Table 4.
Facilitators and barriers: control beliefs.
| Superordinate theme, subtheme and composition | Participants who highlighted the theme | ||
| Superordinate theme 4: facilitators | |||
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Facilitators adopted by the illegal sellers of medicines | ||
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POMsa accessibility (accessibility to POMs without the need for a prescription) | 3, 4, 7, 9, and 18 |
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Medicine availability (provide a wide range of medicines, including branded medicines, medicines that are not licensed in the United Kingdom, and medicines that are not available in the NHSb) | 5, 6, 9, 11, 13, and 14 |
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Provision of a variety of easy and secure payment options as well as the availability of web-based payment systems that offer refund and protection (eg, PayPal’s Purchase Protection) | 6, 7, 9, 17, 20, 8, and 17 |
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Customer support offered by the illegal sellers’ websites | 17 |
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Illegal sellers’ marketing (pop-up advertisements and direct links) | 4, 11, and 13 |
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Ability to make bulk purchasing without limits. | 2, 6, 7, 9, 15, and 18 |
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Facilitators offered by various internet platforms | ||
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Social media platforms (easy communication) | 5, 9, 11, and 14 |
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Review websites | 1, 8, 10, 11, 14, 17, and 18 |
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Search engines (eg, Google), which facilitate the searching process | 4 and 9 |
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Signposting by support communities available on different internet platforms | 4 and 5 |
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COVID-19 outbreak (facilitating conditions) | ||
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Anxiety and fear due to COVID-19 | 7 |
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Mobility restrictions owing to lockdown or self-isolation | 5, 14, 18, and 20 |
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Overburdened medical staff during the COVID-19 outbreak | 4, 9, 10, 14, 16, 17, 18, and 20 |
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Spread of misinformation on social media and other platforms | 7 and 9 |
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Consumer personality | ||
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Willingness to take risk | 6 and 19 |
| Superordinate theme 5: barriers | |||
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General barriers | ||
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Complexity of medication instructions: POMs that require complex instructions for use (eg, injections) | 3 and 18 |
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Financial capabilities: cannot afford to pay for medicines available on the web | 3 and 4 |
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Website-specific barriers | ||
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Absence of suitable payment options | 5, 9, 11, 12, 13, and 17 |
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Language barrier if the website is in a non-English language | 17 |
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Delivery problems such as the websites that do not deliver to the United Kingdom | 5, 11, and 19 |
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Illegal website closures or seizure of the parcels at the UK borders by organizations stopping the purchase of POMs on the web (eg, customs and the Interpol) | 2, 3, 5, 7, and 11 |
aPOM: prescription-only medicine.
bNHS: National Health Services.