title: Nature and frequency of drug-related problems in self-medication (over-the-counter drugs) in daily community pharmacy practice in Germany.
abstract: OBJECTIVE
  To quantify drug-related problems (DRPs) in self-medication (over-the-counter [OTC] drug use) identified by community pharmacists (CPs) in Germany at the time the drug is dispensed.
  
  
  METHODS
  One hundred CPs were asked to document 100 consecutive customers presenting symptoms or requesting OTC drugs using a standardized documentation form. The number of 10,000 encounters seemed reasonable to evaluate the set objective. For each encounter, data such as age, sex, and first or repeated request and the availability of a patient file in the pharmacy including drug history were documented. Furthermore, identified DRPs, problem descriptions, and solutions were documented. Data were transcribed electronically, coded, checked for validity, and analyzed.
  
  
  RESULTS
  In total, 109 CPs documented 12,567 encounters identifying DRPs in 17.6% of all cases. Four indications comprised more than 70% of all DRPs: pain, respiratory, gastrointestinal, and skin disorders. Four DRPs were responsible for almost 75% of all DRPs identified: self-medication inappropriate (29.7%), requested product inappropriate (20.5%), intended duration of drug use too high including abuse (17.1%), and wrong dosage (6.8%). If a drug history was available, significantly more cases with wrong dosage (p < 0.05) and drug-drug interactions (p < 0.001) were detected. All patients with identified DRPs were counseled accordingly. Furthermore, the most frequent interventions were referral to a physician (39.5%) and switching to a more appropriate drug (28.1%).
  
  
  CONCLUSIONS
  In nearly one of five encounters, a direct pharmacist-patient interaction about self-medication revealed relevant DRPs. Having access to patient files including data on prescription and OTC drugs may increase patient safety.
authors.affiliation: Department of Medicine, Center for Drug Information and Pharmacy Practice (ZAPP), ABDA-Federal Union of German Associations of Pharmacists, Berlin, Germany. c.eickhoff@abda.aponet.de
authors.forename: Christiane
authors.initials: C
authors.lastname: Eickhoff
authors.forename: Andrea
authors.initials: A
authors.lastname: Hämmerlein
authors.forename: Nina
authors.initials: N
authors.lastname: Griese
authors.forename: Martin
authors.initials: M
authors.lastname: Schulz
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000592:standards / Q000706:statistics & numerical data*; D003157:Community Pharmacy Services / Q000592:standards / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000139:chemically induced / Q000453:epidemiology; D005858:Germany; D006801:Humans; D004366:Nonprescription Drugs / Q000009:adverse effects*; D010595:Pharmacists; D024382:Professional Role; D012651:Self Medication / Q000009:adverse effects* / Q000706:statistics & numerical data*
chemical_list: D004366:Nonprescription Drugs