sample of 178 metropolitan and 97 regional pharmacies in WA. Respondent pharmacists were surveyed regarding: knowledge of optimal migraine treatment as per current guidelines, resources required to appropriately recommend triptans, and attitudes and perspective toward down-scheduling. Data were analysed using descriptive statistics and multivariate regression analysis. Pharmacist/pharmacy characteristics influencing readiness were evaluated by assigning respondents a score based on responses to Likert scale questions. These questions were assigned to five domains based on an implementation model, and these scores were used in a general linear model (GLM) to identify demographic characteristics associated with readiness across each domain. Results. A total of 114 of the 275 pharmacies returned useable questionnaires (response rate: 41.5%). The two most commonly recommended first line OTC agents were a combined paracetamol/non-steroidal anti-inflammatory drugs and aspirin (44/104; 42.3% and 22/104; 21.2%, respectively) which provided context to the respondents' knowledge of optimal migraine treatment. Responses to questions in relation to triptans and the warning signs requiring referral were in line with current guidelines, demonstrating respondents' knowledge in these areas. Nevertheless, most respondents demonstrated uncertainty in relation to the pathogenesis of migraine. If triptans were available OTC, 66/107 (61.7%) would recommend them first-line. The majority (107/113; 94.7%) agreed that down-scheduling would improve timely access to effective migraine medication, and 105/113 (92.9%) agreed that if triptans were downscheduled, pharmacists may be better able to assist people in the treatment of migraine.

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Pharmacy students’ use and views on over-the-counter (OTC) medicines: a questionnaire study

Cited by 7 publications

References 18 publications

Managing migraine with over-the-counter provision of triptans: the perspectives and readiness of Western Australian community pharmacists

Managing migraine with over-the-counter provision of triptans: the perspectives and readiness of Western Australian community pharmacists

Future Pharmacists’ Opinions on the Facilitation of Self-Care with Over-the-Counter Products and Whether This Should Remain a Core Role

Peer Review #3 of "Managing migraine with over-the-counter provision of triptans: the perspectives and readiness of Western Australian community pharmacists (v0.1)"

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