Menoufia Medical Journal

ORIGINAL ARTICLE
Year
: 2016  |  Volume : 29  |  Issue : 4  |  Page : 1066--1070

Self-medication among the attendants to a family health center in Al Sadat city, Menoufia Governorate


Taghreed M Farahat1, Hala M Shaheen1, Hala M Mohammed2, Sabah A Mohammed3,  
1 Department of Family Medicine, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
2 Department of Community Medicine, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
3 Family Medicine, Al Sadat City Family Health Center, Alsadat Menoufia, Egypt

Correspondence Address:
Sabah A Mohammed
Family Medicine, Al Sadat City Family Health Center, Alsadat Menoufia, Sadat, 32897
Egypt

Abstract

Objectives The aim of the present study was to determine the prevalence of self-medication among attendants to a family health center and identify the determinants of participants practising self-medication. Background Self-medication is the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms. It includes the use of nonprescription drugs and a range of different alternative medicines such as herbal remedies and traditional products. In most illness episodes, self-medication is the first option, making it a common practice worldwide. Materials and methods In this cross-sectional study, a validated self-administered questionnaire was used to collect data among attendants in the studied area. The study was conducted in a family health center in Al Sadat city, Menoufia governorate, Egypt, from April 2014 to March 2015. The sample size of the study was 368 participants. Results Of the 368 participants, 47.8% were males and the remaining 52.2% were females –71.5% were in the age group of 12–65 years. Overall, 32.6% participants were students, whereas 35.3% were unemployed; 66.8% of the participants consumed over the counter (OTC) medications. The most common source of information about self-medication was pharmacist (37%). Minor illness (39.8%) and previous good experience (17.9%) were the most frequent reasons for self-medication. Conclusion Easy availability of OTC drugs is a major factor responsible for the consequences such as antimicrobial resistance and increased load of morbidity. There is a need for concerned authorities to make existing laws regarding the purchase of OTC drugs more stringent for their rational use.



How to cite this article:
Farahat TM, Shaheen HM, Mohammed HM, Mohammed SA. Self-medication among the attendants to a family health center in Al Sadat city, Menoufia Governorate.Menoufia Med J 2016;29:1066-1070


How to cite this URL:
Farahat TM, Shaheen HM, Mohammed HM, Mohammed SA. Self-medication among the attendants to a family health center in Al Sadat city, Menoufia Governorate. Menoufia Med J [serial online] 2016 [cited 2020 Apr 5 ];29:1066-1070
Available from: http://www.mmj.eg.net/text.asp?2016/29/4/1066/202509


Full Text

 Introduction



Self-care is what people do for their own selves to establish and maintain health and prevent and deal with illnesses. It is a broad concept encompassing hygiene, nutrition, environmental and socioeconomic factors, and self-medication [1],[2]. Self-medication is obtaining and consuming medication without professional supervision regarding indication, dosage, and duration of treatment. However, self-medication does not only mean the consumption of modern medicines but also of herbs [3],[4]. Medicines for self-medication are often called 'nonprescription' or 'over the counter' (OTC) drugs and are available at pharmacies without a doctor's prescription. In some countries OTC products are also available in supermarkets and other outlets. Self-medication is widely practised in both developed and developing countries [3]. Studies have revealed an increase in trends of self-medications, particularly among the youth. This can be attributed to socioeconomic factors, lifestyle, the increased potential to manage certain illnesses, availability of medicinal products, and exposure to advertisements [2]. Moreover, knowledge of drugs and their use are the main causes of self-medication, especially among pharmacists and physicians. In most illness episodes, self-medication is the first option, making it a common practice worldwide [1]. Self-medication if practised appropriately could lighten the demand on doctors and make people more health conscious. However, if abused, it could delay accurate diagnosis and appropriate treatment, and could cause toxicity, side-effects, drug interaction, and unnecessary expenditure [5]. Pharmacists have a key role to play in providing the patients with assistance, advice, and information about medicines available for self-medication. Moreover, the Internet is emerging as a major source of information on health issues and (with appropriate control) offers great promise in helping people with self-care. The type and extent of self-medication and the reasons for its practices may vary from country to country [6].

