Knowledge and use of over-the-counter drugs in Italy: an exploratory survey-based study in the general population

During the past decade the misuse of over-the-counter (OTC) medicines has become a global public health concern especially among young people. In this study, we aimed to explore the OTC consumption and related misuse in Italy and to identify the demographic characteristics of people/individuals who are involved in this phenomenon, understanding eventual risk factors. The study consisted of an anonymous online survey distributed by direct contact and via the Internet between June-November 2021 to the general population living in Italy. Descriptive statistics were reported, and binary regression analyses were performed to identify risk factors for lifetime misuse of OTC. The study was approved by the University of Hertfordshire (aLMS/SF/UH/02951). The final sample size was composed of 717 respondents. The sample was mainly represented by female (69.3%) students (39.9%) in the 20-25 years age group (30.0%). Based on the survey responses, study participants were divided into two groups according to the presence/absence of OTC abuse/misuse (127 versus 590), which were compared for possible predictors of OTC diversion. Multivariate regression showed that OTC abuse/misuse was associated to the knowledge of the effects of OTC [odds ratio/OR = 2.711, 95%Confidence Interval/CI 1.794-4.097, p <0.001]. On the contrary, the educational level appeared to be a protective factor [OR = 0.695, 95%CI 0.58-0.94, p = 0.016]. Although, according to our data, the phenomenon of OTC abuse appeared to be limited, increasing attention is needed because of possible underestimation and high-risk outcomes. Preventive strategies, including a simplified access to information, may play a key role in the limitation of OTC misuse.