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Assessing The Over-The-Counter Medications In Primary Care And Translating
The Theory Of Planned Behavior Into Interventions (ID 223654)

Grant Agreement number: 223654
Project acronym: OTC SOCIOMED
Project title: Assessing the Over The Counter medications in Primary Care and translating
the theory of Planned Behaviour into interventions
Funding Scheme: FP7-HEALTH-2007-B -3.1-5 BETTER USE OF MEDICINES
Period covered: from 01/12/2009 to 31/05/2012
Project website address:

Executive summary

September 2012

Executive summary
The inappropriate provision and consumption of non-prescribed medicines consists a public health problem of outmost importance for developed as well as for developing countries. The problem has been shown to be widespread in Mediterranean countries with enormous health risks. The OTC SOCIOMED project aimed at assessing the extent of inappropriate provision and consumption of non-prescribed medicines in certain Southern European countries and identifying factors that influence the provision and consumption of non-prescribed medicines in four primary care groups [general practitioners (GPs) – pharmacists (PHs) – patients – clients]. It further aimed to implement theory-guided interventions, addressing physicians’ training needs and behavioural components playing an influential role in the inappropriate provision of non-prescribed medicines. The project was based on the multivariate model of Transcultural Health Care Utilisation (Slikkerveer, 1990), which identifies a series of actors affecting utilisation as well as the Theory of Planned Behaviour (TPB, Ajzen, 1991), which explains the psychosocial factors determining prescribing patterns and guidance compliance. The project was designed to last 24 months, in an integrated sequence of seven (7) work packages and involved 12 participating entities from 8 countries (Greece, Sweden, Netherlands, France, Cyprus, Czech Republic, Malta, Turkey). Work package 1 involved tasks related to project monitoring and coordination. Work package 2 described the consumption of non-prescribed medicines by patients and pharmacy clients and the provision of non- prescribed medicines by GPs and PHs. It further made regional and geographical comparisons in the consumption and provision of non-prescribed medicines (Northern-Central-Southern Europe, rural-urban settings). Work package 3 assessed GPs’ and PHs’ beliefs, attitudes and perceived behaviour control based on Theory of Planned Behaviour (TPB) and explored the role of TPB in explaining GPs’ and PHs’ intention to provide medicines in patients without well documented evidence. Work package 4 assessed patients’ and clients’ beliefs, attitudes and perceived behaviour control based on TPB and explore the role of TPB in explaining patients’ and clients’ intention to consume medicines. Work package 5 involved the design, implementation and evaluation of a multifaceted intervention addressing GPs’ beliefs and attitudes towards medicines and aiming to test the feasibility of a pilot intervention as well as change GPs’ intention to provide medicines to patients without well documented evidence. Work package 6 reviewed and evaluated the project results and interventions using a nominal group process. Finally, work package 7 involved the dissemination of the project’s results through a variety of dissemination channels as well as developed a set of recommendations/practical guidelines, summarizing the knowledge gained from the project. These recommendations were distributed to a number of stakeholders identified through a mapping process, including public and private organizations/bodies involved in medical research and education, health care planning, drug industry distribution and monitoring. Conclusively, the project identified modifiable determinants of the provision and consumption of non-prescribed medicines and delivered well-designed interventions promoting better use of non-prescribed medicines in Europe and especially in Southern European countries, where the problem of inappropriate provision of non-prescribed medicines seems to be predominant. The study further provided an operationalized structure to define and evaluate interventions targeting similar behaviours in various health care professions and disciplines. It introduced common evaluation standards and tools, translated in multiple European languages and tested in multiple European primary care environments, which could serve as an example for other districts and regions within Europe that share similar geographic and socio-cultural characteristics. In that respect, it could further enable comparisons among training interventions within Europe.