Changing the roles of doctors and pharmacists

People are buying more medications for themselves,1 and increasingly powerful drugs are obtainable without prescription.2 In view of these trends, it is timely to examine their implications for patients and health care professionals. A series of articles starting in this issue of the BMJ (p 629) examines the move towards greater over the counter access to drugs and its relation to increasing public awareness of health and medicines, the changing roles of doctors and pharmacists, pharmaceutical industry strategies, and the question of safety and abuse of drugs.2

Over the counter (OTC) drugs are available to the public without prescription. They include traditional pharmacy preparations and drugs that have more recently been deregulated from their previous status as “prescription only medicines.” Policies on over the counter drugs vary around the world. In many European countries, over the counter drugs are available only through pharmacies,3 but in the United States, all over the counter drugs can be sold in general retail outlets. In Australia, pharmacists are required to personally advise purchasers of specific over the counter drugs.

Britain and Ireland have two categories for over the counter drugs: drugs on the general sales list may be sold in general retail premises, while drugs in the pharmacy category are restricted to sale by registered pharmacies.2 This is supposed to ensure that pharmacists monitor patients and give advice on correct usage. However, this responsibility is frequently …