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

Background: 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 identify the demographic characteristics of people/individuals involved in this phenomenon, understanding eventual risk factors. Methods: 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 sta-tistics were reported, and binary regression analyses were performed to identify risk factors for life-time misuse of OTC. The University of Hertfordshire approved the study (aLMS/SF/UH/02951). Results: The final sample size was composed of 717 respondents. The sample was mainly repre-sented 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 diver-sion. Multivariate regression showed that OTC abuse/misuse was associated with 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]. Conclusion: Although, according to our data, the phenomenon of OTC abuse appeared to be lim-ited, increasing attention is needed because of possible underestimation and high-risk outcomes. Preventive strategies, including simplified access to information, may play a key role in limiting OTC misuse.