 Materials and Methods



This cross-sectional study was conducted in a family health center in Al Sadat city, Menoufia governorate, Egypt, from April 2014 to March 2015.

The sample size for the study was 368 participants, which was calculated on the basis of the total number of attenders in previous 6 months, which was 3471, and the prevalence of self-medication in previous studies, which was 25–75%, at a power 95% using the EP Info (Atlanta, Georia, USA) program.

The studied participants were divided in to two groups. Group 1 included participants who practised self-medication without prescription. Group 2 included those not practising self-medication. All participants were chosen by using the systematic random sample technique from the attendants to the family health center. All participants included in the study accepted to complete the questionnaire after giving an oral consent.

Pretested questionnaire was prepared in English and consisted of three parts to collect all relevant data. The first part included sociodemographic characteristics of the participants. The second part was designed to determine the type of attendant clinical visit. The third part dealt with the pattern of self-medication (i.e., use self-medication or not, for whom, reasons for using, type of drug, reasons for using, sources of information about drug, sources of drug supply, etc.).

The collected data were tabulated and analyzed by using the Statistical Package for Social Science (SPSS) version 22 (using IBM personal computer, SPSS Inc., Chicago, Illinios, USA). Qualitative data were expressed as number and percentage and analyzed by using the c2-test.

A P value greater than 0.05 was considered statistically nonsignificant. A P value less than 0.05 was considered statistically significant and a P value less than 0.01 was considered statistically highly significant.

 Results



In this cross-sectional study, a total of 368 questionnaires were distributed to be filled by the participants. The results are as follows.

Sociodemographic characteristics of the studied group

There was a statistically significant difference between group 1 (use self-medication) and group 2 (do not use self-medication). Self-medication was higher in the age group of 12–65 years. About 72% of the attendants were taking self-medication. In addition, there was a highly statistically significant difference between the two groups; self-medication was higher among married attendants (48.4%), unemployed attendants (42.7%) and among those with secondary educational level (23.2%) ([Table 1]).{Table 1}

In this study the most common type of clinical visits of the attendants was regular visit (38.6%) ([Table 2]).{Table 2}

Self-medication practice assessment data

Self-medication was commonly used for a person's self (72.4%). The most common reason for self-medication was minor illness (39.8%), followed by previous good experience with the drug (17.9) and high cost of consultation (16.7%) ([Table 3]).{Table 3}

The most common source of information about self-medication was pharmacist (37%), followed by previous consultation (23.2%) and friends and relatives (19.9%). The drug was requested from the pharmacist by mentioning the name of the drug (54.1%), followed by mentioning symptoms (31.3%) ([Table 4]).{Table 4}

In this study, it was found that 66.8% participants practised self-medication [Figure 1].{Figure 1}

According to the complaint, headache and body ache represented 17.1%, cough and cold represented 13.4%, fever 9.3%, diarrhea 7.7%, other reasons, such as decrease in body weight, weight gain, burning micturation, per anal itching, decrease appetite and so on, represented 35.9% [Figure 2].{Figure 2}

In this study the outcome of self-medication was 'cured' for 46.7% participants and 'improved' for 43.1% [Figure 3].{Figure 3}

 Discussion



Self-medication was significantly affected by age and highly significantly affected by marital status, educational level, and occupation. The highest prevalence was reported for the age group of 12–65 years. As regards sex of the attendees, 54.5% were females and 47.5% were males. This in agreement with a study conducted in the Pokhara valley, Western Nepal, by Shankar et al. [7], in which it was shown that more females indulged in self-medication than did males. This can be explained by the fact that many families prefer male children than females, so they seek medical advice for boys early. Further analysis of the participants as regards their educational level showed that 18.3% of the actual drug users were illiterate. This in agreement with another study conducted in India (Bhavani Nagar) in 2010, in which most of the participants had no formal education (22.3%) [8]. Education of the participants was found to be a major factor influencing the practice of self-medication in various studies including the present one [9],[10]. However, these findings are in contrast to those of a study conducted in Spain in 2008 that found that the likelihood of self-medication increases with increasing educational level. This was in agreement with the published studies by Carrasco-Garrido et al. [11] and Figueiras et al. [12] who showed that individuals with higher education have more knowledge about medications as compared with the less educated, and may be more competent in self-medication.

