TABLE 2—

Summary of Studies in Systematic Review of Nonrecreational Prescription Medication Sharing

Study (Year of Publication)	Location	Design	Sample Size, No.	Response Rate, %	Type of Shared Medicines	Reported Reasons/Sources	Recommended Interventions
Hogan et al. (1990)17	University hospital, Saskatoon Saskatchewan, Canada	Cross-sectional survey with one-on-one interviews of randomly selected dermatology outpatients with diverse sociodemographics	114	NR	Topical corticosteroids, topical antifungals and antibiotics, oral antibiotics, topical antiacne medications, crotamiton cream, codeine with acetylsalicylic acid	Got from family members or friends	Asking patients with cutaneous disorders about previous use of medications from all sources while delivering care
Anglin and White (1999)18	Community health clinic and other settings in rural eastern Kentucky	Ethnographic research: interviews with health and social workers and nonprofessional staff and observation of clinic	16	NA	Not specified	Ran out of medications, obtained from another person or health care provider, lacked money to pay for prescribed medications, to make prescriptions last longer, self-medication, got medicines through social networks	Close monitoring of medication use by health care providers, educating patients through pharmacy and nurses, reducing poverty and improving medication access, tightening communication between physicians and pharmacists to reduce overprescribing and leftover medicines
Thompson and Stewart (2001)19	Metropolitan areas of Melbourne, Australia	In-home interviews with noninstitutionalized persons aged ≥ 65 y	204	87	Central nervous system and musculoskeletal agents; genitourinary agents; alimentary, cardiovascular, respiratory agents; NSAIDs	Ran out of medications, person asked to share medication, forgot own medication, to try the medication	Promoting pharmacy collection of unwanted medicines from customers
Daniel et al. (2003)1	United States	Analysis of data from Youthstyles (mail survey of respondents aged 9–18 y)	1568	52	NR	Got from family members, leftover medicines; had prescription for same medicine; had the same medical problem as the person who had the medicine; wanted something strong for pimples or oily skin; ran out of medications; emergency; cost; needed for pain, headache, or sleep; wanted to relax or feel good; influenced by advertising	Educating girls and their parents about the need to take medication safely, targeting educational messages to adolescents on safe use of medications
Sorensen et al. (2003)20	Australia, 4 states	Cross-sectional survey (researcher-administered questionnaires) of community-dwelling, older war veterans and widowers at risk for medication misadventures and living in their own homes	1086	NR	NSAIDs, COX-2 inhibitors, benzodiazepines, cardiovascular medications, H-2 antagonists and proton pump inhibitors, codeine or dextropropoxyphene combinations, paroxetine, thyroxin sodium, warfarin, α-2 receptor agonists (inhalers), latanoprost, quinine, allopurinol, bethamethasone (ointment), diphenoxylate with atropine sulfate, prochlorperazine	Shared with spouse	NR
Hamrosi et al. (2006)21	Community health centers and hospitals in midwestern New South Wales, Australia	Qualitative in-depth interviews with Aboriginal health workers	11	NA	Not specified	Shared between family and friends	Providing education that considers community culture and giving appropriate and adequate education training for Aboriginal health workers
Goldsworthy et al. (2008)22	United States, 20 cities	Cross-sectional survey (one-to-one interviews), of respondents aged 12–44 y, with diverse sociodemographic characteristics	700	NR	Allergy medications (e.g., Allegra, Claritin), pain medications (e.g., Darvoset, OxyContin), antibiotics (e.g., amoxicillin, doxycyclin, Bactrim/Septra), mood medications (e.g., Paxil, Zoloft, Valium, Ritalin), acne medication (e.g., Accutane), birth control pills	Got from family members; had leftover medicines; had prescription for same medicine; had the same medical problem as the person who had the medicine; wanted something strong for pimples or oily skin; ran out of medications; emergency; cost; needed for pain, headache, or sleep; wanted to relax or feel good; influenced by advertising; got from someone who knew about medications; helped a friend	NR
Petersen et al. (2008)23	United States	Analysis of data from 2001– 2006 US Healthstyles survey (cross-sectional mail survey of individuals), with emphasis on women of reproductive age (n = 7400)	26 289	72.2	Allergy medications, pain medications, antibiotics, mood medications, birth control pills, acne medications	Got from family member; already had prescription but ran out; had the same medical problem as the person who had the medicine; needed for pain, headache or sleep; emergency; had leftover medicines; cost; wanted to relax or feel good; wanted something strong for pimples or oily skin; influenced by advertising	Discussing the risk of sharing with the patient during prescribing, designing programs to promote safe disposal of unwanted medicines, ensuring access to health care and medications for women of reproductive age
