Older Adults Lack Understanding of OTC Drugs Despite Common Use

Despite frequent use of OTC medications, older adults over 65 exhibited a significant lack of knowledge regarding these drugs, according to a study published in Exploratory Research in Clinical and Social Pharmacy.¹ Through improving health literacy and increasing awareness, researchers believe there is an urgent need to prevent OTC misuse among this population.

“Misuse of OTC medications occurs when individuals take the medication in a way or dosage other than directed on the package or administer them for the effect it produces, either to get high or mix OTC medicines to create new products,” wrote the authors of the study. “Because OTCs do not require a prescription, there is limited knowledge or consideration of how these medications are used, including the extent of their misuse.”

Indeed, with the ready availability of OTC medications, misuse is almost inevitable if pharmacists or other health care providers are not counseling patients. According to the Defense Health Agency, OTC misuse leads to approximately 178,000 hospitalizations a year.² Furthermore, the World Health Organization reported that close to 50% of all individuals misuse OTCs, contributing to increasing levels of morbidity and mortality.¹

Despite convenient access to most community pharmacies, as well as pharmacists often being the last provider patients see before taking a drug, OTC misuse is still expected to persist as these drugs’ overall market growth continues.

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According to an article published in US Pharmacist, experts believe rising drug prices and an increased number of underinsured patients could be leading to a significant rise in OTC demand.³ OTC products continue to hold a significant space in the US drug market, accounting for 10% of all pharmaceuticals and exhibiting a 4-year growth rate of over 3.5%.⁴

These issues and trends across the OTC drug market have encouraged researchers of the current study to better understand older adults’ medication use, or misuse for that matter.

“The study investigated the impact of OTC drug misuse on older patients' health, including prevalence, types of misuse, and related health issues,” they wrote.¹ “It also examined factors such as polypharmacy and explored negative outcomes, including hospitalization.”

To capture the older patient's perspectives on OTC drug use, researchers conducted a cross-sectional survey study across various Saudi cities from November 2024 to March 2025. Surveys were either conducted in person or online. They addressed patients’ demographics, OTC and overall medication use, awareness of drug-drug interactions, and their educational needs.

Researchers explored studies on OTC use and misuse in older adults to curate their survey questionnaire. Only adults 65 years or older living in Saudi Arabia at the time of the study were included in the final analysis. Participants also had to report use of OTC medications within the past 12 months prior to being included.

The study included a total of 386 geriatric participants (64.2% aged 65 to 69 years; 57.3% women). Among the study population, several individuals reported chronic conditions, with diabetes being the most prevalent (49.7%).

Regarding their general medication use habits, 84.7% said they use prescription medications, while 80.7% reported use of OTC medications.¹ Finally, regarding the concurrent use of 5 or more drugs—also known as polypharmacy—28.5% of patients used at least 5 prescription or OTC medications.

Although overall medication use was so common among older adults, so too were misuse behaviors and gaps in understanding the medications they are typically using.

First, 14.2% of patients said they’ve experienced an OTC overdose. Another 33.2% reported that they use OTC medications for purposes other than recommended. While just under half (49%) reported the “occasional combination” of OTCs and prescription drugs, only 37.6% actively kept a well-documented medication record.

Along with these habits potentially leading to poor health outcomes, participants’ lack of understanding of OTC and prescription drugs was also substantial. Across the study population, 39.4% were unaware of the dangers of misuse, 38.3% did not know potential side effects, 43.5% were unaware of interactions with prescribed medications, and 56.2% did not know about contraindications.¹

Furthermore, regarding the inverse of patients possessing more drug knowledge, those aware of potential adverse effects and contraindications were less likely to misuse medications than those without the proper understanding.

“The study showed that most participants frequently used OTC medications, primarily analgesics, yet lacked knowledge about these drugs,” they concluded.¹ “It underscores the urgent need for interventions to prevent OTC misuse among the aging population, focusing on enhancing health literacy and safe drug practices. Recommended strategies include media campaigns and clinical programs to raise awareness about OTC misuse risks.”

READ MORE: OTC Resource Center

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REFERENCES

1. Alfarhan M, Ashqar J, Ajeebi J, et al. Prevalence and impact of non-prescription medication misuse in the geriatric population. Explor Res Clin Soc Pharm. 2025 Sep 30;20:100663. doi: 10.1016/j.rcsop.2025.100663.

2. Over-the-counter medication misuse. Defense Health Agency. June 15, 2020. Accessed November 18, 2025. https://ph.health.mil/topics/healthyliving/asm/Pages/OverCounter.aspx

3. Dinkins MM. Patient counseling: a pharmacist in every OTC aisle. US Pharm. 2010;35(4)(OTC Trends suppl):9-12. https://www.uspharmacist.com/article/patient-counseling-a-pharmacist-in-every-otc-aisle

4. Trygstad T. OTC market grows alongside consumer preferences. Pharmacy Times. June 18, 2024. Accessed November 18, 2025. https://www.pharmacytimes.com/view/otc-market-grows-alongside-consumer-preferences