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Evidence review needed for OTC analgesics?

Research published to coincide with Self Care Week, which starts today (November 18), has called for an evidence review of OTC analgesics.

A survey of 242 community pharmacists found that while only 13 per cent believed paracetamol is more effective than OTC ibuprofen, most (89 per cent) still recommended paracetamol first-line.

More recommendations were made for paracetamol (branded 41 per cent; generic 24 per cent) for the treatment of headache and migraine in comparison to ibuprofen (branded 17 per cent; generic 18 per cent).

Some 65 per cent of pharmacists believed paracetamol is safer than ibuprofen, with 58 per cent believing that the risks of prescription-strength ibuprofen can be transferred to OTC doses.

Among the conclusions drawn were that pharmacist advice on taking OTC ibuprofen with food and not recommending for patients with minor GI issues and asthma contradicted the available clinical evidence. Moreover, pharmacists’ beliefs around ibuprofen were extrapolated from prescription use rather than the OTC evidence base.

Improved education on the safety and efficacy of analgesics in the OTC environment is required to ensure patients receive advice that optimises outcomes, the researchers say.

Improved education

Commenting on the results, Fin McCaul, owner of Prestwich Pharmacy and co-author of the research, said: “Results show that pharmacists’ perceptions of analgesic safety and efficacy do not reflect the existing evidence base for OTC use, which may negatively impact on patient outcomes and satisfaction with pharmacy advice.”

Pharmacists’ beliefs around ibuprofen are extrapolated from prescription use, rather than the OTC evidence base, which demonstrates comparable safety for ibuprofen and paracetamol at OTC doses, he continued. “Pharmacists’ advice on taking OTC ibuprofen with food and not recommending for patients with minor GI issues or asthma also contradicts the evidence and Summary of Product Characteristics.”

Terry Maguire, senior lecturer at School of Pharmacy, Queen’s University Belfast and research investigator, added: “The results demonstrate that improved pharmacy education on the safety and efficacy of analgesics in the OTC environment is required to ensure patients receive advice that optimises clinical outcomes and reduces the risk of dissatisfaction with pharmacists’ recommendations.”

The survey was conducted by IQVIA (formerly IMS Health) and funded by Reckitt Benckiser, manufacturer of Nurofen.

E-learning package launched for Self Care Week

The Self Care Forum marked the start of Self Care Week, which has the theme ‘Think self care for life’, with the launch of an e-learning package aimed at pharmacists and other health professionals to enable them to incorporate self care messages in their consultations.      

The course is ideal for community pharmacists, according to Professor Rob Darracott, Self Care Forum trustee.

“Community pharmacists are well placed to deliver self care advice, while signposting people to the most appropriate care for their health needs, whether this is self care or an NHS service,” he said. “Ensuring people can safely look after their own health is important. This programme makes it clear that self care is not ‘no care’ – it is care with the support people need to look after themselves and their families.”

The programme, which comprises four short modules, can be accessed free of charge on the E-Learning for Life platform. 

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