Goldsworthy and Mayhorn (2009)24	United States, public spaces of 11 urban and suburban areas	Cross-sectional survey (one-on-one interviews) of demographically diverse adolescents aged 12–17 y	594	NR	Allergy medications, pain medications, mood medications, antibiotics, acne medications, birth control pills	To avoid health care provider visit	Providing training to health care providers on the risk of borrowed medications and educating patients on the proper use of medications and risks of sharing; developing messages on sharing, e.g., within product label; public awareness campaigns
Mayhorn and Goldsworthy (2009)25	United States, 11 locations across country	Cross-sectional survey (one-on-one interviews) of demographically diverse individuals	2773	NR	Allergy medications (e.g., Zyrtec, Clarinex, Flonase), pain medications (e.g., Darvoset, OxyContin), antibiotics (e.g., amoxicillin, doxycyclin, Bactrim/Septra), mood medications (e.g., Paxil, Zoloft, valium, Ritalin), acne medication (e.g., Accutane), birth control pills	NR	Increasing public awareness on medication sharing dangers, adding sharing prohibition messages to labeling, providing training to health care providers
Ali et al. (2010)26	Universiti Sains Malaysia	Cross-sectional survey (one-on-one interviews) of randomly sampled female students	481	90.7	Not specified	Got from family or friends, leftover medicines	NR
Goulding et al. (2011)27	University College Cork, Ireland	Cross-sectional survey (anonymous electronic questionnaire) of students, aged 18–25 y	343	NR	Contraceptives, antibiotics, analgesics	Got from family or friend, cost, inconvenience of visiting doctors, didn't feel sick enough to see doctor	Educating about adverse drug events of medications, discouraging patients from sharing; advising patients to safely dispose of medications
Auta et al. (2011)28	University of Jos, Nigeria	Cross-sectional survey (self-administered questionnaire) of randomly sampled students	730	81.6	Cold/flu medications, pain medications, antibiotics, dermatological medications, mood medications, antimalarials	Emergency, had the same medical problem as the person who had the medicine, influenced by advertising, ran out of medicines, got from someone who knew about medicines or from family members, leftover medicines	Educating public on danger of medication sharing
Goebel et al. (2011)29	California, 2 hospitals and 6 affiliated community sites	Cross-sectional cohort study (one-on-one interviews), analysis of self-reported substance misuse for pain management among veterans	343	NR	NR	For pain management	NR
Ward et al. (2011)30	New York, 4 clinical sites at an urban academic medical center	Cross-sectional survey (one-on-one interviews) of randomly sampled individuals aged ≥ 18 y	641	80	Opioids (Schedule II–IV), NSAIDs and COX-2 inhibitors, benzodiazepines, antibiotics, antihypertensives, others	Got from family members, friends, someone from street, or Internet; to get high, convenience, self-medication, cost	Regularly asking patients about medication use, cautioning patients about borrowing medications even if they deny the behavior
Ellis et al. (2011)31	Illawarra region, New South Wales, Australia	Mixed methods (focus group discussion followed by self-administered survey); convenience sample of independently living adults aged ≥ 65 y	focus group, n = 28; survey, n = 226	65	Antihypertensive, heart disease medications, arthritis or joint inflammation medications, strong pain medications, diabetic medications, depression/anxiety medications, antibiotics, others	Got from family members, ran out of medicines, forgot to fill prescriptions, severe pain, cost, could not go to chemist or doctor, self-medication, tried medication before visiting doctor, medication similar to previous prescription	NR
Kheir et al. (2011)32	Qatar	Cross-sectional telephone interview with randomly sampled household representatives	49	18	Antidiabetic medications, anti-infective medications, inhaled bronchodilators, inhaled corticosteroids, oral corticosteroids	Shared with family members	NR
Hodgetts et al. (2011)33	Central North Island, New Zealand	Focus group discussion with community health workers with heritage linkage with Māori people and employed by Māori tribal health provider	7	NA	Most prescription medications	Shared among family members and social networks, avoided visits to general practitioner/pharmacy, ran out of medications, obtained prescription medicines from general practitioner by presenting false proxy symptoms, cost, cultural barrier	Integrating medication-sharing concerns into training of health care providers
Kamutingondo et al. (2011)34	Hamilton, New Zealand	Ethnographic research (interviews, photographs, diaries, mapping, material objects, and media content) among 4 Zimbabwean households	17	NA	NR	To demonstrate care among family members during illness, to sustain and nurture social relationship among households	NR

Note. COX = cyclooxygenase; NA = not applicable; NR = not reported; NSAID = nonsteroidal anti-inflammatory drug.