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Drugs & Aging

, Volume 22, Issue 5, pp 361–370 | Cite as

Switching of Prescription Drugs to Over-the-Counter Status

Is it a Good Thing for the Elderly?
  • Sally-Anne Francis
  • Nina BarnettEmail author
  • Michael Denham
Current Opinion

Abstract

Prescription medicines are increasingly being switched to over-the-counter (OTC, nonprescription) status in the developed world, with the support of government policy. These changes may provide greater choice for individuals and offer potential savings in government spending on health while expanding the market for pharmaceutical companies. However, there is concern regarding the safety of these reclassifications.

Elderly people are the largest consumers of prescription and OTC medicines and are more vulnerable to drug adverse effects and the risks of multiple or inappropriate medications. Commonly purchased agents such as NSAIDs have recognised adverse effects which have been shown to be more common in the elderly. Furthermore, all sedatives, including antihistamines, have a propensity to cause falls in older people. As many doctors do not ask patients about OTC medicine use, problems related to use of these drugs may go undetected. Furthermore, the increased availability of OTCs may result in a delay in patients consulting medical practitioners for potentially serious conditions, although this has not so far been investigated. In the UK, the recent switch of a low-dose HMG-CoA reductase inhibitor (statin) to OTC status has caused concern. Although there might theoretically be some benefits from improved access to medications used in primary and secondary prevention of heart disease, the actual outcomes of use of this reduced dose of the statin will be difficult or impossible for patients or practitioners to monitor.

OTC drug use implies a mutual responsibility for communication between patients and health professionals that in practice is not always achieved. Epidemiological research is needed to investigate patterns of OTC use and evaluate the potential risks of OTC medicines in elderly people. Governments, regulatory bodies, professionals and the drug industry have a responsibility to ensure that robust systems are in place if the increased use of OTC medicines by elderly people is to be safe and effective.

Keywords

Cimetidine Famotidine Vulvovaginal Candidiasis Nasal Decongestant General Medical Practitioner 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  • Sally-Anne Francis
    • 1
  • Nina Barnett
    • 2
    Email author
  • Michael Denham
    • 3
  1. 1.Department of Practice and Policy, School of PharmacyUniversity of LondonLondonUK
  2. 2.Pharmacy Department, London, Eastern and South East Specialist Pharmacy ServicesNorthwick Park HospitalHarrowUK
  3. 3.Department of GeriatricsNorthwick Park HospitalHarrowUK

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