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 55 studies of the 104 initially screened were included in the review. The country most frequently reported on was Australia (10/55; 18%), followed by multi-location/global studies (9/55; 16%). The majority (30/55; 55%) of studies focussed on the views and experiences of pharmacy professionals, and approximately a quarter (13/55; 24%) 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 far more 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.

The authors have declared no competing interest.

This study did not receive any external funding

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Conflict statement: None of the authors have any conflict of interest to disclose in relation to this work.

Funding statement: This research was conducted as part of Royal Pharmaceutical Society Science & Research Team’s regular programme of work. No specific external funding was received.

All data produced in the present work are contained in the manuscript