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The significance of over-the-counter (OTC) medication in the management of disease is growing with recent and accelerated reclassification of prescription medicines. Such agents exert powerful pharmacological actions increasing the potential for adverse drug reactions, to which older people are particularly susceptible. As high consumers of prescription (Rx) and OTC drugs, it is important to examine OTC drug use by older people. Random samples of older people (>65yrs) from three FHSA registers were taken. 2818 respondents were interviewed at home about medication status, disability, morbidity and access to primary care. The most commonly used OTCs were oral analgesics (19%) and vitamins & tonics (10%). Fewer men than women had used OTCs in the previous 24hrs (34% cf 41%). Those in social class I exhibit a greater tendency to self-medicate than social class V (47% cf. 36%). There was no association with age. People with severe disability were less likely to self-medicate (p=0.025) as were those who had recently been hospitalised (pKO.001). An insignificant association (p=0.058) was found with depression and anxiety. No relationship was found with self-perceived health or loneliness. A strong negative relationship exists between the number of Rx medicines and OTC usage (p<0.001) suggesting that people who receive fewer Rx drugs meet medication needs with OTCs. Among specific factors relating to GP practices, those concerning the patient's perception of the quality and quantity of contact with dieir GP are the most significant (very satisfied 36%, dissatisfied 59%; p=0.016). Previous studies report that 50% of patients do not discuss OTC drug use with their GP. Healthcare professionals should be aware of the patient characteristics which predict OTC drug use and recognise its importance in older people with respect to polypharmacy and adverse drug reactions.

Characterisation of Non-Prescription Drug Use by an Elderly Population