Proper Selection of OTC Products: The Role of the Pharmacist

Each year, millions of patients use OTC drugs on a routine basis to self-treat common health care ailments. A survey conducted by the National Council on Patient Information and Education (NCPIE) reported that the most commonly used OTC products include¹:

• Analgesics
• Cough, cold, and flu preparations
• Allergy and sinus
• Heartburn/indigestion
• Constipation/diarrhea
• Wound care
• Dermatologic conditions

Since the use of OTC products has increased for all major therapeutic categories, education about proper use of OTC products is essential. In view of the fact that the number of OTC products on the market continues to expand, selection of these products may be overwhelming for many patients. According to the American Pharmacists Association, of the 3.5 billion health problems treated yearly, an estimated 2 billion health problems are treated with the use of OTC products.¹ Results from a survey by the NCPIE reported that 73% of patients prefer to self-treat their ailments with OTC products, and the majority of patients consider OTC drugs to be safe and effective.² In addition, 51% of patients reported that they used an OTC drug while using a prescription drug.^2,3 Furthermore, the survey reported that only 37% of patients who use OTC drugs consult the pharmacist to ensure proper selection and use.² As the number of OTC drugs on the market continues to increase, and as the FDA approves more prescription drugs to nonprescription status, the potential for drug interactions increases as well. Therefore, it is important that patients consult pharmacists so that they become educated about the appropriate use of these products. Pharmacists can provide patients with the necessary information to make proper selections when choosing OTC products and can encourage them to thoroughly read the labels of OTC products and to always ask questions if they are uncertain about the selection of and proper use of OTC products.

In recent years, many advances have been made to ensure the safe and proper use of OTC drugs. For example, in 2002, the NCPIE initiated a public education program known as Be MedWise to promote awareness with regard to the proper and safe use of OTC drugs.⁴ In addition, other improvements to increase the safety and efficacy of OTC drugs include the development of the ?Drug Facts? label by the FDA in 2002. The intent of the standardized ?Drug Facts? label was to improve and make the selection and understanding of OTC products easier for patients. The standardized labels must state pertinent product information, which includes⁵:

• The active ingredients, including the amount of each dosage unit
• The intended purpose of the drug
• The indications for use of the drug
• A listing of specific warnings with regard to circumstances in which the products should not be used, as well as when to consult a health care professional (eg, certain medical conditions). Also included in the warning section is information about potential interactions and side effects associated with use of the drug.
• Detailed dosage instructions including route of administration, dosing interval, and duration of use
• The product?s inactive ingredients to alert patients with a history of allergies or sensitivities In addition, technical terms that may be considered confusing to the average patient have been replaced with the use of simple terms in an easy-to-read format.

The Role of the Pharmacist

While more is being done to promote awareness regarding the importance of the safety and appropriate use of OTC drugs, pharmacists are still the patient?s best resource in the proper selection of OTC products. Moreover, while it is important for all patients to properly use OTC products, individuals of advanced age, individuals with pre-existing medical conditions such as diabetes, the pediatric population, and those currently using prescription drugs should always consult a health care professional when considering the use of OTC drugs to avoid possible contraindications, drug?drug interactions, food?drug interactions, drug?alcohol interactions, and/or dosing errors. In assisting patients in the selection of OTC products, pharmacists should assess the patient?s symptoms/condition to determine if self-treatment is appropriate or if medical treatment is warranted, as well as evaluating for potential allergies. When patients are taking multiple OTC products, pharmacists should encourage patients to always check the active ingredients of these products and ensure that a particular ingredient is not in another product they are taking to avoid possible over-dosages, and to use only products that treat their specific symptoms and therefore avoid the unnecessary use of multiple products. As the profession of pharmacy continues to progress, the role of the pharmacist will expand as well. In the midst of these advances, pharmacists will always be considered the ?drug experts? and the fundamental source of drug information for all patients who use these products. While it is virtually impossible for pharmacists to counsel every patient who uses an OTC product, pharmacists should remain accessible to patients. When a patient does seek guidance with regard to these products, pharmacists also should seize the opportunity to educate the patient about the importance of using these products appropriately. By conducting a thorough evaluation of the patient?s needs, pharmacists can assist patients in making informed decisions regarding OTC selections to optimize therapy and ensure the sfe use of these products. When used correctly, OTC products are very effective in treating a variety of common ailments. Recommendations from pharmacists enable patients to make educated choices regarding the use of OTC products.

Ms. Terrie is a clinical pharmacy writer based in Haymarket, Va.

References

• Pal S. Handbook of Nonprescription Drugs. 15th ed. Washington, DC: American Pharmacists Association; 2006:1-13.
• Covington T. Nonprescription drug therapy: issues and opportunities. Am J Pharm Educ. 2006 December 15;70(6):137. www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1803691.
• Uses and attitudes about taking over-the-counter medicines: findings of a 2003 national opinion survey conducted for The National Council on Patient Information and Education. Be MedWise Web site. www.bemedwise.org/survey/summary_survey_findings.pdf. Accessed April 30, 2007.
• Fact Sheet: The Be MedWise Campaign. Be MedWise Web site. www.bemedwise.org/press_room/sept_2003_fact_bmw.pdf. Accessed April 30, 2007.
• Backgrounder: The "Drug Facts" Label as a Consumer Education Tool. Be MedWise Web site. www.bemedwise.org/press_room/sept_2003_drug_facts_bg.pdf. Accessed April 30, 2007.