Pharmacists’ perceived integration into practice of over-the-counter simvastatin five years post reclassification
- 282 Downloads
Background Simvastatin 10 mg was reclassified in 2004 to over-the-counter (OTC) status in the UK, indicated for the prevention of a first major coronary event in individuals at moderate risk of the event. The primary reason behind the reclassification was to reduce the burden of disease management in general practice. Community pharmacists’ adoption of OTC simvastatin into practice immediately post reclassification was reported to below but there has been no systematic update on current practice. Objective The aim was to investigate pharmacists’ adoption into practice, and attitudes to, OTC simvastatin 5 years post reclassification in the UK. Setting Community pharmacists at all community pharmacies in Scotland. Method A pre-piloted postal questionnaire was distributed to all community pharmacies in Scotland (N = 1138). Self rated adoption was measured on a five point scale. Factors associated with decision making were investigated using a 24-item Likert-type agreement scale. Main outcome measure Pharmacists’ perceived integration of reclassified simvastatin; factors associated with decision making. Results Response rate was 49.5 % (n = 563). A high majority reported not supplying the reclassified medicine mainly owing to a perceived lack of evidence, low patient demand, customer complaints about the retail price and lack of access to patient medical records. A minority agreed to reclassification being an opportunity for their role development. Conclusions Community Pharmacists’ views of reclassified simvastatin supply 5 years post reclassification, as compared to the time it was newly reclassified, suggest low uptake. This lack of progress over time suggests that, against policy initiatives, OTC availability is unlikely to have impacted on the level of general practice led management of patients at risk of coronary events.
KeywordsCommunity pharmacy Efficacy Reclassified medicines Simvastatin Over the counter United Kingdom
The research student (VP) was partly supported by a research grant from Community Pharmacy Scotland (CPS). Many thanks to participating community pharmacist respondents and the Wellcome Trust Clinical Research Facility, Edinburgh for supporting statistical analysis.
Conflicts of interest
The authors have no conflicts of interests to declare.
- 1.Scottish Executive Health Department. The right medicine: a strategy for pharmaceutical care in Scotland. Edinburgh: Scottish Executive; 2002.Google Scholar
- 2.The Wales Assembly Government. Remedies for success: a strategy for pharmacy in Wales. Cardiff: Wales Assembly Government; 2004.Google Scholar
- 3.Department of Health. Making the best use of pharmacy workforce. London: Department of Health; 2004.Google Scholar
- 5.The Royal Pharmaceutical Society of Great Britain. RPS e-PIC references on: prescription only medicines reclassified to pharmacy only medicines. London: The Royal Pharmaceutical Society of Great Britain; 2008.Google Scholar
- 6.The Royal Pharmaceutical Society of Great Britain. Practice guidance: OTC simvastatin. London: The Royal Pharmaceutical Society of Great Britain; 2004.Google Scholar
- 7.Anonymous. Simvastatin over the counter. Drug Ther Bull. 2005;43:25–8.Google Scholar
- 8.Blenkinsopp J, Gathoga L, O’Connell K, Mukhtar M, Rehman I, Shan N, Tariq M. OTC simvastatin supply—what changes in practice and education do pharmacists want? Pharm J. 2004;273:191–3.Google Scholar
- 11.Royal Pharmaceutical Society of Great Britian. Potential candidates for reclassification from POM to P. Available:www.rpsgb.org.uk/pdfs/pomtopreclasslist.pdf. Accessed 12 Sept 2007.
- 14.Rogers EM. Diffusion of innovations. New York: Free Press; 2003.Google Scholar
- 17.Hird M. Over-the-counter simvastatin—is it hype or a genuine hope for the future? PJ. 2004;273:156–60.Google Scholar