title: Community pharmacists' adoption of medicines reclassified from prescription-only status: a systematic review of factors associated with decision making.
abstract: OBJECTIVE
  Subsequent to reclassification of legal status, more than 90 prescription-only medicines have become available in the UK alone without a prescription. Similar changes are taking place internationally. The aim was to systematically review studies reporting factors associated with community pharmacists' decision making around adoption of these reclassified medicines into practice.
  
  
  METHODS
  A systematic review of English language peer-reviewed published literature from 1990 to 2010 was conducted. Literature was identified through MEDLINE, EMBASE, IPA, CINAHL, BSP, Cochrane Library and PsychINFO databases and other sources including key conference abstracts.
  
  
  RESULTS
  A total of 38 studies were included. Twenty-eight factors associated with pharmacists' decision making were identified. Medicine safety was consistently shown to be one of the key factors; however, the importance of evidence base and financial benefits of reclassification were less obvious. A paucity of high-quality studies limits generalisation of findings.
  
  
  CONCLUSIONS
  Patient safety appears to be the key to pharmacists' decision making. However, the study quality limitations indicate the need for further robust research. The 28 factors identified in this systematic review from international literature can aid rigorous research instrument development for future evaluations.
authors.affiliation: School of Pharmacy and Life Sciences, Faculty of Health and Social Care, The Robert Gordon University, Aberdeen, UK.
authors.forename: Vibhu
authors.initials: V
authors.lastname: Paudyal
authors.forename: Denise
authors.initials: D
authors.lastname: Hansford
authors.forename: Scott
authors.initials: S
authors.lastname: Cunningham
authors.forename: Derek
authors.initials: D
authors.lastname: Stewart
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration*; D003657:Decision Making; D006801:Humans; D004366:Nonprescription Drugs / Q000145:classification / Q000627:therapeutic use*; D010595:Pharmacists / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D055553:Prescription Drugs / Q000145:classification / Q000627:therapeutic use; D006113:United Kingdom
chemical_list: D004366:Nonprescription Drugs; D055553:Prescription Drugs