Improving health and well-being through over-the-counter counselling – an observation study
Authors: Gombos H , Svendsberg K , Sletvold H , Krogstad T 
Published: April 2024

Abstract

Introduction
The use of over-the-counter (OTC) medication in self-care gives patients empowerment in their healthcare. However, if the patients do not know enough about the medication, it may lead to misuse.[1] Pharmacies are easily accessible, low threshold first-line health providers, where these products are sold. Considering the United Nations Sustainable Development Goals (SDGs),[2] pharmacy personnel are in an excellent position to educate the public on correct self-care, increasing good health and well-being (3rd goal). By ensuring that the customer buys the correct product and does not self-treat unnecessarily, pharmacies may contribute to responsible consumption (12th goal).[2]

Aim
Assessing the impact of OTC medication counselling in the 3rd and 12th SDG context: which aspects help promote good health and well-being, and how can counselling influence responsible consumption of OTC medication?

Methods
Observations with detailed notes of encounters on OTC medications were performed by two observers, for validity, in 7 pharmacies in and around a Nordic capital city. Pharmacies were recruited through convenient sampling, aiming to include pharmacies of different sizes and locations. The study population consisted of 253 observations. Results were analysed using thematic analysis focusing on evidence-based advice concerning the 3rd and 12th SDGs.

Results
The theme “customer autonomy” shows that most customers come to the pharmacy with a known product in mind. Employees rarely address the appropriateness of the customers’ chosen product, and only correct the customer if they clearly found the wrong one. Responsible consumption is not addressed. Considering good health and well-being, the theme “Presumed Knowledge” contains how employees most often ensure that the customer has previous experience, taking this as proof of the customer´s health literacy. When the employee informs about the product, they rarely give explanations for the advice, as described in the theme “Coaching opportunity”.

Conclusion
Pharmacy employees rarely take advantage of the opportunity to educate the public on proper OTC medication use, and thus do not contribute sufficiently to increase knowledge of good health. There is a lot of potential for pharmacies to utilise evidence-based advice in everyday practice, and ways of promoting good health knowledge in pharmacy practice need to be explored. Pharmacy employees do not contribute substantially to reducing consumption, as they most often sell the product the customer asks for without considering the necessity. Tailored OTC counselling could shape consumer behavior towards responsible OTC medication use, ultimately contributing to improved health outcomes, reduced waste, and a more sustainable healthcare landscape.
A strength of using the observation method is that it is possible to examine how pharmacy personnel work in everyday situations. One limitation might be that since both the customer and employee were informed that observers were present, the employee might be inclined to improve their performance. However, the observers could clearly see the instances where the employee changed their conduct, and in most instances, the extra effort did not improve the information exchange.

References
1. Hughes CM, McElnay JC, Fleming GF. Benefits and Risks of Self Medication. Drug Safety. 2001;24(14):1027-37.
2. United Nations. The 2030 Agenda for Sustainable Development. United Nations. 2015. Available from: https://sdgs.un.org/goals