Improving OTC Counseling: Health Literacy, High-Risk Patients, and the Future of Pharmacy Care

Pharmacy Times interviews Renee’ Acosta, R.Ph., M.S., on strategies to improve OTC counseling in the context of widely varying patient health literacy, identifying high-risk populations, and emerging trends shaping the future of OTC care and pharmacy technician involvement. She emphasizes that a major challenge in OTC counseling is the lack of multilingual labeling compared to prescription medications, making clear, verbal communication essential. Pharmacy technicians should never assume patients can read or fully understand OTC labels, and instead should use simple, plain language, avoid medical jargon, and confirm understanding through direct, accessible explanations. Techniques such as using translation tools, recording instructions in a patient’s preferred language, or employing apps and devices to support communication can significantly improve comprehension and adherence.

Acosta highlights the importance of tailoring counseling strategies to vulnerable populations, particularly very young pediatric patients, older adults, and individuals who are pregnant or breastfeeding. For pediatric patients, strict attention must be paid to age-appropriate labeling and dosing devices, with clear instruction to use provided syringes or dosing cups rather than household utensils. In older adults, heightened caution is needed due to polypharmacy and increased susceptibility to drug interactions and adverse effects. Patients with multiple chronic conditions or poorly controlled diseases, such as hypertension or diabetes, require additional evaluation before recommending OTC products.

She also stresses that technicians should be alert to patients with complex medication profiles, as well as those whose conditions may worsen with inappropriate OTC selection. Looking ahead, Acosta notes that the OTC landscape is rapidly evolving, with ongoing regulatory review by the FDA, increasing movement toward self-care, and growing consumer interest in herbal, botanical, and “natural” products. She highlights emerging trends such as biosensors, wearable health technologies, and non-traditional wellness products like collagen supplements or mushroom-based beverages, which patients may not recognize as relevant to medication counseling.

The interview emphasizes the expanding role of pharmacy technicians in ensuring clear communication, identifying at-risk populations, and capturing a complete picture of all patient health behaviors in an increasingly complex OTC and self-care environment.