title: A detailed analysis of online pharmacy characteristics to inform safe usage by patients.
abstract: BACKGROUND
  Evidence suggests that consumers potentially put themselves at risk when purchasing medicines on-line. Whilst logos provided by regulators may provide some level of reassurance there may be other indicators which could be used by consumers to identify those websites which may be safely used.
  
  
  OBJECTIVE
  Identify characteristics of on-line pharmacies which are related to whether websites are regulated or non-regulated and those characteristics which could be used by patients to increase the likelihood of accessing regulated sites.
  
  
  METHODS
  Online pharmacies which supply diazepam, fluoxetine and simvastatin.
  
  
  METHODS
  Using piloted search terms via Google and Yahoo search engines, identified websites were screened for regulatory status, adherence to regulatory standards, administrative requirements, clinical assessment requirements and additional details deemed to be of relevance to a user. Characteristics of regulated and non-regulated (defined as those with an absence of a correctly linked regulatory logo) websites were compared to identify differences which could be used to improve patient safety.
  
  
  METHODS
  Regulatory status, adherence to regulatory standards, quality of information provision, barriers to medicines access.
  
  
  RESULTS
  113 websites sold diazepam, fluoxetine and simvastatin; were identified within the first 100 results. Less than quarter were found to be regulated online pharmacies. 80 websites were willing to sell the medication without a prescription. The unregulated internet pharmacy websites (defined as those with an absence of a correctly linked regulatory logo) were found to adhere more closely to the clinical criteria, were less significantly likely to disclose a contact name and address, telephone number of the pharmacy or demand a prescription prior to sale (P < 0.05, Fisher's Exact).
  
  
  CONCLUSIONS
  The three prescription-only medicines which are liable to abuse, have potentially serious interactions and require counselling to ensure patient safety are readily available via the internet. When purchasing medicines via this route UK consumers should be made aware of the importance of regulatory logos and additionally should ensure that the seller can be meaningfully contacted by the contact details provided. The provision of clinical information should not be used alone as an indication of the seller's provenance.
authors.affiliation: Medicines Management Research Group, School of Pharmacy, University of East Anglia, Norwich, NR4 7TJ, UK, b.al-won@uea.ac.uk.
authors.forename: Bassam M
authors.initials: BM
authors.lastname: Alwon
authors.forename: Gennifer
authors.initials: G
authors.lastname: Solomon
authors.forename: Faseeha
authors.initials: F
authors.lastname: Hussain
authors.forename: David J
authors.initials: DJ
authors.lastname: Wright
mesh_terms: D006801:Humans; D020407:Internet / Q000191:economics / Q000592:standards*; D061214:Patient Safety / Q000191:economics / Q000592:standards*; D060946:Pharmaceutical Services, Online / Q000191:economics / Q000592:standards*; D010865:Pilot Projects; D055553:Prescription Drugs / Q000191:economics / Q000592:standards*; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D055553:Prescription Drugs