Pharmacy teams ‘key’ to preventing harm from dependence on OTC medicines

Pharmacy teams have a ‘key role in preventing harm’ from patients becoming dependent or addicted to over the counter (OTC) medicines, the sector’s regulator has said.

The General Pharmaceutical Council (GPhC) stressed that pharmacists and pharmacy technicians can limit or refuse supply of certain OTC medicines where necessary and should ensure that a medicine is suitable before supplying it.

Its comments come after a survey conducted for ITV’s Tonight programme sparked concerns about the sale and supply of pharmacy medicines and a range of OTC medicines such as painkillers, sleeping aids and nasal sprays.

Chief pharmacy officer at the GPhC, Roz Gittins, said: ‘Pharmacy teams have a key role in preventing harm and improving health, particularly in relation to medicines that are liable to misuse.

‘Pharmacists and pharmacy technicians are trained healthcare professionals who can limit or refuse supply where necessary and should support people to get the right care if there are concerns about dependence.

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‘We expect pharmacy staff to ask relevant questions and use their professional judgement to make decisions, ensuring they have the information they need to provide appropriate care.’

The survey for ITV suggested that around 10 million people in the UK may have put themselves at risk of dependency or addiction to codeine-based medicines, and many patients exceed recommended usage periods.

The poll, carried out by Savanta of more than 2,000 people across the UK, found almost one-in-five people who have taken codeine-based painkillers did so for more than ten days in a row.

The programme also showed some individuals ‘pharmacy hopping’ in an attempt to bypass safeguards, highlighting the importance of professional intervention at every supply point.

The Pharmacists’ Defence Association (PDA) said: ‘These findings reinforce long-standing concerns within the pharmacist profession about the risks associated with medicines that are readily accessible but carry addiction potential.’

A recent PDA survey found that 94% of pharmacists opposed facilitated self-selection of pharmacy medicines, where patients can browse and select higher-risk medicines from open shelves prior to any pharmacist interaction.

The member organisation has argued that facilitated self-selection risks shifting decision making away from clinical professionals and into a retail environment, increasing the potential for harm.

Dr Gittins said: ‘We don’t believe that there should be open display of P-Medicines [pharmacy medicines] without key safeguards being in place – specifically that there is pharmacist supervision.

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‘This facilitated self-selection means a person may choose their medication, but the pharmacy team would need to ensure that it is suitable before supplying it: the same applies for online sales.’

She welcomed the government’s commitment to introduce a single patient record that can be accessed in all settings, including community pharmacy because this will give pharmacists more information about the patients they are providing services for and enable them to provide safe, effective care.

Ms Gittins added: ‘We recognise that the experiences highlighted in the programme may be concerning, particularly for people who have experience of dependence on over-the-counter medicines or those who have supported someone who has.

‘We fully acknowledge the impact this can have on individuals, families and the wider community, and take appropriate action when concerns are raised with us.’

Aditya Aggarwal, a locum pharmacist and healthtech advisor, said in a blog post that the GPhC response did not go far enough to address the problem.

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He said: 'Talking to patients, its clear many have been buying codeine based products for years, and they are convinced that only codeine can fix their recurring headache. The likely reality is codeine dependence is causing the headache in the first place.

‘We strongly suspect many patients are going from pharmacy to pharmacy, buying a single pack from each one, but we’re powerless to stop it, because we have no proof.

'Front line staff need government support to reduce the sales of codeine based products. Currently the entire burden falls on them, making it the pharmacist’s personal responsibility while they are not supported to make the refusal safe.'