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Factors influencing pharmacists’ over-the-counter drug recommendations
  1. Darija Grebenar1,
  2. Eric Nham2,
  3. Robert Likic3
  1. 1 Department of Health and Care, ZU Farmacia, Zagreb, Croatia
  2. 2 University of Zagreb School of Medicine, Zagreb, Croatia
  3. 3 Department of Internal Medicine, Division of Clinical Pharmacology, Clinical Hospital Centre Zagreb and University of Zagreb Medical School, Zagreb, Croatia
  1. Correspondence to Dr Robert Likic, Department of Internal Medicine, University of Zagreb Medical School, Zagreb 10000, Croatia; robert.likic{at}


Background Self-care is a growing trend all over the world, and pharmacists have a major role in it since they are the most easily accessible medical experts.

Objectives Our aim was to investigate factors influencing pharmacists’ over-the-counter (OTC) drugs recommendations in Croatia.

Setting A random sample of 565 (50%) of all pharmacies in Croatia.

Methods A cross-sectional study with a five-point Likert scale online questionnaire covering medical and non-medical factors influencing OTC drug recommendation was distributed in October 2017 to a random sample of pharmacies.

Results 206/565 (response rate 36.5%) responses were collected. The most important factors influencing pharmacists’ recommendation were: composition of the OTC product and its active component (4.76±0.47), scientific evidence of effectiveness (4.54±0.60), feedback from the patients (4.32±0.61) and information from professional journals (4.22±0.67). On average, medical factors had greater importance (4.5±0.58) for pharmacists’ OTC recommendation than marketing (3.18±0.84) and social factors (3.15±0.79). Female pharmacists appeared less inclined to recommend an OTC product based on advice of other pharmacists (OR=0.61, CI=0.43 to 0.86, p=0.005) and pharmacists working directly in a pharmacy attached more importance to active components of OTC products during their OTC product counselling (OR=2.28, CI=0.92 to 5.65, p=0.03).

Conclusion It is vital to know that pharmacists’ OTC recommendations are mainly influenced by medical factors and to a lesser degree by marketing and social factors.

  • over the counter
  • drug
  • OTC
  • recommendation
  • pharmacist
  • factors

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  • Contributors DG collected the data and wrote the manuscript, EN analysed the data and critically reviewed the manuscript while RL designed the study, helped to collect and analyse the data and critically reviewed the manuscript. All authors have approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was exempt from review by the institutional ethics board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.