International Journal of Clinical Pharmacy

, Volume 33, Issue 4, pp 627–633 | Cite as

Over-the-counter orlistat: early experiences, views and attitudes of community pharmacists in Great Britain

  • Anita Elaine Weidmann
  • Scott Cunningham
  • Gwen Gray
  • Denise Hansford
  • James McLay
  • John Broom
  • Derek Stewart
Research Article

Abstract

Objectives of the study To describe community pharmacists’ early experiences, views and attitudes with over-the-counter orlistat, 9 months post legal re-classification from November 2009 to January 2010. Setting 13,200 (81%) randomly selected registered community pharmacies across Great Britain out of a potential 16,200. Methods A cross-sectional postal questionnaire survey of the main pharmacist with greatest responsibility for over-the-counter (OTC) supply. Main outcome measures Pharmacists’ early experiences, views and attitudes of orlistat supply, demographic data of respondents and personal opinions with the supply of orlistat. Results Questionnaires were returned by 32.4% (n = 4,026) of pharmacists surveyed. Just over half (51.9%, n = 2,091) reported no sales of orlistat in the previous 4 weeks with only 5.1% (n = 203) reporting frequent (5.1%) or very frequent supply in the same time frame. Two thirds (66.5%, n = 2,676) agreed or strongly agreed that the sale of orlistat was a good opportunity to extend their role as a healthcare professional and 92% (n = 3,712) felt confident in their ability to supply this product. Over half (57.9%, n = 2,334) admitted that customers frequently complained about the cost of the product and 47.8% (n = 1,926) agreed that customers could misuse the product. Conclusion Despite community pharmacists welcoming orlistat re-classification to increase medicines availability as an opportunity to extend their healthcare professional role there were concerns about poor public uptake, high cost and the potential for misuse. Exploratory studies collecting the views and experiences of the general public about the access and provision of weight management services through community pharmacies are warranted.

Keywords

Community pharmacist Great Britain Obesity Orlistat OTC Over-the-counter medicines Pharmacist experience Pharmacist views 

Notes

Acknowledgments

We would like to acknowledge D. Watt, A. Thomson, R. Walsh, E.L.T. Wong, M. McLean, J. Banks, A. Ali, S. Darcy, J. Flattery, N. Goburdhun, M. Holohan, A. Javeed, L. Adams for assistance with data collection, W Greig for data input and all the community pharmacist respondents for completing questionnaires. The study was funded by Robert Gordon University.

Funding

This study is funded by Robert Gordon University, School of Pharmacy and Life Science, Aberdeen.

Conflicts of interest

The authors declare no conflict of interest. All authors are employed by either Robert Gordon University or Aberdeen University.

