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Background Over-the-counter drugs are widely available and have a strong presence in advertising. So far, there has been a lack of reliable studies that examine which attitudes, attributions and usage patterns exist among patients using OTC drugs. Methods In the course of an exploratory waiting room survey, 300 patients were interviewed in 20 family practices in Rhineland-Palatinate and Saarland. In addition to descriptive analysis, a T-test for independent samples was used to identify significant differences between two groups. Results 63 % of those surveyed state that they consume over-the-counter medication frequently or occasionally. 45 % usually do not seek advice or inform themselves about effects, risks and side effects before buying or taking OTC preparations; 55 % state that advice is usually provided by their family doctor and/or pharmacist. For 57 % of those surveyed, the package insert is a frequent means of providing information about the over-the-counter medication they use. OTC preparations are linked to an application profile that focuses on the (preventive) treatment of cold symptoms, flu-like symptoms or pain relief. The common perception of non-prescription drugs as uncomplicated to use (60 %), low-dose (67 %) and weakly effective (70 %) products, which can sometimes also be taken for strengthening or prevention, does not always correspond with the actual opportunities and risks of an OTC self-medication. Conclusions Given the easy availability of over-the-counter drugs and their strong presence in advertising, it is important that patients have a realistic idea of the possibilities and risks of OTC products. In addition to advice from pharmacists, trustworthy, long-term support from family physicians as well as their continuous information and advice activities do play a central role. [ABSTRACT FROM AUTHOR]