International Journal of Clinical Pharmacy

, Volume 34, Issue 1, pp 63–71 | Cite as

Pharmacists’ attitudes towards an evidence-based approach for over-the-counter medication

  • Lezley-Anne HannaEmail author
  • Carmel M. Hughes
Research Article


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.


Effectiveness 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.


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.School of PharmacyQueen’s UniversityBelfastUK

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