What constitutes evidence for over-the-counter medicines? A cross-sectional study of community pharmacists’ knowledge, attitude, and practices

To assess the knowledge, attitude and practices of evidence-based medicine (EBM) with regard to over-the-counter (OTC) medicines among New Zealand community pharmacists. A pre-piloted, self-administered online questionnaire was disseminated through email to 2788 registered community pharmacists. The questionnaire covered the aspects of knowledge, attitude and barriers towards EBM, and factors influencing pharmacists’ product recommendations. Responses were collected over 4 weeks in January 2021. Data were analysed using SPSS (version 26). A total of 326 responses were collected (11.7% response rate). Participants had an average knowledge score of 15.6 (out of 33). More than 50% had a favourable attitude towards EBM. Insufficient time (20.2%) and a lack of resources (16.4%) were reported as the major barriers to practicing EBM. The majority (72.8%) of participants believed that guideline recommendations were important for OTC recommendations; however, 44.9% would always use their own judgement. Recent graduates (P = 0.048) and pharmacists with a higher level of education (P = 0.00) scored significantly higher for knowledge. A higher knowledge score predicted ‘more favourable’ attitude towards EBM. Deficiencies exist in community pharmacists’ EBM-related knowledge, attitude and practices. An educational intervention targeting older pharmacists is required since the relevant knowledge was found to be deteriorating with age.