The Pharmaceutical Journal
Vol 270 No 7235 p203
8 February 2003

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Product selection hints useful yet lack of evidence acknowledged

'Non-prescription medicines', 2nd edition, by Alan Nathan. Pp xiii+384. Price £24.95. London: Pharmaceutical Press; 2002. ISBN 0 85369 506 7

With increasing opportunities for prescribing of more powerful drugs over the counter the need for guidance is becoming acute and Alan Nathan's comprehensive book generally fulfils the requirement well.

This completely revised second edition assesses the range of non-prescription medicines that can be recommended for the most frequently encountered minor illnesses. Product selection hints throughout the book are particularly useful. Changes in the legal status and new approaches to treatment are both described in detail. A new section on emergency hormonal contraception has been added. The formulary style is clear with plenty of space and an interesting type face.

The author states that "the book sets out to present and objectively assess the available scientific and clinical information in order to help pharmacists and other health professionals make reasoned judgements". The lack of a single reference is surprising in an era where evidence-based medicine is an important issue. It is difficult to see how "reasoned judgements" can be achieved effectively without giving an opportunity to consult primary reference sources where they are available and indeed have been used by the author. In truth there is little scientific evidence available for many over-the-counter products, except perhaps for those subject to POM-to-P switches in recent years. To be fair, the author acknowledges this fact concluding that "in the absence of other evidence a medicine's track record in terms of sales and user satisfaction may be as good a reason for recommendation as any other". In the introduction the author talks about "health care in the United Kingdom" but some of his remarks refer only to the current position in England — beware of the marauding Scots and Welsh!

The book will be a useful addition to pharmacists' bookshelves. It will certainly be of benefit to other health professionals too and provide interesting reading to members of the public intending to self treat.

Steven Kayne