Physical Therapists' Knowledge, Advice, and Administration of Nonprescription Medications to Their Clients

By Lansbury, Gwenda; Sullivan, Gerard | Journal of Allied Health, Spring 2002 | Go to article overview

Physical Therapists' Knowledge, Advice, and Administration of Nonprescription Medications to Their Clients


Lansbury, Gwenda, Sullivan, Gerard, Journal of Allied Health


Physical therapists often have limited knowledge and little formal training in pharmacology, yet they frequently advise their clients on the use of over-the-counter (OTC) medications and administer these in the course of treatment. This practice may have a bearing on professional liability if side effects and contraindications are not adequately considered. In addition, some nonprescription medications may have an effect on physical therapy care. The purpose of this study was to assess physical therapists' knowledge about OTC medications, and the extent to which they advise clients about OTC medications and administer them. To examine these issues, a self-administered, anonymous questionnaire was mailed to a random sample of 25% of clinical physical therapists registered in New South Wales, Australia (n = 660). It was found that a substantial proportion of practicing physical therapists advised and administered OTC medications despite their limited training and knowledge in the area. J Allied Health. 2002; 31:43-50.

CONCERN HAS BEEN RAISED about physical therapists advising and administering medications to their clients.1-5 Minimal information on pharmacology is included in physical therapy training programs, with the consequence that physical therapists often have limited knowledge about the appropriateness, side effects, and contraindications of specific medications.6

On the basis of research by Lansbury and Sullivan,7 which examined the administration of medications by physical therapists, the New South Wales Physiotherapists Registration Board (NSWPRB) developed a policy statement8 on medicines that can be legally supplied, administered, or used in the practice of physical therapy. (This research was undertaken in New South Wales, the largest of six states in the country and of which Sydney is the capital. The NSWPRB was established by the New South Wales [NSW] state government to regulate the profession and to advise on policy to protect the well-being and best interests of clients.) In essence, these medications are limited to products that are freely available via retail outlets (overthe-counter [OTC] drugs), such as analgesic rubs, aspirin, paracetamol, most vitamins, and most herbal preparations. Physical therapists were warned that they are responsible for ensuring familiarity with the product being supplied, including dosage and any possible side effects. They also were instructed to ensure that any products they supplied or recommended were not likely to interact with other medication their patients were taking.

Particularly in cases in which physical therapists have little knowledge about medications, supplying or recommending medications may be dangerous.6 Drug therapies are important, however, in the practice of physical therapy because certain types of medications may facilitate treatment, by relieving pain, reducing inflammation, and increasing relaxation of muscles. There is also the danger of side effects of medications, whether they are prescribed or OTC, such as dizziness, confusion, or other feelings of ill health. These side effects may hinder physical therapy treatment. It is important for physical therapists to be aware of benefits and disadvantages of medications, many of which are available OTC, including their side effects and contraindications.

Lansbury and Sullivan5 and Sullivan and Lansbury6 surveyed physical therapists and reported on their knowledge of prescription medications and the administration of these to their clients during physical therapy treatment. This study examined the same issues in relation to nonprescription medications and investigated advice physical therapists give to clients about nonprescription medications. To date, this issue has not been examined in the professional literature, but it is important because many OTC medications have similar properties to prescription medications. The possibility that OTC medications may interact with prescription medications needs to be considered by those recommending them, particularly in a professional capacity. …

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