rochecasey165398

Over-the-counter (OTC) codeine is a commonly used painkiller that can be misused to increase the risk of addiction and accidental death. This is a growing public health concern given that deaths associated with OTC codeine have been increasing over the past decade and are disproportionate to their relative availability. OTC codeine is a weak opioid analgesic that acts on the central nervous system to relieve pain and act as a cough suppressant. It is important to remember that OTC codeine should only be used for short term relief of mild to moderate pain that has not responded to lower dose OTC painkillers such as paracetamol and ibuprofen. https://files.fm/f/yzstrabxpv should not be taken to treat long term pain or for the treatment of a cough, as it can cause side effects including drowsiness, nausea and constipation.

Currently, OTC codeine is sold in a range of formulations that vary in strength and dosage. The lowest doses (i.e. 8 mg per tablet and 20 mg in liquid medicines) are sold with a patient leaflet to inform consumers of the risks associated with use. The highest doses are available only with a doctor’s prescription. OTC codeine is often combined with other ingredients to improve the effectiveness of the painkiller and reduce adverse events such as nausea, dizziness and drowsiness. These additional ingredients include antihistamines, anxiolytics/sedatives, antidepressants and paracetamol. It is vital to note that the combination of OTC codeine with other medication can be extremely dangerous, especially when taking other opioids such as morphine or dihydrocodeine, and is also inappropriate for people with certain pre-existing health problems such as respiratory disease.

An educational Patient Safety Card has been developed and piloted in community pharmacies to see if it can be used to effectively nudge customers into the safe and appropriate use of OTC codeine products. The card was designed using the principals of the Antimicrobial Resistance checklist and five clinical points considered key to the safe and appropriate use of OTC codeine. The card was printed on A6-sized paper and distributed to 36 community pharmacies from a large national pharmacy chain, purposefully selected based on OTC codeine sales volumes, the type of community (high street, local community and shopping centre), geographical spread and taking into account Covid-19 operational impact. The card was accompanied by a simple data entry ‘tracker’ for use by pharmacy staff.

Pharmacists were asked to complete the tracker for each OTC codeine purchase that they received during the study period. They were also asked to note whether the customer was a known purchaser of OTC codeine at that pharmacy (“known customer”). The vast majority of respondents (91.3%, n = 21) of pharmacy staff who completed the questionnaire indicated that they found it very or quite easy to use. The feedback from staff was positive and it was reported that the card supported their conversations with customers, helping them to reinforce the key messages of how to take and use OTC codeine safely and appropriately.