Cross-sectional national survey of pharmacists’ experiences over-the-counter (OTC) medicine abuse and misuse in community pharmacies in Finland.

Background: The problem of Over-The-Counter (OTC) drug misuse and abuse can lead to addiction or use of more dangerous drugs down the road. This study aimed to explore the perceptions and experiences of Finnish community pharmacists of the use, abuse and misuse of OTC medicines. In addition, it aims to identify the patterns of abuse and misuse of OTC medicine categories. Furthermore, purposes were also to identify respondents’ perceptions of the most appropriate methods to prevent inappropriate use of OTC medicines in their pharmacies.

Methods: This was a cross-sectional national survey using a web-based platform. A structured questionnaire based on apreviously validated one, was sent to all registsred 5594 pharmacists in Finland (Dispencers, Pharmacists and Pharmacy owners). Data were managed and analyzed in SPSS (Version 27.0). Descriptive frequencies and Kruskall-Wallis H and Mann-Whitney U tests of association are reported.

Results: A total of 442 e-questionnaires were returned. The main reported OTC drugs suspected of abuse were antitussive cough preparations (e.g. codeine or dextrometorphane; 90.8%, n=397/437), laxatives (e.g. bisacodyl, sodium picosulfate; 64.5% (n=397/437), loperamide 49.3% (n=214/433) and travel sickness medicine (e.g. cyclizine or meclozinehydrochlorid; 29.6% (n=130/439). Nasal decongestants (e.g. xylometazoline) were the most common reported OTC drugs liable for misuse, followed by antitussives and non-steroidal anti-inflammatory drugs (NSAIDs; Md all=5). Predominant methods to manage OTC medicine abuse in community pharmacies were educating pharmacy customers about proper use of OTC medicines, asking how they use the medicine, and advising them on correct administration and dose.

Conclusion: This study revealed that pharmacists in Finland are aware of the liability of some OTC medicine to abuse and misuse and are employing different methods to prevent it in their pharmacies. However, such methods are considered ineffective and more proactive methods are suggested.