Education And Debate

Over the Counter Drugs: The future for self medication

BMJ 1996; 312 doi: (Published 30 March 1996) Cite this as: BMJ 1996;312:835
  1. Colin Bradley, senior lecturer in general practicea,
  2. Alison Blenkinsopp, director of education and researchb
  1. a Medical School, University of Birmingham, Birmingham B15 2TT
  2. b Department of Pharmacy Policy and Practice, University of Keele, Keele, Staffordshire ST5 5BG
  1. Correspondence to: Dr Bradley.

    The increasing trend towards deregulation of more medicines to over the counter status has implications for the primary health care team as well as for consumers and patients. Better information for patients could improve the safety of over the counter medicines, but better systems need to be devised for reporting adverse reactions. “Collaborative care” could bring financial benefits. Doctors, nurses, and pharmacists need to discuss how they will respond to self medication practices, and ways of rewarding pharmacists for advising patients need to be found. Improved communication between doctors and pharmacists and the involvement of nurses could bring health care professionals into a new and more constructive interaction with each other and with the patient—or the changes required could split the professions as they each try to keep control of medicines.

    Predicting the future is always risky, but current trends and the stated intentions of policy makers and stakeholders are often helpful. As we argued in the first article in this series, the factors promoting greater availability and use of over the counter medicines far outweigh the inhibitors.1 The uncertainty is therefore how far this trend will go and how health care professionals and consumers will respond.

    Current trends

    More drugs were changed from prescription only medicines (POM) to pharmacy (P) medicines in the past two years than over the previous decade.1 Furthermore, the range now encompasses drugs which have, on prescription, been used for potentially more serious and longer term conditions.2 Some of the more recently deregulated medicines (H2 antagonists, for example) may not seem to doctors to be natural choices for over the counter use. However, formulations, dosages, and licensed indications for drugs that become available over the counter are not necessarily the same as those which pertain to its use as a prescription only preparation.

    The …

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