Advertisement

European Journal of Clinical Pharmacology

, Volume 71, Issue 11, pp 1389–1396 | Cite as

Use of over-the-counter (OTC) drugs and perceptions of OTC drug safety among German adults

  • E Barrenberg
  • E GarbeEmail author
Pharmacoepidemiology and Prescription

Abstract

Purpose

In Europe, little empirical evidence is available about over-the-counter (OTC) drug consumption and risk perceptions. The objective of this study was to describe consumers’ OTC drug use and perceptions of OTC drug safety in Germany.

Methods

An online survey based on a quota sample with combined strata for age, gender, and education of 300 adult German participants was conducted in June and July 2013. The survey questionnaire covered the participants’ OTC and prescription drug use, risk perceptions of OTC and prescription drugs, package leaflet reading habits, and OTC drug off-label use.

Results

Seven day prevalences of OTC drug use were higher in women (52.0 %) than in men (40.8 %). The risk perception of specific OTC drugs was impacted by the route of administration, the indication, and the drugs’ ingredients. Products for dermal application or plant-based products were considered ‘rather not risky’ by 82.7–96.6 % of the participants, depending on the product. Products for oral use or chemically synthesized substances were considered less safe. While 48.0 % of consumers reported always reading the package leaflet of OTC drugs, 44.5 % reported not reading it if they knew the drug or believed the drug was very safe. People, 60 years and older, reported significantly lower levels of OTC drug off-label use (9.3 %) than younger people (22.0 %).

Conclusions

The 7-day prevalence of OTC drug use in Germany is high, especially among women. Consumers generally have balanced perceptions regarding OTC drug safety. Behaviours and knowledge related to OTC drug use should be considered by health care providers and regulators.

Keywords

Non-prescription drugs OTC drugs Risk perception Survey 

Notes

Acknowledgments

The authors wish to thank IMS Health for kindly having provided information about 30 OTC drugs most commonly sold in Germany and Heike Gerds for proofreading.

Conflict of interest

The study did not receive any external funding. EB has no conflict of interest. EG is running a department that occasionally performs studies for pharmaceutical industries. These companies include Bayer, Celgene, GSK, Mundipharma, Novartis, Sanofi, Sanofi Pasteur MSD, and STADA. EG has been a consultant to Bayer, Nycomed, Teva, GSK, Schwabe and Novartis.

Author contributions

EB and EG conceptualized the study. EB conducted the data analysis and prepared the manuscript, and EG provided substantive intellectual input and critically reviewed the manuscript.

Supplementary material

228_2015_1929_MOESM1_ESM.docx (16 kb)
Supplementary Table 1 (DOCX 15.6 kb)

