Original Research

The misuse of codeine containing medicines: Perceptions and behaviours of qualified pharmacy professionals

Elmien Bronkhorst, Munira Adamjee, Madan Poka
South African Family Practice | Vol 66, No 1 : Part 2| a5862 | DOI: https://doi.org/10.4102/safp.v66i1.5862 | © 2024 Elmien Bronkhorst, Munira Adamjee, Madan Poka | This work is licensed under CC Attribution 4.0
Submitted: 01 November 2023 | Published: 10 May 2024

About the author(s)

Elmien Bronkhorst, Department of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Munira Adamjee, Department of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Madan Poka, Department of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa

Abstract

Background: Pharmacy professionals working in community pharmacies frequently provide pharmacist-initiated therapy, including codeine-containing medicines. Codeine is an opioid with great potential for misuse, adding to the global opioid epidemic burden. Professional pharmacy personnel are the first intervention point in relation to management of codeine use. This study highlights the importance of pharmacy professionals’ perceptions and behaviours in combatting the opioid epidemic.

Methods: A descriptive cross-sectional study was conducted. Simple random sampling included pharmacy professionals in the metropolitan city of Johannesburg. An electronic questionnaire was distributed via e-mail and data analysed descriptively.

Results: Findings indicate that pharmacy personnel routinely ask patients about codeine use (n = 48; 53.9%), avoid dispensing over-the-counter (OTC) codeine as an initial treatment (n = 61; 69%) and express confidence to identify and manage codeine misuse (n = 69; 77.5%). Despite this, increased patient demands for OTC codeine (n = 69; 77.5%) were concerning, highlighting the ease of availability from internet sources (n = 76; 85.4%) and multiple pharmacies (n = 84; 94.4%). Apprehension about the lack of patient awareness on adverse health consequences (n = 66; 74.2%) and the risk of codeine dependence (n = 79; 88.8%) was expressed.

Conclusion: Growing concern regarding availability and accessibility of codeine-containing medicines within the community pharmacy sector is highlighted. Adverse health consequences of codeine misuse and dependence are not understood by customers and the ineffective information provided by pharmacy personnel was highlighted as a concern.

Contribution: The results of this study give insight to the influence of dispensing personnel’s attitude towards the growing challenges with respect to codeine containing medication abuse.


Keywords

codeine; pharmacy personnel; misuse; dependence; behaviours

Sustainable Development Goal

Goal 3: Good health and well-being

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