What pharmacists have to say about medicines sharing

woman being handed pills by her husband

Why do people share prescription medicines, and is it always a bad thing?

People share medicines by either lending or borrowing them, and prescription medicines that are reported to be most commonly shared between people are those used to treat pain, allergies and bacterial infections – but what are the risks?

Researchers from the School of Pharmacy at the University of Auckland, New Zealand, decided to interview pharmacists (n = 8), doctors (n = 4) and nurses (n = 6) across a variety of community and hospital settings, to find out what they thoughts about medicines sharing.

Their results revealed a variety of both benefits and adverse consequences attached to the practice.

Among 18 total participants, most believed that in some instances the benefits from sharing outweighed potential risks. For example:

  • Sharing asthma inhalers or epinephrine injection in emergency situations;
  • Sharing a few doses of medicine when a higher degree of medicine adherence is need; and
  • Sharing oral contraceptive pills to avoid disrupting the pill-taking cycle.

Some participants also viewed medicine recycling/sharing within a family as an efficient and cost-effective use of resources “if done safely”.

However participants noted several potential adverse consequences of medicines sharing, for example:

  • The lender’s medicines might be contraindicated for the borrower;
  • Poor treatment outcomes among some patients;
  • Shared medicine that alleviates symptoms might mask an underlying medical condition.

Some pharmacists added that during sharing, medicines might be removed from their original containers and information contained on labels, leaflets and package inserts might not be transferred to the borrower, leading to loss of important medicine instructions.

In addition, sharing antibiotics to self-treat conditions caused by viruses was seen by participants as a major risk factor for drug resistance.

And sharing certain medicines such as eye drops, antimicrobial creams and ointments was also viewed as a potential public health threat, with participants concerned that patients might not realise the need to follow certain safety precautions to avoid infection.

“The sharing of eye drops is very common. Also it’s a really good way to share infections,” said one hospital pharmacist in an interview.

Pharmacists voiced their concerns about patients’ knowledge regarding safe use of strong analgesics e.g. tramadol and morphine.

They stated some of their patients were often prescribed an oversupply of these medicines, and might share their unused medicines.

On finding out whether a person is sharing medicines, participants expressed difficulty.

“I suspect a lot of the time patients don’t want to tell you that they’re sharing medicines because they know that it is not the right thing to do,” said a hospital pharmacist.

“I suspect you don’t hear about it most of the time so it would be very difficult to obtain accurate statistics on something that no-one tells you about.”

One pharmacist suggested the need to ask patients routinely about their sharing practices during medicine reconciliation (i.e. comparing medicine orders and patient records with current medicines of the patient).

Broad intervention strategies are needed to target individuals, the public and the health system in order to educate people about safe medicine sharing practices, the authors concluded.

The study was published in the Journal of Pharmacy Practice and Research.

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1 Comment

  1. Jarrod McMaugh

    I’ve actually joined a number of the “buy swap sell” facebook groups in the area around my pharmacy for two reasons – it helps identify shoplifters, and it helps identify when medications are being diverted (benevolently or not).

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