Changes in over-the-counter drug misuse over 20 years: perceptions from Scottish pharmacists

Background Over-the-counter (OTC) medicines are available without prescription, allowing convenience and facilitating self-care. As more OTC drugs become available, concerns regarding misuse have increased. This study explored pharmacists' perceptions about OTC drugs misuse, products involved and measures taken to address misuse. Methods This was a cross-sectional postal survey. A questionnaire, based on one used previously (1995, 2000 and 2006), was posted to all community pharmacists in Scotland (n = 1246) in 2014. Questions related to suspected OTC misuse in their area, the products involved and resultant changes in policy. Data were managed and analysed in SPSS. Descriptive frequencies and x 2 tests of association are reported. Responses were compared across the four cohorts. Results The 2014 response rate was 57% (709). The proportion of pharmacists reporting suspected OTC misuse increased to 80.8% from 70.8% in 2006. Codeine-containing products were most frequently perceived to be misused; previously Nytol (diphenhydramine) had been most cited. Of pharmacists reporting suspected misuse, 91.3% had altered policies, including refusing sales and referring patients elsewhere. Conclusions Pharmacists are increasingly reporting OTC misuse in their areas, particularly involving codeine products. The majority adapted sales policies to reflect these concerns.