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The BMA is urging GPs to make discussion of OTC medicines an integral part of every patient consultation.

GPs can improve patient safety and potentially reduce their own workload by routinely considering OTC products, as a potential cause of presenting symptoms or as a cost-effective alternative to an NHS prescription, the BMA says.

In a new report from its science board, the association has warned of the 'potentially dangerous consequences' of interactions between OTC and prescribed drugs. GPs needed to improve their awareness of non-prescription drugs being taken by their patients, the report added.

GPs rarely mention OTC products during consultations but this needed to change, the report recommended. 'There are several points in the consultation at which the GP should be aware of OTC medicines. This will become increasingly so as the range and potency of OTC medicines increases,' it concluded.

'One woman taking ibu-profen reported that she went to the GP with increased epigastric pain and was prescribed a PPI without any inquiry into concomitant medication use.'

The report urged GPs to inquire about use of OTC products as a routine part of history taking.

GPs could also bear in mind the option of recommending an OTC product as a cost-effective way of managing symptoms ­ particularly viral conditions where patient pressure might otherwise result in an antibiotic prescription.

Research had shown patients managed in this way were less likely to see their GP in future with viral symptoms.

The BMA released its report as the UK drug regulator signalled its plans to step up the drive to switch treatments from POM to OTC.

Dr June Raine, post licensing division director of the Medicine and Healthcare Products Regulatory Agency, earlier this month revealed the next wave set to head OTC, including appetite suppressants, urinary incontinence treatments and migraine drugs.

Speaking at a conference in Switzerland, Dr Raine also suggested drugs for obesity, osteoporosis, dyspepsia and flu could be switched.

Dr Peter Fellows, chair of the GPC prescribing subcommittee, said patient education was needed to counter the 'pressure to purchase' of marketing drugs directly to patients.

Professor Saad Shakir, director of the drug safety research unit at the University of Portsmouth and also a GP, said improved training for pharmacists was also vital.

'While making more medicines available OTC makes it easier for patients, complex drugs require professional support which I do not think all pharmacists have the time or willingness to provide.'



·Training programmes for all health professionals about OTC drugs and doses

·Self-management education courses for children and adults

·Include OTC treatment in the NHS core electronic patient record

·Better record-keeping of patient OTC use

By Joe Lepper

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