# Community pharmacists preparedness to control OTC medication abuse in Saudi Arabia: a nationwide cross-sectional survey-based study

## TL;DR

This study assesses Saudi community pharmacists' awareness and preparedness to address over-the-counter medication abuse, finding high awareness but a need for clearer policies.

## Contribution

The study provides the first nationwide assessment of Saudi pharmacists' preparedness to control OTC medication abuse.

## Key findings

- Most pharmacists perceive codeine-containing products as the most addictive OTC medications.
- Pharmacists report high knowledge of OTC abuse but identify lack of patient records and workload as major barriers.
- Common responses to suspected abuse include patient advice and physician referral.

## Abstract

Over-the-counter (OTC) medication misuse, abuse, and addiction are increasingly recognized issues not only in Saudi Arabia but also worldwide. Investigating OTC medication abuse and pharmacists' preparedness to control it is an urgent research area that will help to establish strategies to reduce associated harms.

To explore community pharmacists' awareness, views, and preparedness to control OTC medication's abuse in Saudi Arabia.

This cross-sectional study was conducted between November 2021 and February 2022. Data were collected using an online self-administered questionnaire distributed to community pharmacists across Saudi Arabia.

A total of 813 out of 919 community pharmacists completed the survey (response rate: 88.5%). Most of them were male (702, 86.3%), non-Saudi (623, 76.6%), bachelor's degree holders (648, 79.7%), professionally classified as pharmacists (534, 65.7%), aged ≤ 40 years (756, 93.0%), and from the western region (363, 44.6%). Using a 5-point Likert scale, pharmacists perceived their knowledge of OTC medication abuse to be high (mean score 4.3±/0.9, 86.0%). OTC medication classes most perceived as carrying a risk of addiction were codeine-containing products (82.2%), followed by cough suppressants/antitussives (69.5%). Dealing with a suspicious patient/customer who may be abusing OTC medication, most respondents said they would provide advice to patients as necessary (707, 87.0%) and refer to a physician (696, 85.6%). The top-rated barriers to preventing OTC medication abuse were lack of patient records on OTC medication use (mean score 3.2±/1.4, 64.0%) and workload (mean score 3.1 ± 1.5, 62.0%).

Most community pharmacists in Saudi Arabia are aware of OTC medication abuse. Establishment of clear policies and guidelines regarding purchasing limits and monitoring practices is urgently needed.