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

Context 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.

Objective We conducted a systematic review to investigate types of prescribed medication shared, factors that influence this behaviour, including reasons for sharing and the consequences and impact of these practices, including potential harms and risks.

Study design and Analysis Systematic review.

Population and Setting People of any age and in any setting. Primary studies that investigated non-recreational sharing of prescription medicine in people of any age.

Dataset We searched five bibliometric databases: Medline, EMBASE, PsycINFO, CINAHL and Cochrane library from the inception of databases to February 2023. Searches were supplemented by forward citation searches and hand-searching reference lists of included studies. Results were synthesised using narrative synthesis.

Results 19 studies (23 papers) met the inclusion criteria. Analgesics were the most shared, followed by antibiotics (n=12) and allergy medication (n=9). Prevalence ranged from 13-78%. Common reasons 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. Characteristics associated with sharing were age, female sex, having asthma and unused medicines stored at home.

Conclusions: Medication sharing behaviour is common and involves a range of medicines for a variety of different reasons. Data on the prevalence and predictors of prescription medication sharing are inconsistent. A better understanding of non-modifiable and potentially modifiable behavioural factors which contribute to sharing is needed to support development of effective interventions aimed at mitigating unsafe sharing practices.