FACTORS INFLUENCING PURCHASE OF AND COUNSELLING ABOUT PRESCRIPTION AND OTC MEDICINES AT COMMUNITY PHARMACIES IN TALLINN, ESTONIA

Development of community pharmacy services in post-socialist countries has been influenced by several factors: external determinants, such as transition in the economy, the social sphere and the political organization of the country, and internal factors, such as worldwide reorientation within the pharmacy profession, changing the position of pharmacist within health care system (1, 2). In the described situation many post-socialist countries retained traditional community pharmacy services along with step-bystep improvement towards patient orientation and provision of more detailed drug information to assure safe and effective use of medicines (3, 4). Estonia can be seen as an example of country in transition providing mostly traditional community pharmacy services ñ dispensing and counselling of prescription and over-the-counter (OTC) medicines; counselling on self-medication and preparation of medicines (5). Counselling about prescription and OTC medicines at community pharmacy Community pharmacists have traditionally provided two types of services ñ dispensing of and counselling on prescription medicines, and provision of advice on self-care and self-medication (6). With regard to prescription medicines, patients consider physicians as the primary and pharmacists as the secondary source of information (7). At the community pharmacy, provision of information concerning prescription medicines is initiated and guided by the pharmacist. During the counselling process, pharmacist can identify possible drug-related problems, increase the likelihood of patientsí adherence to drug therapy and optimize the quality of care of the particular patient (7). The role of the pharmacist in giving advice concerning OTC medicines and self-medication has increased during last decades. If surveys carried out 10ñ15 years ago reported negative attitudes of patients about the pharmacist being a therapeutic consultant or suggesting OTC medicines proposed by physician (8), later studies refer to pharmacists as credible and accessible sources of information in case of minor ailments and OTC medicines (9, 10). There are no considerable differences in providing information concerning prescription or OTC medi- The aims of the current survey were to evaluate factors influencing purchase of prescription and OTC medicines of pharmacy customers in Tallinn, Estonia and to identify the role of community pharmacists in counselling of prescription and OTC medicines. Structured questionnaire was used to interview pharmacy customers (n = 1820) in six community pharmacies of Tallinn, the capital city of Estonia. The survey instrument consisted of 15 multiple-choice items. According to the survey results, prescription and OTC medicines were bought from community pharmacies almost equally. The most popular OTC medicines were analgesics (38%), cold and cough medicines (21%). The older survey participants and these with lower income and with elementary school education bought more prescription medicines (p < 0.01). Survey participants with higher income were purchasing more OTC medicines and food supplements (p < 0.01). Before purchase of medicines recommendations were received mainly from physicians about prescription and from pharmacists about OTC medicines. However, the counselling provided by community pharmacists in selecting of both types of medicines was highly appreciated. Pharmacists as source for drug information were less trusted among the survey participants < 25 and 26ñ40 years (p < 0.01). Fast service and confidential counselling about medicines was less important for the respondents with elementary school education (p < 0.01)