In the present study it was shown that 42.7% of the actual drug users were unemployed, 26.8% were students, and that 19.1% of the actual drug users were government employees and 8.5% were nongovernmental employees. Moreover, 2.8% were retired, 31.7% were single, 48.4% were married, 18.3% were widows, and 1.6% were divorced. The risk factors for self-medication in the present study were age, educational level, occupation, and marital state. The socioeconomic and educational variables have been reported to be the main contributors to self-medication practice in many countries around the world, with higher educational levels being associated with the tendency to self-medicate [13],[14].

The study shows that, according to reasons of clinical visit of the family health center, 38.6% of the attendants to the family health center came for a regular visit, 16.8% for chronic disease (diabetes mellitus/hypertension), 14.1% for family planning, 17.4% for antenatal care, and 13% for child health (vaccination and follow-up, growth and development).

Self-medication practice assessment data

Mildness of the illness (39.8%) followed by prior experience (17.9%) were the two major reasons given by the respondents for self-medication. The same reasons were also reported in a similar study in Gondar, Ethiopia, in 2010 by Abay and Amelo [15]. Similarly, mildness of disease (58%) and previous experience (29%) were the two major reasons reported in the study conducted in Palestine in 2007 [16]. Another cause for self-medication was high cost of consultation (16.7%); this is in agreement with various other studies in which 35-86% of the participants reported saving money as the main cause of self-medication. As WHO noted, self-medication provides a cheap alternative to people who cannot afford to pay medical practitioners. Thus, self-medication is often the first response to illness among people of the lowincome class [17],[18]. As regards for whom self-medication was used, 72.4% used it for themselves, followed by for their children (27.6%).

The present study showed that the most common source of information about self-medication was pharmacist (37%), followed by previous consultation (23.2%), friends and relatives (19.9%), Internet or advertisements (11%), health staff, (5.7%) and mass media (3.3%). Furthermore, the findings of our study showed that drugs were commonly requested by mentioning the name of the drug (54.1%), followed by mentioning symptoms (31.3%), showing old packages of the drug (11.4%), and showing old prescription (3.3%). This in agreement with another study conducted in New Delhi, India, in 2007. In that study, pharmacists were reported to be the most important source (42.1%) of information about drugs for those who practice self-medication [19]. In contrast, in another study conducted among the urban population of Jammu, India, in 2005, doctors were found to be the most common source of drug information followed by chemists and advertisements. These findings are in agreement with earlier reports that advertisements about drugs were an important source of drug information [20],[21]. This is in agreement with a study conducted in Amman in 2008 in which most of the respondents (74%) who practised self-medication purchased their medicines by telling brand names, which could be attributed to easy-to-remember and famous brand names of certain pharmaceutical companies [22].

 Conclusion and Recommendations



This study revealed a considerable rate of self-medication among the studied participants, which should drive the attention of the authorities to this problem. Self-medication practices were common among the studied population. Factors like age, sex, educational level, occupation, and medication knowledge significantly affected it. There is a need to ensure community education and safety and efficacy of OTC drugs. Furthermore, there is a need for concerned authorities to make existing laws regarding OTC drugs more stringent for their rational use. Periodic studies on the knowledge, attitude, and practice of self-medication may give an insight into the pattern of drug use.

Acknowledgements

The author thanked the attendants who accepted to participate and helped in collecting data and also thanked all administrative persons who facilitated conduction of the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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