References

  1. 1.
    Cohen JP, Paquette C, Cairns CP (2005) Switching prescription drugs to over the counter. BMJ: British Medical Journal 330:39PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    Wazaify M, Shields E, Hughes CM, McElnay JC (2005) Societal perspectives on over-the-counter (OTC) medicines. Fam Pract 22:170–176. doi: 10.1093/fampra/cmh723 CrossRefPubMedGoogle Scholar
  3. 3.
    Brune K, Hinz B, Otterness I (2009) Aspirin and acetaminophen: should they be available over the counter? Curr Rheumatol Rep 11:36–40CrossRefPubMedGoogle Scholar
  4. 4.
    Michelsen A (2012) Medikamente sind keine Smarties [Medicines aren’t smarties]. In: Fuhrmann T (Ed.) ZDF Morgenmagazin of 10.01.2012.Google Scholar
  5. 5.
    Hackenbroch V, Höflinger L (2011) Verblüffende Sorglosigkeit [astonishing carelessness]. In: Der Spiegel no. 50. Spiegel Verlag 2011:146–148Google Scholar
  6. 6.
    Mensing M, Streich W, Terschüren C (2011) Die Bevölkerungsbefragung zur Gesundheit 2009. Eine repräsentative Erhebung für NRW [A representative population health survey for North Rhine-Westphalia]. In: LIGA.NRW (Ed.). Landesinstitut für Gesundheit und Arbeit Nordrhein-Westfalen, Düsseldorf.Google Scholar
  7. 7.
    Beitz R, Dören M, Knopf H, Melchert H-U (2004) Selbstmedikation mit Over-the-Counter (OTC) Präparaten in Deutschland [Self-medication with OTC drugs in Germany]. Bundesgesundheitsblatt–Gesundheitsforschung–Gesundheitsschutz 47:1043–1050Google Scholar
  8. 8.
    Tennis P (1990) Drug utilization by the 30–64 year-old people in two cities in the Federal Republic of Germany in 1984. Eur J Clin Pharmacol 38:447–452CrossRefPubMedGoogle Scholar
  9. 9.
    Krska J, Jones L, McKinney J, Wilson C (2011) Medicine safety: experiences and perceptions of the general public in Liverpool. Pharmacoepidemiol Drug Saf 20:1098–1103. doi: 10.1002/pds.2178 CrossRefPubMedGoogle Scholar
  10. 10.
    Calamusa A, Di Marzio A, Cristofani R, Arrighetti P, Santaniello V, Alfani S, Carducci A (2012) Factors that influence Italian consumers’ understanding of over-the-counter medicines and risk perception. Patient Educ Couns 87:395–401. doi: 10.1016/j.pec.2011.10.003 CrossRefPubMedGoogle Scholar
  11. 11.
    Brabers AE, Van Dijk L, Bouvy ML, De Jong JD (2013) Where to buy OTC medications? A cross-sectional survey investigating consumers' confidence in over-the-counter (OTC) skills and their attitudes towards the availability of OTC painkillers. BMJ Open 3:e003455. doi: 10.1136/bmjopen-2013-003455 PubMedCentralCrossRefPubMedGoogle Scholar
  12. 12.
    Wazaify M, Kennedy S, Hughes CM, McElnay JC (2005) Prevalence of over-the-counter drug-related overdoses at accident and emergency departments in Northern Ireland – a retrospective evaluation. J Clin Pharm Ther 30:39–44. doi: 10.1111/j.1365-2710.2004.00607.x CrossRefPubMedGoogle Scholar
  13. 13.
    Stoelben S, Krappweis J, Rossler G, Kirch W (2000) Adolescents' drug use and drug knowledge. Eur J Pediatr 159:608–614CrossRefPubMedGoogle Scholar
  14. 14.
    Knopf H, Wolf IK, Sarganas G, Zhuang W, Rascher W, Neubert A (2013) Off-label medicine use in children and adolescents: results of a population-based study in Germany. BMC Public Health 13:631. doi: 10.1186/1471-2458-13-631 PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Maximiles Panels (2013) Panelbook 2013. Panelbiz. http://wwwpanelbizcom/files/2413/7337/4169/Maximiles_Panelbook_Germany_2013_Webversion.pdf. Accessed 03.10.2014.Google Scholar
  16. 16.
    Raab-Steiner E, Benesch M (2012) Der Fragebogen. Von der Forschungsidee zur SPSS-Auswertung [The questionnaire. From research idea to SPSS analysis]. facultas wuv Universitätsverlag, ViennaGoogle Scholar
  17. 17.
    Working Group on Promoting Good Governance for Non-prescription Drugs in Europe (2013) Report of the Working Group on Promoting Good Governance of Non-prescription Drugs in Europe. DG Enterprise and Industry. http://ec.europa.eu/enterprise/sectors/healthcare/files/docs/otc_report_en.pdf. Accessed 22 May 2015.
  18. 18.
    Hanna LA, Hughes CM (2011) Public's views on making decisions about over-the-counter medication and their attitudes towards evidence of effectiveness: a cross-sectional questionnaire study. Patient Educ Couns 83:345–351. doi: 10.1016/j.pec.2011.02.016 CrossRefPubMedGoogle Scholar
  19. 19.
