Survey shows concerns about use of OTC drugs

Consumers often mix or take too much

Many pharmacists are concerned about the way consumers medicate themselves with over-the-counter (OTC) drugs, and a recent survey backs them up.

Of the more than 1,000 American adults surveyed for "Attitudes and Beliefs About Over-the-Counter Medicines: A Dose of Reality," one-third say they take more than the recommended dose of a non-prescription medicine, believing that will increase its effectiveness. A third also say they are likely to combine nonprescription medicines when they have multiple symptoms, such as a headache and a sore throat.

The issues regarding self-medication with OTC drugs are getting renewed attention with the possibility that blockbusters such as loratadine (Claritin) and omeprazole (Prilosec) will soon join the OTC ranks. The National Council on Patient Information and Education in Bethesda, MD, wondered about the extent to which the facts contained on an OTC drug’s label are now being incorporated into the American public’s decisions about self-care. It commissioned a comprehensive survey to track the opinions influencing self-medicating behaviors.

Conducted by Harris Interactive, the survey consisted of two complementary polls: one of 1,011 adult Americans ages 18 and over, conducted in October and November 2001, and the other involving 451 pharmacists, nurses, and general practice physicians surveyed in November and December 2001. (One hundred fifty-one respondents were pharmacists.) By comparing attitudes and beliefs of the general public with health practitioners, the survey identified areas where education about OTC use is most needed.

Here is a summary:

1. The majority of Americans take non-prescription medicines routinely for a variety of common ailments.

  • Three in five Americans (59%) report having taken at least one OTC drug product in the past six months. Slightly more Americans have taken an OTC medicine during the last six months (54%) than a prescription drug.
  • Americans take OTC medicines for a wide variety of ailments, most commonly for pain (78%); cough, cold, flu, or sore throat (52%); allergy or sinus problems (45%); heartburn, indigestion, and other stomach problems (37%); constipation, diarrhea, and gas (21%); minor infections (12%); and skin problems (10%).

2. Despite widespread use of non-prescription medicines, many consumers need more information about when and how to take these products.

  • Health professionals are concerned about a lack of understanding about active ingredients in OTC medicines, especially because different OTC products may contain the same active ingredient. Of the 79% of physicians, nurses, and pharmacists in the poll who say the potential for inappropriate use of OTC remedies is a concern, seven in 10 (69%) cite not understanding active ingredients as the biggest problem.
  • This is confirmed by the consumer poll, which found that only 34% of the public could identify the active ingredient in their brand of pain reliever.
  • In addition, only 11% correctly say that non-prescription medicines formulated for babies are usually more concentrated than formulations for older children.

3. At the same time, consumers tend to overlook important label information when selecting and using OTC products.

  • Although the vast majority of Americans (95%) read some portion of the OTC drug label, the survey finds that many do so selectively when buying or using a non-prescription medicine. When asked what information they look for when buying an OTC drug for the first time, two in five (41%) cite usage information (such as directions for use and information on dosage level and symptoms), one in three (34%) mention the active ingredient, and one in five (21%) say warnings information.
  • Similarly, half (51%) of those surveyed say they seek out usage information when they plan to take an OTC product for the first time. However, only 20% look for the active ingredient.

4. Because some Americans have an incomplete knowledge about OTC medicines, they may take too much of a single product or mix OTC drugs inappropriately.

  • According to the consumer poll, a third of Americans say they take more than the recommended dose of a non-prescription medicine, believing that it will increase the effectiveness of the product. Of these consumers, two-thirds (69%) say they take more than the recommended amount at a single time; three-fifths (63%) say they take the next dose sooner than directed; and two-fifths (44%) say they take more than the recommended number of doses in a day.
  • At the same time, one-third of Americans (36%) say they are likely to combine non-prescription medicines when they have multiple symptoms, like a headache and a sore throat. This practice can increase the risk that consumers take more than one OTC product at a time that contains the same active ingredient.
  • Among the 79% of physicians, nurses, and pharmacists who said they were concerned about the problem of taking non-prescription medicines incorrectly, practitioners cited these factors: combining OTC and prescription medicines (51%); the chronic use of an OTC medicine (44%); using an OTC drug for a prescription indication (32%); and taking more than one OTC product at a time that has the same active ingredient (27%).

5. Besides new and easy-to-read label information, the involvement of health practitioners will increase the public’s ability to understand the risks and benefits of OTC remedies.

  • When discussing the use of non-prescription medicines, the survey finds that the majority of practitioners (65%) spend more than a minute offering specific counseling. Most of this time is spent on: how to take a product (62%); what OTC drug to use (56%); how well the product works (54%); drug interactions (50%); taking more than one OTC drug at a time (49%); cautions prior to or following surgery (43%); and taking more than the recommended dose of an OTC medicine (42%).