References

  1. 1.
    Pi-Sunyer X. The medical risk of obesity. Postgrad Med. 2009;121(6):21–33.PubMedCrossRefGoogle Scholar
  2. 2.
    Ono Y, Guthold R, Strong K. World Health Organisation. 2010. WHO global comparable estimates. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/index.html. Accessed Apr 2011.
  3. 3.
    World Health Organization Ministerial conference on counteracting obesity. European Charter on counteracting obesity. EUR/06/5062700/8. Istanbul, Copenhagen: WHO Regional Office for Europe; 16 Nov 2006. Available at: http://www.euro.who.int/en/what-we-do/health-topics/diseases-and-conditions/obesity/publications/pre-2009/european-charter-on-counteracting-obesity. Accessed Apr 2011.
  4. 4.
    EMEA European Medicines Agency: European Medicines Agency recommends first switch from prescription only to non-prescription for a centrally authorised medicine. Doc. Ref. EMEA/CHMP/493770/2008 2008. London; 23 Oct 2008. Available at: http://www.ema.europa.eu/docs/en_GB/document_library/Press_release/2009/11/WC500014828.pdf. Accessed Apr 2011.
  5. 5.
    EMEA, European Medicines Agency recommends suspension of the marketing authorisation of Acomplia. Doc. Ref. EMEA/CHMP/537777/2008, 2008. London; 23 Oct 2008. Available at: http://www.ema.europa.eu/docs/en_GB/document_library/Press_release/2009/11/WC500014774.pdf. Accessed Apr 2011.
  6. 6.
    EMEA, European Medicines Agency recommends suspension of the marketing authorisation of Sibutramine, EMA/39408/2010; 21 Jan 2010. Available at: http://www.ema.europa.eu/docs/en_GB/document_library/Press_release/2010/01/WC500069995.pdf. Accessed Apr 2011.
  7. 7.
    Anderson JW. Orlistat for the management of overweight individuals and obesity: a review of potential for 60-mg, over-the-counter dosage. Expert Opin Pharmacother. 2007;8(11):1733–42.PubMedCrossRefGoogle Scholar
  8. 8.
    Royal Pharmaceutical Society of Great Britain: Practice guidance: OTC Orlistat. 2009. Available at: http://www.rpharms.com/support-pdfs/otcorlistatguid.pdf. Accessed Apr 2011.
  9. 9.
    Filippatos TD, Derdemezis CS, Gazi IF, Nakou ES, Mikhailidis D, Elisaf MS. Orlistat-associated adverse effects and drug interactions. A critical review. Drug Saf. 2008;31(1):53–65.PubMedCrossRefGoogle Scholar
  10. 10.
    Hauptman J, Lucas C, Boldrin MN, Collins H, Segal K. Orlistat in the long-term treatment of obesity in the primary care setting. Arch Fam Med. 2000;9:160–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Rossner S, Sjorstrom L, Noack R, Meinders E, Noseda G. Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity. Obes Res. 2000;8:49–61.PubMedCrossRefGoogle Scholar
  12. 12.
    Davidson MH, Hauptman J, DiGiorolamo M, Foreyt JP, Halsted CH, Heber D, et al. Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. JAMA. 1999;281:235–42.PubMedCrossRefGoogle Scholar
  13. 13.
    Schwartz SM, Bansal VP, Hael C, Rossi M, Engle JP. Compliance, behaviour change and weight loss with orlistat in an over-the—counter setting. Obesity. 2008;16(3):623–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Anon: Over-the counter medicines: in whose best interest? Lancet 2009;373(9661):354Google Scholar
  15. 15.
    Williams G. Orlistat over the counter. Has a minimal effect on obesity and is no substitute for a healthy lifestyle. BMJ. 2007;335:1163–4.PubMedCrossRefGoogle Scholar
  16. 16.
    Edwards PJ, Roberts I, Clarke MJ, Diguiseppi C, Wentz R, Kwan I, Cooper R, Felix LM, Pratap S. Methods to increase response to postal and electronic questionnaires. Cochrane Database Syst Rev. 2009;8(3):MR000008.Google Scholar
  17. 17.
    NICE Clinical Guideline 43: Obesity—guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. National Institute for Health and Clinical Excellence: London; 2006. pp. 1–84. Available at: http://www.nice.org.uk/nicemedia/pdf/CG43NICEGuideline.pdf. Accessed Apr 2011.
  18. 18.
    McColl E, Jacoby A, Thomas L, Soutter J, Bamford C, Steen N, Thomas R, Harvey E, Garratt A, Bond J. Design and use of questionnaires: a review of best practice applicable to surveys of health service staff and patients. Health Technol Assess. 2001;5(31):1–256.PubMedGoogle Scholar
  19. 19.
    Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.PubMedCrossRefGoogle Scholar
  20. 20.
    Wadden TA, Berkowitz RI, Womble LG, Sarwer DB, Phelan S, et al. Randomized trial of lifestyle modification and pharmacotherapy for obesity. N Engl J Med. 2005;353(20):2111–20.PubMedCrossRefGoogle Scholar
  21. 21.
    Feigenbaum A, Pasternak S, Zusk E, Arid M, Vinker S. Influence of intense multidisciplinary follow-up and orlistat on weight reduction in a primary care setting. BMC Farm Pract. 2005;6(1):5.CrossRefGoogle Scholar
  22. 22.
    Tinelli M, Bond C, Blenkinsopp A, Jaffray M, Watson M, Hannaford P. Community Pharmacy Medicines Management Evaluation Team. Patient evaluation of a community pharmacy medications management service. Ann Pharmacother. 2007;41(12):1962–70.PubMedCrossRefGoogle Scholar
  23. 23.
    Krska J, Lovelady C, Connolly D, Parmar S, Davies MJ. Community pharmacy contribution to weight management: identifying opportunities. Int J Pharm Pract. 2010;18(1):7–12.PubMedCrossRefGoogle Scholar
  24. 24.
    Toubro SDI, Hermansen I, Herborg H, Astrup A. Dietary guidelines on obesity at Danish pharmacies. Results of a 12-week course with a 1-year follow up. Ugeskr Laeger. 1999;161:5308–513.PubMedGoogle Scholar
  25. 25.
    Um ISI, Armour C, Krass I, Gill T, Chaar BB. Managing obesity in pharmacy: the Australian experience. Pharm World Sci. 2010;32:720–71.CrossRefGoogle Scholar
  26. 26.
    Cohen JP, Paquette C, Cairns CP. Switching prescription drugs to over the counter. BMJ. 2005;330:39–41.PubMedCrossRefGoogle Scholar
  27. 27.
    Stewart D, John D, Cunningham S, McCaig D, Hansford D. A comparison of community pharmacists’ views of over-the-counter omeprazole and simvastatin. Pharmacoepidemiol Drug Saf. 2007;16:1290–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Hansford D, Cunningham S, John D, McCaig D, Stewart D. Community pharmacists’ views, attitudes and early experiences of over-the—counter simvastatin. Pharm World Sci. 2007;29(4):380–5.PubMedCrossRefGoogle Scholar
  29. 29.
    Hagler Robinson A. Orlistat misuse as purging in a patient with binge-easing disorder. Psychosomatics. 2009;50(2):177–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Malhotra S, McElroy SL. Orlistat misuse in bulimia nervosa. Am J Psychiatry. 2002;159(3):492.PubMedCrossRefGoogle Scholar
  31. 31.
    Nelson S, Hwang KO, Bernstam EV. Comparing clinician knowledge and online information regarding Alli (Orlistat). Int J Med Inform. 2009;78:772–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Seston E, Hassell K. Workforce update—joiners, leavers, and practising and non-practising pharmacists on the 2009 register. Pharm J. 2010;284:80–2.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Anita Elaine Weidmann
    • 1
  • Scott Cunningham
    • 1
  • Gwen Gray
    • 1
  • Denise Hansford
    • 1
  • James McLay
    • 2
  • John Broom
    • 3
  • Derek Stewart
    • 1
  1. 1.School of Pharmacy and Life SciencesRobert Gordon UniversitySchoolhill, AberdeenUK
  2. 2.School of Medicine and DentistryAberdeen UniversityAberdeenUK
  3. 3.Centre for Obesity Research and EducationRobert Gordon UniversityAberdeenUK

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