**5. Conclusions**

The case of codeine illustrates the possible impact of regulatory up-scheduling of medicines in community pharmacy. If CMs were to be up-scheduled to a rigorous pharmacy-specific regulatory level, such as Pharmacy-only (Schedule 2), the accessibility of CMs would be restricted to the community pharmacy setting, providing more opportunities for pharmacists and pharmacy personnel to engage with a patient's request for CMs and counsel on CM use, thereby contributing substantially to the appropriate and safe use of CMs. An added benefit would be enhancing patient or consumer awareness of any potential risks or interactions of CMs, rather than the current common belief that CMs are 'natural' products with no risks associated to their intake, regardless of patient history or conditions. However, careful collaboration and consideration about how such a regulatory change would impact other key-stakeholders, including other types of retailers providing these products and CM practitioners, requires a strategic and collaborative approach.

**Author Contributions:** B.C., C.O.L.U. and J.E.H. conceptualized the review and developed the search strategy. K.A.L. conducted the search and initial screening of papers. K.A.L., B.C. and J.E.H. reviewed the papers. K.A.L. and B.C. conducted the coding. J.E.H., B.C. and K.A.L. conducted the thematic analysis. K.A.L. drafted the manuscript that was reviewed by B.C. and J.E.H. C.O.L.U. conducted a critical review. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Conflicts of Interest:** The authors declare no conflict of interest relevant to this study.

**Appendix A**

**Figure A1.** Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model.


**Figure A2.** Sample of search strategy (Medline).
