After reading this chapter, the student pharmacist, community practice resident, or pharmacist should be able to:
Understand the importance of self-care and over-the-counter (OTC) products and how to integrate into daily workflow.
Describe the key components of obtaining a medication history for an OTC consult.
Assess and counsel a self-care patient using a structured process.
Be familiar with advanced services that are provided in a community pharmacy setting and how OTC products can be incorporated into these services.
Self-care is defined as “the independent act of preventing, diagnosing, and treating one's own illnesses without seeking professional advice.”1 Self-care includes dietary interventions, dietary supplements, nonprescription or OTC products, home diagnostics, and monitoring and lifestyle modifications.1 Self-care plays a vital role in health-care, and pharmacists are in a key position to assist patients with these interventions. Two of the most rewarding aspects of a community pharmacist's responsibilities are assisting patients in the selection of OTC medications and counseling patients on the proper use of these products.
OTC medicines are important to America's health-care, providing $102 billion annually in value to the U.S. healthcare system.2 There are more than 300,000 marketed OTC medications in the market in 80 different therapeutic classes.3,4 OTC medicines are available in the following categories: pain and fever, gastrointestinal, respiratory, ophthalmic, otic, reproductive, and genital and dermatologic disorders.1
OTC product sales in 2010 were estimated at $17 billion dollars compared with $2 billion dollar in 1965.5 As more products come to market and as brand-extension products expand, pharmacists must be proactive when talking with consumers about these medications. Since OTC products are readily available to consumers, they need to be able to identify the problem and be able to identify exclusion for self-treatment and select the correct product for treatment. An incorrect diagnosis by a consumer, such as mistaking heartburn for symptoms of a heart attack, or improper product selection, such as selecting the incorrect dose of a pediatric analgesic, may lead to an adverse event or hospitalization.6
According to the 2010 American Pharmacists Association (APhA) Annual Survey, pharmacists make an average of 29 OTC recommendations each week, approximately 81% of consumers purchase an OTC product that their pharmacists recommended and the average time for an OTC consultation was about 3 minutes.7 Convenience is cited as a primary reason patients choose OTC medications. In a 2008 National Council on Patient Information and Education (NCPIE) survey of 1005 Americans, 78% of participants stated they self-medicate because it saves a trip to the doctor's office, 78% of participants stated that their illness was not serious enough to warrant a doctor's visit, and 77% of participants stated that it saves time.8 In addition to convenience and time, OTC medicines also save consumers money.8
A study conducted in 2010 shows that “90% of both consumers and physicians recognize that there ...