Dispensing behaviour in relation to opioid-containing antitussives: a survey among community pharmacists
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Published on: February 10, 2023
Lucia Gasparovic1, Dominik Stämpfli1, Andrea Burden1
1Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland.
Background:
Opioid-containing antitussives are used to symptomatically treat dry coughs but are also consumed recreationally as euphoriant drugs, especially by teenagers and young adults. To curb misuse, in 2019 opioid-containing antitussives in Switzerland were relisted from over-the-counter to requiring a physician's prescription or direct dispensing by a pharmacist.
Aim:
This study aimed to elucidate how this regulatory change impacted the dispensing behaviour of practicing community pharmacists in Switzerland in relation to opioid-containing antitussives.
Methods:
We conducted a cross-sectional survey. The survey consisted of 24 questions and was distributed online via national and cantonal pharmacists' associations' mailing lists to community pharmacists in German, French and Italian. The survey was analysed descriptively. No outcomes for hypothesis testing were specified.
Results:
Our survey was completed by 405 practicing community pharmacists. Most pharmacists reported that the upregulation of opioid-containing antitussives to prescription products led to less frequent (85.8%) and more cautious (74.3%) dispensing. The misuse potential was considered the most important deciding factor when dispensing opioid-containing antitussives. Despite being widely considered as effective (78.4%), opioid-containing antitussives were reported to be used mainly as second and third choice for dry cough, with the most popular first-line choice being butamirate-containing antitussives (43.0%). Notably, French-speaking participants showed the most restrictive attitude towards opioid-containing antitussives, with 49.6% reporting not dispensing them at all.
Conclusions:
Most pharmacists perceived a change in dispensing patterns after the upregulation, with the new dispensing competencies being rated as beneficial by some and as burdensome by others. There were regional differences in attitudes towards opioid-containing antitussives which seemed to be influenced by neighbouring countries.
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