Prescription medication sharing for non-recreational purposes: A systematic review of the literature

Problem

Prescription medication sharing is defined as the lending or borrowing of prescription medications where the recipient of those medicines is someone other than the person for whom the prescription is intended. Sharing of prescription medication can cause significant harm to the individuals who engage in these practices. Adverse consequences include increased risk of side effects, delayed health seeking, masking of the symptoms and severity of disease. Prevalence estimates vary across different populations, and peoples’ reasons for sharing and their perceptions of risks from sharing are poorly understood. This systematic review aimed to provide a better understanding of the types of medications shared, reasons for sharing, and the perceived benefits and risks of sharing.

Approach

Medline, EMBASE, PsycINFO, CINAHL and Cochrane library were searched from inception of databases to February 2023 using a combination of medical subject headings and free-text terms. Any primary study design that investigated non-recreational sharing of prescription medicine in people of any age. Two authors independently screened the articles, extracted data using a standardised extraction form and assessed methodological quality using the Mixed Methods Appraisal Tool. PROSPERO ID CRD42021252209.

Findings

The search yielded 3503 records after deduplication of which 53 full-text citations were assessed for eligibility and 19 studies (23 papers) met the inclusion criteria. Seven studies were from the USA, three from New Zealand, one each from Croatia, Saudi Arabia, Malaysia, Nigeria, Philippines, Australia, Ireland, Uganda, and South Korea. A total of 14 studies reported that painkillers were most commonly lent/shared, followed by antibiotics (n=8) and allergy medication (n= 8). Prevalence of sharing ranged from 13-78%. Common reasons for sharing were running out of medication (n=7); cost (n=7) and emergency (n=6). Perceived risks included borrowed medicine was ineffective, adverse drug reactions, loss of medication instructions and misdiagnosis. Perceived benefits included resolution of the problem, time and money saving and maintenance of good relationships with friends/colleagues.

Consequences

Findings suggest that medication sharing is a common behaviour and involves a wide range of medicines for a variety of different reasons across different countries and settings. This review highlights that there is insufficient data on reasons for medication sharing, how people decide to engage in this behaviour and whether they are aware of the potential risks, alongside a lack of any research in this topic area from the UK setting.