Pharmacy-Led Intervention Helps Manage OTC Medication Misuse

Pharmacy staff’s conviction of the Senior Safe program’s effectiveness was the key factor leading to the success of this pharmacy-led resource, according to a study in Pharmacy (Basel).¹

Researchers believe this confidence led to successful integration of Senior Safe, highlighting a desire to further scale pharmacy staff and their ability to provide patient interventions. With its focus on OTC medication misuse among older adults, the program’s success further demonstrates pharmacy staff’s medication expertise.

“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 a study published in Exploratory Research in Clinical and Social Pharmacy.² “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.”

READ MORE: Proactive Warning Is Crucial in Preventing OTC Drug Abuse

As patient ages increase, so too do major and minor health-related risks. With older adults being more in need of medication as they get older and pharmacists being the country’s most accessible health care professionals,³ community pharmacies are primed as the premier locations for both OTC and prescription-only management.

On top of the pharmacy staff’s unique opportunity to increase OTC misuse services, there have also been reports of older adults having a significant lack of understanding of OTC medications despite commonly using them.⁴ Maneuvering various OTC-related trends on both the patient and provider sides, researchers of the current study put the pharmacy’s expertise to the test through the Senior Safe pharmacy-based intervention.

The Senior Safe Program

“A pharmacy staff-informed approach was used when designing Senior Safe, a US evidence-based intervention created to reduce older adult (age 65+) misuse of certain OTC products without generally exacerbating workload,” wrote the authors of the Pharmacy (Basel) study.¹ “Senior Safe was implemented into 67 pharmacy sites comprising a large Midwestern health care system and represented a large-scale health system-level intervention.”

The program’s goal was simple: prevent older adults from misusing OTC medications. Researchers went about this by redesigning OTC aisles in participating pharmacies, distinguishing products between low- and high-risk based on Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.^1,5

The low-risk, “safer” products were given green signage, while high-risk products were represented with a red stop sign. The “highest risk products” were placed behind the pharmacy counter (BTC) with proper signage. Upon implementation of the OTC aisle redesign, Senior Safe “immediately” exhibited success in preventing misuse while not increasing pharmacy staff workload.

Although the program provided short-term success in adults’ OTC misuse, researchers wanted to better understand its long-term viability.

“To understand the beliefs of pharmacy staff that support confidence in Senior Safe’s long-term viability, a survey was sent to pharmacists and technicians who worked with adopting and enacting Senior Safe in their pharmacies,” they continued.¹ “The survey was designed to evaluate pharmacy staff perceptions about various aspects of leadership support, encountering and addressing issues related to intervention adoption, and their preparation for their role in enacting Senior Safe, as well as Senior Safe’s effectiveness at reducing OTC medication misuse and the confidence in its activity in 5 years.”

Pharmacy Staff’s Confidence in Senior Safe Program

To explore confidence among facilitators of Senior Safe, pharmacy staff were sent surveys to complete, with 59 pharmacists and 94 technicians submitting responses. Despite survey completions reaching a total of 160 respondents, only the 153 pharmacists and technicians provided their pharmacy role.

After statistical analysis of survey responses from Senior Safe participants, the 2 factors that contributed to staff views of the program were perceiving Senior Safe as well-integrated into leadership operations and believing the program’s intervention actually reduced OTC misuse.

“It is possible that, when implementing a novel pharmacy program, identifying staff’s confidence in these content areas can help pinpoint which staff may need extra support and which staff members might help champion ongoing adoption efforts,” the authors wrote.¹

Although this novel program held a focus on pharmacy staff and their confidence in day-to-day practice, it also highlighted their ability to be champions of OTC misuse in the older population. As pharmacists have continuously shown, they are uniquely positioned to help guide patients through their medication journeys.

However, researchers believe the results of this study help go beyond the pharmacist’s medication advice but rather show the ability of pharmacists and pharmacy technicians to introduce successful patient guidance together, without increasing the workload.

“Pharmacy staff are essential to the continued successful use of pharmacy-based interventions, just as they have been with Senior Safe,” concluded the authors of the study.¹

READ MORE: OTC Resource Center

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REFERENCES

1. Gilson AM, Moore KG, Resendiz SM, et al. "But will it last?": Examining how pharmacy staff perceptions influence beliefs about the sustainability of a pharmacy-based intervention targeting older adult over-the-counter (otc) medication misuse. Pharmacy (Basel). 2025 Dec 1;13(6):174. doi: 10.3390/pharmacy13060174.

2. 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;20:100663. https://doi.org/10.1016/j.rcsop.2025.100663

3. Valliant SN, Burbage SC, Pathak S, et al. Pharmacists as accessible health care providers: quantifying the opportunity. J Manag Care Spec Pharm. 2022 Jan;28(1):85-90. doi: 10.18553/jmcp.2022.28.1.85.

4. Nowosielski B. Older adults lack understanding of OTC drugs despite common use. Drug Topics. November 18, 2025. Accessed January 8, 2026. https://www.drugtopics.com/view/older-adults-lack-understanding-of-otc-drugs-despite-common-use

5. Beers criteria. Cleveland Clinic. May 3, 2023. Accessed January 8, 2026. https://my.clevelandclinic.org/health/articles/24946-beers-criteria