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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Family Practice 1/2014

Irrational prescribing of over-the-counter (OTC) medicines in general practice: testing the feasibility of an educational intervention among physicians in five European countries

BMC Family Practice > Ausgabe 1/2014
Christos Lionis, Elena Petelos, Sue Shea, Georgia Bagiartaki, Ioanna G Tsiligianni, Apostolos Kamekis, Vasiliki Tsiantou, Maria Papadakaki, Athina Tatsioni, Joanna Moschandreas, Aristoula Saridaki, Antonios Bertsias, Tomas Faresjö, Åshild Faresjö, Luc Martinez, Dominic Agius, Yesim Uncu, George Samoutis, Jiri Vlcek, Abobakr Abasaeed, Bodossakis Merkouris
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2296-15-34) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

CL was the coordinator of the FP7 European project and conceived the idea of this study. CL and GB prepared the first draft, SS, IGT and EP contributed at a next stage and AK, VT, MP, AT, JM, AS, AB, TF, AF, LM, DA, YU, JV, AA, TE and BM all contributed to the study design and the final manuscript. CL, MP, AB and EP contributed to the revision of the manuscript. All authors reviewed and approved this manuscript before its submission.



Irrational prescribing of over-the-counter (OTC) medicines in general practice is common in Southern Europe. Recent findings from a research project funded by the European Commission (FP7), the “OTC SOCIOMED”, conducted in seven European countries, indicate that physicians in countries in the Mediterranean Europe region prescribe medicines to a higher degree in comparison to physicians in other participating European countries. In light of these findings, a feasibility study has been designed to explore the acceptance of a pilot educational intervention targeting physicians in general practice in various settings in the Mediterranean Europe region.


This feasibility study utilized an educational intervention was designed using the Theory of Planned Behaviour (TPB). It took place in geographically-defined primary care areas in Cyprus, France, Greece, Malta, and Turkey. General Practitioners (GPs) were recruited in each country and randomly assigned into two study groups in each of the participating countries. The intervention included a one-day intensive training programme, a poster presentation, and regular visits of trained professionals to the workplaces of participants. Reminder messages and email messages were, also, sent to participants over a 4-week period. A pre- and post-test evaluation study design with quantitative and qualitative data was employed. The primary outcome of this feasibility pilot intervention was to reduce GPs’ intention to provide medicines following the educational intervention, and its secondary outcomes included a reduction of prescribed medicines following the intervention, as well as an assessment of its practicality and acceptance by the participating GPs.


Median intention scores in the intervention groups were reduced, following the educational intervention, in comparison to the control group. Descriptive analysis of related questions indicated a high overall acceptance and perceived practicality of the intervention programme by GPs, with median scores above 5 on a 7-point Likert scale.


Evidence from this intervention will estimate the parameters required to design a larger study aimed at assessing the effectiveness of such educational interventions. In addition, it could also help inform health policy makers and decision makers regarding the management of behavioural changes in the prescribing patterns of physicians in Mediterranean Europe, particularly in Southern European countries.
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