    Almalak H, Albluwi AI, Alkhelb DA, Alsaleh HM, Khan TM, Hassali MA, Aljadhey H (2014) Students’ attitude toward use of over the counter medicines during exams in Saudi Arabia. Saudi Pharm J 22:107–112. doi: 10.1016/j.jsps.2013.02.004 PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    Porteous T, Bond C, Hannaford P, Sinclair H (2005) How and why are non-prescription analgesics used in Scotland? Fam Pract 22:78–85. doi: 10.1093/fampra/cmh719 CrossRefPubMedGoogle Scholar
  21. 21.
    Nielsen MW, Hansen EH, Rasmussen NK (2003) Prescription and non-prescription medicine use in Denmark: association with socio-economic position. Eur J Clin Pharmacol 59:677–684. doi: 10.1007/s00228-003-0678-z CrossRefPubMedGoogle Scholar
  22. 22.
    Sihvo S, Klaukka T, Martikainen J, Hemminki E (2000) Frequency of daily over-the-counter drug use and potential clinically significant over-the-counter-prescription drug interactions in the finnish adult population. Eur J Clin Pharmacol 56:495–499CrossRefPubMedGoogle Scholar
  23. 23.
    Al-Windi A, Elmfeldt D, Svardsudd K (2000) The relationship between age, gender, well-being and symptoms, and the use of pharmaceuticals, herbal medicines and self-care products in a swedish municipality. Eur J Clin Pharmacol 56:311–317CrossRefPubMedGoogle Scholar
  24. 24.
    Isacson D, Bingefors K (2002) Epidemiology of analgesic use: a gender perspective. European Journal of Anaesthesiology Supplement 26:5–15CrossRefPubMedGoogle Scholar
  25. 25.
    Ditzel P (2010) Arzneimittel zum halben Preis für Bedürftige [Drugs at half price for the needy]. DAZOnline Online Portal der Deutschen Apothekerzeitung – Deutscher Apotheker Verlag. http://www.deutsche-apotheker-zeitung.de/spektrum/news/2010/02/10/arzneimittel-zum-halben-preis-fuer-beduerftige/1738/print.html. Accessed 22.05.2015
  26. 26.
    Medizinische Hilfe Solingen (2014) Medikamententafel – Grünes Rezept – Medikamente bezahlbar machen [Medication bank – green prescription – making drugs medicines affordable]. http://www.medizinische-hilfe-solingen.de. Accessed 01.05. 2015
  27. 27.
    Izzo AA (2012) Interactions between herbs and conventional drugs: overview of the clinical data. Med Princ Pract 21:404–428. doi: 10.1159/000334488 CrossRefPubMedGoogle Scholar
  28. 28.
    Izzo AA, Ernst E (2009) Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 69:1777–1798. doi: 10.2165/11317010-000000000-00000 CrossRefPubMedGoogle Scholar
  29. 29.
    Bopp A, Herbst V (2009) Handbuch Rezeptfreie Medikamente [handbook of OTC drugs]. Stiftung Warentest, BerlinGoogle Scholar
  30. 30.
    Masters GM (1997) Introduction to environmental engineering and science. Prentice Hall, Upper Saddle River, USAGoogle Scholar
  31. 31.
    Hamacher H, Wahl MA (eds) (2011) Selbstmedikation [self-medication]. Deutscher Apotheker Verlag, Stuttgart, GermanyGoogle Scholar
  32. 32.
    Ellen PS, Bone PF, Stuart EW (1998) How well do young people follow the label? An investigation of four classes of over-the-counter drugs. J Public Policy & Marketing 17:70–85Google Scholar
  33. 33.
    Edwards P, Roberts I, Clarke M, DiGuiseppi C, Pratap S, Wentz R, Kwan I (2002) Increasing response rates to postal questionnaires: systematic review. BMJ 324:1183PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Baur N, Florian MJ (2009) Stichprobenprobleme bei Online-Umfragen [sampling challenges in online-surveys]. In: Jakob N, Schoen H, Zerback T (eds) Sozialforschung im Internet: Methodologie und Praxis der Online-Befragung [social research in the internet: methodology and practice of online-surveying]. VS Verlag für Sozialwissenschaften, Wiesbaden, GermanyGoogle Scholar
  35. 35.
    Wolf M, Sagl S (2012) (N)Onliner Atlas 2012. TNS Infratest, Berlin. http://www.initiatived21.de/wp-content/uploads/2012/06/NONLINER-Atlas-2012-Basiszahlen-f%C3%BCr-Deutschland.pdf. Accessed 01.05.2015.
  36. 36.
    Caskie GI, Willis SL, Warner Schaie K, Zanjani FA (2006) Congruence of medication information from a brown bag data collection and pharmacy records: findings from the Seattle longitudinal study. Exp Aging Res 32:79–103. doi: 10.1080/03610730500326341
  37. 37.
    Landry JA, Smyer MA, Tubman JG, Lago DJ, Roberts J, Simonson W (1988) Validation of two methods of data collection of self-reported medicine use among the elderly. The Gerontologist 28:672–676CrossRefPubMedGoogle Scholar
  38. 38.
    Mitchell M, Jolley J (2013) Research design explained. Calif Wadsworth Cengage Learning, Belmont, USAGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of Clinical EpidemiologyLeibniz Institute for Prevention Research and Epidemiology - BIPS GmbHBremenGermany
  2. 2.Core Scientific Area ‘Health Sciences’ at the University of BremenBremenGermany

Personalised recommendations