Sharing Prescription Medicines: An Exploration Of Patients’ and Health Professionals’ Perspectives

Abstract

Background Prescription medicine sharing has been defined as giving one’s own medicine to someone else (lending) or using someone else’s medicine (borrowing).Medicines can be shared for non-medical purposes (recreational sharing or drug abuse) or for their intended therapeutic benefits (non-recreational sharing, e.g. sharing antibiotics or asthma inhaler to self-treat). Although most forms of sharing are non-recreational in nature, recreational sharing has been the focus of past research. Limited research evidence is available around nonrecreational sharing. Therefore, this thesis aimed to explore adults’ non-sharing behaviours and to propose the content of interventions to reduce potential risks and harms of sharing. Methods A sequential, exploratory, mixed-methods research design was employed, in which findings from a systematic review, qualitative studies with patients (N=17) and health professionals (N=18) and a theory-based, secondary analysis of qualitative data informed the design and conduct of an online survey (N=233) which measured various dimensions of sharing behaviour. Results Participants reported sharing a range of prescription medicines; medicines used to treat pain, allergies, asthma and infections were chief among them. The qualitative research participants reported both real and perceived positive and negative consequences of sharing, and they suggested several factors which might contribute to sharing, including lack of access to healthcare, lack of information about risks of sharing, altruism, forgetting to carry around own medicines, and concern about missing regular doses of medicines. Having the same illness or symptoms as the other person and having leftover medicines were reported as possible opportunities for sharing. The online survey findings showed that female gender, older age, and history of asthma, allergies, sleep problems or chronic pain were the main non-modifiable predictors of sharing behaviours, whereas the modifiable risk factors for sharing included access-related issues, stronger emotional belief about borrowing, higher concern about missing doses, higher concern for the wellbeing of others, stronger beliefs about the benefits and safety of lending. Conversely, higher perceived risk of harm of borrowing and lending had protective effect on medicine borrowing and lending. Based on the data, different interventions are proposed to reduce potential risks of sharing, including increasing patients and health professional awareness about the risks of sharing, improving access to healthcare, collecting leftover medicines from households, and limiting the supply of prescription medicines to the actual need of the patient. Conclusions The findings suggest that medicine sharing is a complex behaviour and abolishing sharing practices might not be possible. Therefore, minimising the potential risks/harms of sharing should be a priority whilst also acknowledging the positive attributes of sharing.