Self-medication errors in community pharmacies

Safe self-medication requires using medicines for the correct indication and only temporarily. Identifying risk factors and developing protective factors can help prevent self-medication errors and improve self-medication safety.

To identify self-medication errors in community pharmacies and to classify the associated risk and protective factors, with a special focus on high-risk OTC medicines.

This retrospective nationwide register-based study included the self-medication errors reported in the Finnish national Incident Reporting System in community pharmacies. Self-medication errors occurring in incident reports were classified into customer- or professional-related. A qualitative content analysis of risk and protective factors of included self-medication errors was conducted.

Altogether, 316 self-medication errors were identified. Customer-related self-medication errors (n = 219) were the most common, of which 80% were near misses. More than half (59%) of medicines involved in these errors were classified as National High-Risk OTC medicines. Professional-related self-medication errors (n = 97) were mostly actual errors (91%), and 37% of these involved look-alike, sound-alike (LASA) medicines. Use of high-risk OTC medicines, contraindications, and misconceptions about OTC medicine use were associated with customer-related self-medication errors. Medication counseling, including assessment of medication needs, interactions, and contraindications, was the most common protective factor against self-medication errors. LASA medicines and inadequate assessment of medication needs were associated with professional-related self-medication errors.

National High-Risk OTC medicines contributed to more than half of incidents when customers selected medicines but posed a low risk when pharmacists selected medicines. Pharmacists' medication counseling was the most important protective factor in preventing self-medication errors from reaching customers.