Pharmacists’ attitudes towards an evidence-based approach for over-the-counter medication
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Background With increasing deregulation of prescription-only medicines and drive for self-care, pharmacists have greater scope to manage more conditions. This brings added responsibility to be competent healthcare professionals who deliver high quality evidence-based patient care. Objective This study sought to establish pharmacists’ attitudes towards an evidence based approach for over-the-counter medication. Setting Pharmacists working in community pharmacies across Northern Ireland. Method Following ethical approval, a pre-piloted, self-completed questionnaire was distributed to all community pharmacies in Northern Ireland (n = 529) in September 2008. The development of the questionnaire was largely informed by the findings of a previous qualitative study. It consisted of six sections (mainly closed questions) covering factors that influence decisions regarding over-the-counter medication, recently deregulated prescription-only medicines, medications that lack evidence of effectiveness, knowledge of evidence-based practice, evidence-based practice with over-the-counter medication and demographic information. On receipt of questionnaires, responses to the closed questions were imported into SPSS® (version 17.0) for analysis which largely took the form of descriptive statistics. Chi-square and the Mann–Whitney U test were used for association between responses and demographic information with an a priori level of less than 0.05 (P < 0.05) set as significant. Main outcome measure Pharmacists’ attitudes and opinions in relation to decision making about over-the-counter medication and evidence of effectiveness were measured. Results A 39.5% (209/529) response rate was achieved. Most pharmacists [191/208 (91.8%)] ‘strongly agreed’ or ‘agreed’ that safety was the over-riding concern when dealing with over-the-counter medication. While 88.3% (181/205) ‘strongly agreed’ or ‘agreed’ that they were familiar with the concept of evidence-based practice, only 38.0% (78/205) ‘strongly agreed’ or ‘agreed’ they knew how to critically appraise research papers. Furthermore, less than a quarter [49/205 (23.9%)] appeared to be familiar with the work of the Cochrane Collaboration. Most [188/207 (90.8%)] ‘strongly agreed’ or ‘agreed’ that regardless of evidence of effectiveness, cough medicines were an important management option. Conclusion Safety was the primary concern when making decisions about over-the counter medicines. Pharmacists lacked knowledge of evidence-based practice and considered medicines which lacked evidence of effectiveness to have an important role in self-care. These factors present barriers to the widespread implementation of evidence-based practice.
KeywordsEffectiveness Evidence based practice Non-prescription medication Northern Ireland Over-the-counter medication Pharmacy
The authors wish to thank the pharmacists who participated in this study.
The corresponding author was supported by payment of academic fees from the Northern Ireland Centre for Pharmacy Learning and Development and Queen’s University Staff Training and Development Unit. Neither organisation had any involvement in the design of the study, data collection or interpretation and writing of the manuscript.
Conflicts of interest
The authors have no conflicts of interest.
- 1.Department of Health. The NHS plan: a plan for investment a plan for reform. London: The Stationery Office; 2000. ISBN-10: 0101481829; ISBN-13: 978-0101481823.Google Scholar
- 2.Department of Health. Building on the best. Choice, responsiveness and equity in the NHS. London: The Stationery Office; 2003. ISBN-10: 010160792X; ISBN-13: 9780101607926.Google Scholar
- 3.Department of Health. Self care—a real choice: self care support, a practical option. London: The Stationery Office; 2005. Report no: 266322.Google Scholar
- 4.Department of Health. Our health, our care, our say: a new direction for community services. London: The Stationery Office; 2006. ISBN: 0101673728.Google Scholar
- 6.Guyatt G, Rennie D, Meade MO, Cook DJ. Users’ guides to the medical literature. A manual for evidence-based clinical practice, 2nd ed. Chicago: AMA Press; 2008. ISBN-10: 0071590382; ISBN-13: 978-0071590389.Google Scholar
- 7.Pharmaceutical Society of Northern Ireland. Code of ethics. [Online] Available: http://www.psni.org.uk/documents/312/Code+of+Ethics+for+Pharmacists+in+Northern+Ireland.pdf (Accessed July 11, 2011).
- 9.Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook, 2nd ed. California: Sage; 1994. ISBN-10: 0803955405; ISBN-13: 978-0803955400.Google Scholar
- 10.Central Services Agency. Northern Ireland Health and Social Services: pharmaceutical list. [Online] Available: http://www.centralservicesagency.com/files/northern_ireland_pharmaceutica/file/PL1109.pdf (Accessed August 1, 2008).
- 11.Pharmaceutical Society of Northern Ireland. Search the register: search for pharmacy. [Online] Available: http://www.psni.org.uk/search-the-register/search-the-register.php (Accessed May 15, 2008).
- 16.Moser CA, Kalton G. Survey methods in social investigation, 2nd ed. Aldershot: Gower; 1985. ISBN-10: 1855214725; ISBN-13: 978-1855214729.Google Scholar
- 17.Wilson M, Sapsford R. Asking questions. In: Sapsford R, Jupp V, editors. Data collection and analysis. London: Sage; 2006. ISBN-10: 0761943633; ISBN-13: 978-0761943631.Google Scholar
- 24.Emmerton LM, Benrimoj SI. Influences on pharmacists’ recommendation of non-prescription products. Australian J Pharm. 1989;70:594–7.Google Scholar
- 33.Coomarasamy A, Khan, KS. What is the evidence that postgraduate teaching in evidence-based medicine changes anything? A systematic review. BMJ. 2004;329:1017.Google Scholar
- 34.Blenkinsopp A, Bond C. Over-the-counter medication. London: BMA publications unit; 2005. ISBN 0954896521.Google Scholar
- 36.Ernst E. How much of CAM is based on research evidence? Evid Based Complement Alternat Med, Epub. 2009.Google Scholar
- 38.NHS Choices. Homeopathy remains on NHS. [Online] Available: http://www.nhs.uk/news/2010/july07/pages/nhs-homeopathy.aspx (Accessed August 17, 2010).
- 40.Pharmaceutical Society of Northern Ireland. Supplementary professional guidance for pharmacists in Northern Ireland on the provision of homeopathic products within a pharmacy. [Online] Available: http://www.psni.org.uk/documents/706/PSNI+Supplementary+Professional+Guidance+on+Homeopathy.pdf (Accessed September 19, 2011).
- 45.Pharmacy Council of New Zealand. Scopes of Practice. [Online] Available: http://www.pharmacycouncil.org.nz/scopes (Accessed October 31, 2011).