Introduction to Community Pharmacy OTC Medicines

OSPAP Programme: Introduction to Community Pharmacy OTC Medicines in the UK

• This programme introduces over-the-counter (OTC) medicines in UK community pharmacies.
• The presenter is Deanne Marshall.

Objectives

• Overview of community pharmacy OTC: This section covers the legal framework, the role of the Responsible Pharmacist, identifying referral points/warning symptoms, and understanding various conditions and products.
• The Law: The sale and supply of medicines in the UK are restricted by the Medicines Act 1968, part III.
• Responsible Pharmacist: A responsible pharmacist (RP) is always needed in the pharmacy for P (pharmacy) medicines and for dispensing prescriptions.
• Referral points/warning symptoms: Specific health issues warranting referral to a doctor are discussed.
• Conditions: Common conditions treatable with over-the-counter medicines are outlined.
• Products: Licensing restrictions regarding OTC medicinal products are detailed.
• Pharmacy first: The NHS-funded scheme, Pharmacy First, is explained.

The Law

• Legal Classifications: Medicines are categorized into P (pharmacy) medicines, GSL (General Sales List) medicines and POM (Prescription-Only Medicines).
• Pack sizes: Pack size restrictions can impact whether a product can be sold OTC. For example, paracetamol can be sold in different dosages (POM, P or GSL).

P Medicines

• A pharmacy (P) medicine can be sold in a registered pharmacy by a pharmacist, or a supervised person, but not via self-selection.

GSL Medicines

• GSL (General Sales List) medicines can be sold in registered pharmacies using self-selection, and can also be sold in other retail outlets that can limit public access.

Legal Classifications (continued)

• Specific examples of legal classifications: 16 tablets/capsules GSL, 32 tablets/capsules P, 100 tablets/capsules POM. Paracetamol packs containing 32 or fewer tablets are available OTC. Pharmacists can sell multiple packs up to 100 total tablets/capsules in justified circumstances.

Responsible Pharmacist Regulations

• A responsible pharmacist (RP) must be present in a pharmacy to sell P medicines and dispense prescriptions.
• If the RP is present but out of the pharmacy only GSL medicines may be sold.
• Pharmacists must ensure staff are adequately trained to handle OTC medicines in their absence.
  • This includes minimum NVQ Level 2 in Pharmacy Services.

Evidence Base

• A lot more evidence is available for recent P-category switches.
• Older medicines may not have as much evidence, but this doesn't mean they're ineffective.
• Clinical evidence resources include BMJ, NICE, SIGN, Clinical Knowledge Summaries and the Cochrane Library.
• Other searchable databases include Medline and Embase.

Consultation Acronyms

• A range of mnemonic consultation tools/structures are presented for a pharmacist-patient consultation.

Warning Symptoms

• Symptoms that necessitate a referral to a doctor are presented by body system: Chest, Gut, Eye, Ear, Genitourinary, and Other.

Other Things to Consider

• Interactions between OTC medicines, prescribed medicines and herbal medicines.
• Contraindications related to existing conditions and the patient's age.
• Applicable licensing restrictions.
• Legal requirements and confidentiality issues.

Common Illnesses (Examples)

• Gastrointestinal illnesses (GI) (e.g., thrush, apthous ulcers).
• Respiratory illnesses (e.g., colds, sore throat, hay fever).
• Women's and men's health concerns (e.g., cystitis, thrush, menstrual problems).
• Lifestyle considerations (e.g., smoking, alcohol, diet, exercise).
• Skin concerns (e.g., rash, acne, eczema).
• Eye problems (e.g., conjunctivitis, glaucoma).
• Ear issues (e.g., earwax).
• CNS issues (e.g., insomnia, vertigo, migraines).
• Paediatric concerns (e.g., pyrexia).

Vitamins and Minerals

• Water-soluble vitamins (B1-B12, C): Good working knowledge of their function and food sources is needed.
• Minerals (Calcium, Iron, Selenium, Zinc): Good working knowledge of their function and food sources is needed.

Common Herbal Products Sold OTC

• Specific examples of herbal products commonly sold OTC are presented.

Homeopathy

• Explanations of homeopathy, how medicines are made and their use.

Pharmacy First

• This NHS-funded scheme started January 31, 2024.
• It provides treatment for 7 common conditions for which pharmacists are funded to give advice.
• Community pharmacies are presented as a first point of call for advice.
  • Pathways are available for self-referrals and referrals from NHS 111 or a GP, based on the specific condition.

This quiz covers the essential aspects of over-the-counter (OTC) medicines in UK community pharmacies. Learn about the legal framework, roles of the Responsible Pharmacist, and key conditions treatable with OTC products. Enhance your understanding of referral points and the licensing restrictions for pharmacy medicines.