Influence of pharmacists' opinions on their dispensing medicines without requirement of a doctor's prescription.

Objective: To assess the influence of pharmacists' opinions on their dispensing medicines with a "medical prescription only" label without requiring a doctor's prescription.

Methods: We performed a cross-sectional study of 166 community pharmacies in northwest Spain. The opinions of pharmacists on the following were collected as independent variables through personal interview: a) physicians' prescribing practices; b) the pharmacist's qualifications to prescribe; c) the responsibility of the pharmacist regarding the dispensed drugs; d) the customer' qualifications for self-medication; and e) the pharmacist's perception of his or her own work. The dependent variable was the pharmacist's demand for a medical prescription for 5 drugs, which in Spain require a prescription. Multiple linear regression models were constructed.

Results: The response rate was 98.8%. A total of 65.9% of pharmacists reported dispensing antibiotics without a prescription. This percentage was 83.5% for nonsteroidal anti-inflammatory drugs, 46.3% for angiotensin-converting enzyme inhibitors, 13.4% for benzodiazepines, and 84.8% for oral contraceptives. Further results showed that pharmacists with a heavier workload and those who underestimated the physicians' qualifications to prescribe but overestimated their own qualifications to prescribe less frequently demanded medical prescriptions. In contrast, pharmacists who stressed the importance of their duty in rationalizing the consumption of drugs more frequently demanded medical prescriptions.

Conclusion: Our results suggest that to increase the quality of dispensing: a) the importance of the pharmacist's duty in controlling drug consumption should be stressed; b) pharmacies' workload should be optimized; and c) perceptions of physicians' prescribing practices among pharmacists should be improved.