Journal of the American Pharmacists Association : JAPhA · 2025
The public health impact of the Rx-to-OTC switch of triptan in Germany: Systematic review and framework analysis.
СтатьяСистематический обзорНазвание и аннотация: Перевод пока не подготовлен
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Imanuel Candice Aphroditta, Atwan Zeenah, Tabche Celine
Аннотация
BACKGROUND: Migraine is a prevalent and debilitating condition in Germany, affecting 10%-15% of the population. Triptans are the primary treatment for acute attacks. The switch of triptans from prescription (Rx) to over-the-counter (OTC) status in Germany aims to improve access and timely treatment. However, it also raises concerns regarding patient safety and misuse. The public health impact of the triptan Rx-to-OTC switch remains underexplored. This study aims to evaluate the public health implications of the Rx-to-OTC switch of triptans in Germany.
OBJECTIVES: Evaluate the public health implications of Rx-to-OTC switch of triptans in Germany.
METHODS: A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, sourcing data from databases such as Embase, Medline, and PubMed, as well as gray literature. Studies were selected based on relevance to the Rx-to-OTC switch of triptans and its public health impact in Germany. Data extraction and analysis were performed using Covidence and a public health impact framework adapted from the World Health Organization, focusing on patient-relevant, health care system, and socioeconomic aspects.
RESULTS: The review identified both public health benefits and risks of the Rx-to-OTC switch of triptans. The switch enhances safety for healthy adults but poses risks for high-risk individuals due to potential contraindications and adverse reactions. It positively impacts health-related quality of life by reducing symptoms, improving employment factors, and increasing access to treatment. The switch also improves quality of care by shifting healthcare delivery from physician-led to pharmacy-led and self-care, resulting in better access and care. In health care-related aspects, the switch benefits pharmacists by expanding their role but presents challenges for physicians. Socioeconomically, the switch leads to substantial cost savings.
CONCLUSION: Overall, the Rx-to-OTC switch of triptans in Germany has a positive public health impact. It improves access, safety, quality of life, quality of care, pharmacists' roles, and socioeconomic benefit but poses risks for vulnerable groups and physicians' roles in the health care system.
OBJECTIVES: Evaluate the public health implications of Rx-to-OTC switch of triptans in Germany.
METHODS: A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, sourcing data from databases such as Embase, Medline, and PubMed, as well as gray literature. Studies were selected based on relevance to the Rx-to-OTC switch of triptans and its public health impact in Germany. Data extraction and analysis were performed using Covidence and a public health impact framework adapted from the World Health Organization, focusing on patient-relevant, health care system, and socioeconomic aspects.
RESULTS: The review identified both public health benefits and risks of the Rx-to-OTC switch of triptans. The switch enhances safety for healthy adults but poses risks for high-risk individuals due to potential contraindications and adverse reactions. It positively impacts health-related quality of life by reducing symptoms, improving employment factors, and increasing access to treatment. The switch also improves quality of care by shifting healthcare delivery from physician-led to pharmacy-led and self-care, resulting in better access and care. In health care-related aspects, the switch benefits pharmacists by expanding their role but presents challenges for physicians. Socioeconomically, the switch leads to substantial cost savings.
CONCLUSION: Overall, the Rx-to-OTC switch of triptans in Germany has a positive public health impact. It improves access, safety, quality of life, quality of care, pharmacists' roles, and socioeconomic benefit but poses risks for vulnerable groups and physicians' roles in the health care system.