Community pharmacists’ adoption of medicines reclassified from prescription-only status: A systematic review of factors associated with decision making

Vibhu Paudyal, Denise Hansford, Scott Cunningham, Derek Stewart

Research output: Contribution to journalLiterature review

8 Citations (Scopus)


Subsequent to reclassification of legal status, more than 90 prescription-only medicines have become available in the UK alone without a prescription. Similar changes are taking place internationally. The aim was to systematically review studies reporting factors associated with community pharmacists' decision making around adoption of these reclassified medicines into practice.
A systematic review of English language peer-reviewed published literature from 1990 to 2010 was conducted. Literature was identified through MEDLINE, EMBASE, IPA, CINAHL, BSP, Cochrane Library and PsychINFO databases and other sources including key conference abstracts.
A total of 38 studies were included. Twenty-eight factors associated with pharmacists' decision making were identified. Medicine safety was consistently shown to be one of the key factors; however, the importance of evidence base and financial benefits of reclassification were less obvious. A paucity of high-quality studies limits generalisation of findings.
Patient safety appears to be the key to pharmacists' decision making. However, the study quality limitations indicate the need for further robust research. The 28 factors identified in this systematic review from international literature can aid rigorous research instrument development for future evaluations.
Original languageEnglish
Pages (from-to)396-406
Number of pages11
JournalPharmacoepidemiology and Drug Safety
Issue number4
Early online date23 Feb 2012
Publication statusPublished - Apr 2012



  • adoption
  • decision making
  • community pharmacists
  • reclassified medicines

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