The risks and benefits associated with the self-selection of pharmacy medicines (PMEDs): A rapid systematic review

Pharmacy Practice

  • Lauren S. Ross1Science and Research Manager, Royal Pharmaceutical Society (RPS), London, UK.
  • Amira Guirguis2Chair of Science and Research Committee; Professor of Pharmacy, Royal Pharmaceutical Society (RPS), London, UK., 3Pharmacy, Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Wales, UK.
  • Wing Tang4Head of Professional Standards, Royal Pharmaceutical Society (RPS), London, UK.
  • Laura Wilson5Director of Scotland, Royal Pharmaceutical Society (RPS), London, UK.
  • Elen Jones6Director of Wales, Royal Pharmaceutical Society (RPS), London, UK.
  • James Davies7Director of England; Member of Board Trustees, Royal Pharmaceutical Society (RPS), London, UK., 8Commonwealth Pharmacists Association, .
  • Diane Ashiru-Oredope9Deputy Chief Scientist; Professor of Pharmaceutical Public Health, Royal Pharmaceutical Society (RPS), London, UK., 10School of Pharmacy, University of Nottingham.

Volume 24 Issue 2 Pages 1-27

DOI: 10.18549/PharmPract.2026.2.3479

Abstract

Background: Pharmacies in the UK are increasingly implementing a self-selection model for Pharmacy medicines (PMEDs) in physical pharmacies and allowing their purchase from online pharmacies. This model potentially weakens the additional level of protection recommended by the Medicines and Healthcare products Regulatory Agency (MHRA) by removing the opportunity for intervention, possibly risking patient harm. Objective: To assess the risks and benefits associated with a PMEDs self-selection model in pharmacy settings. Methods: A systematic search was conducted across three databases (PubMed/Medline, Embase, and Cochrane Library) from 01/10/2024 to 22/10/2024. The search terms comprised Medical Subject Headings (MeSH) terms and free text with wildcard truncations. Only studies published from 01/2014 – 10/2024 and published in English were eligible for inclusion. Studies identified were exported to Excel, where duplicates were removed. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of all included studies. Results: A total of 54 studies of the 104 initially screened were included in the review. The country most frequently reported on was Australia (9/54; 16%), alongside multi-location/global studies (9/54; 16%). The majority (29/54; 54%) of studies focussed on the views and experiences of pharmacy professionals or students, and approximately half (26/54; 48%) focussed on patient views, experiences, or behaviours. The benefits identified from the included literature were relatively consistent, focussing on access to care, reducing pressure on health systems, and improved patient autonomy. However, the list of risks identified was heterogenous, covering a range of themes, including, adverse effects of medication, inappropriate use of medication, and reduced intervention opportunities, and self-diagnoses delaying required care. The risks associated with medication self-selection were more frequently discussed when compared with benefits. Conclusions: Although this review identified risks and benefits associated with medication self-selection more broadly, none of the included publications solely discussed PMEDs. More research is needed to fully understand the risks and benefits of the self-selection model for this classification of medicines.

Keywords

  • Review Article
  • pharmacy medicines
Pharmacy Practice

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