|Year : 2018 | Volume
| Issue : 1 | Page : 3-8
Assessment of nature, reasons, and consequences of self-medication practice among general population of Ras Al-Khaimah, UAE
Sathvik B Sridhar1, Atiqulla Shariff1, Lana Dallah2, Doaa Anas2, Maryam Ayman2, Padma G M Rao1
1 Department of Clinical Pharmacy and Pharmacology, RAK Medical and Health Sciences University, Ras Al-Khaimah, UAE
2 RAK College of Pharmaceutical Sciences, RAK Medical and Health Sciences University, Ras Al-Khaimah, UAE
|Date of Submission||15-Feb-2017|
|Date of Acceptance||02-Nov-2017|
|Date of Web Publication||13-Feb-2018|
Dr. Sathvik B Sridhar
Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmaceutical Sciences, RAK Medical and Health Sciences University, Ras Al-Khaimah
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Aim: The aim of this study is to assess the nature, reasons, and consequences of self-medication practice among the general population of Ras Al-Khaimah, UAE. Materials and Methods: This was a prospective, cross-sectional, survey-based study. Data with respect to knowledge, awareness, and practices regarding self-medication were collected through an interviewer-assisted questionnaire answered by the study participants. Thus, collected data from 413 survey respondents were analyzed using SPSS version 24.0. Results: The prevalence of self-medication practices among our study respondents was 52.1%. A headache (155 [37.5%]) was the most common clinical condition treated through self-medication practice. Familiarity with the treatment/medication (198 [48%]) was the most common cited reasons, whereas the advertisement and friend's advice were the most (182 [44%]) cited sources of information for self-medication usage. The majority (265 [64.1%]) of the respondents were considered self-medication practice as safe. However, 19 respondents reported side-effects or complications during the due course of self-medication. It was observed that there is a statistically significant association (P < 0.05) between age and employment status of this study participants with self-medication practices. Conclusion: The data from this study show that the self-medication practice is very common among the study population. Variables such as younger age group and occupation status were significantly associated with self-medication practice. We emphasize the role of pharmacist in educating the community regarding safe medication practices such as harmful effects of self-medicating and inappropriate practices such as sharing the medications among family members and friends.
Keywords: Perception and experiences regarding self-medication, reasons and consequences of self-medication, safety of self-medication, self-medication, self-medication practice, nature
|How to cite this article:|
Sridhar SB, Shariff A, Dallah L, Anas D, Ayman M, M Rao PG. Assessment of nature, reasons, and consequences of self-medication practice among general population of Ras Al-Khaimah, UAE. Int J App Basic Med Res 2018;8:3-8
|How to cite this URL:|
Sridhar SB, Shariff A, Dallah L, Anas D, Ayman M, M Rao PG. Assessment of nature, reasons, and consequences of self-medication practice among general population of Ras Al-Khaimah, UAE. Int J App Basic Med Res [serial online] 2018 [cited 2020 May 29];8:3-8. Available from: http://www.ijabmr.org/text.asp?2018/8/1/3/225445
| Introduction|| |
Self-medication is the most common form of self-care which is becoming increasingly significant in many countries. Self-medication is the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms., Responsible self-medication requires that an individual treat their ailments and conditions with medicines that are approved and available without prescription, and which are safe and effective when used as directed.,,
There are various factors that contribute for self-medication such as urge of self-care, feeling of sympathy toward family members in sickness, poverty, ignorance, misbeliefs, extensive advertisement, availability of drugs other than in pharmacy, and lack of easy access to professional health-care services. The prevalence of self-medication varies between the different age groups and depends on various factors such as type, severity, and frequency of illness.,, The studies have found that fever, headache, common cold, and gastrointestinal symptoms such as acidity, diarrhea, and constipation as the most common ailments for which self-medication is being practiced. Although the frequency is less, it was interesting to note that in few studies antimicrobials have been used for self-care through self-medication.
In many cases, patients suffer from similar symptoms of illness, but the underlying pathology of the disease may not be the same. However, patients do not understand it and rely on self-medication that may lead to serious drug-related problems in the form of either therapeutic failure or toxicity.
Although it is inevitable, care must be taken while practicing self-medication. In addition, to promoting the self-medication, due to specific reasons such as affordability and inaccessibility of health-care services, the World Health Organization has also outlined the role of pharmacist in self-medication. As a health-care professional pharmacists can help general public on safe use of self-medication by understanding the patient illness and providing medication information.
There are few of studies conducted in UAE to assess the self-medication use; however, the study population in those studies was limited to student community.,, Through this study, we tried to explore the data from the general population with the aims of estimating the prevalence of self-medication, the common diseases/conditions, for which self-medications were practiced and the common drugs used as self-medications. In addition, this study aims to identify the association of some of the factors such as age, gender, ethnicity, education, and occupation with self-medication practices among our study respondents.
| Materials and Methods|| |
Study design and study site
This was a cross-sectional, survey-based study conducted over 3 months, which included general public of Ras Al-Khaimah, UAE. Approval for the conduct of the study was obtained from the institutional and local research and ethics committee of Ras Al-Khaimah, UAE.
The target sample size was 400 respondents, based on the moderate cumulative R2 = 0.15, alpha set at 0.05 (two tailed). The power of this study was 0.80.
General public of age >18 years with either gender or who were willing to answer the survey questionnaire on voluntary basis were included in the study. Respondents with hearing impairment; who could not speak and/or understand English and/or Arabic language as well as who are mentally challenged were excluded.
A self-administered or interviewer administered survey questionnaire consisting of 14 questions was prepared to assess the self-medication practices among the study population. The questionnaire was validated for its content through expert review and was translated to the Arabic language. All the necessary and relevant data such as sociodemographic (age, sex, nationality, education, and occupation) information, questions-related self-medication practices were included in the questionnaire.
Target population were explained about the purpose of the study by the study investigators and the individuals satisfying inclusion and exclusion criteria were enrolled in the study after understanding their full willingness to participate in the survey on voluntary basis and obtaining the written informed consent for the same.
Thus, collected data were summated and was entered into the Microsoft Excel sheet. The results were analyzed using the statistical package for the social sciences (SPSS) version 24.0 (IBM, Armonk, NY, United States of America). The categorical data was expressed as percentage, whereas the continuous data were expressed as mean ± standard deviation. Chi-square test was used to test the association of different variables with sociodemographic data of the participants.
Relative risk (RR) was calculated to assess the association of variables with reported self-medication practice. RR more than one indicates higher prevalence of self-medication practices in the nonreference group, whereas RR less than one indicates lower prevalence of self-medication practices in the nonreference group.,, A probability value of <0.05 was considered as statistically significant.
| Results|| |
Demographic characteristics of study population
A total of 413 respondents participated in the survey and majority (314/413 [76%]) of the respondents were females. Mainstream (182/413 [44.1%]) of the respondents were within the age group of 19–29 years. A good number (339/413 [82.1%]) of the study respondents were Arabs [Table 1].
Medical and medication history of study respondents
Only 132/413 (32%) survey respondents had chronic illness or any health-related issues, and 129 among them were taking prescribed medication/s for their current health condition/illness [Table 2].
|Table 2: Details regarding the medical and medication history of the patient|
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Self-medication practices of study respondents
More than half (215/413) of the study population mentioned that apart from medication/s prescribed by their doctor; they sometimes take medications on their own to treat themselves. Thus, the prevalence of self-medication practices in our study was 52.1%. Headache (155 [72%]) followed by fever [119 (55.3%)] were the common clinical conditions for which respondents reported self-medication practice [Figure 1].
Familiarity with the treatment/medication (198 [92%]) followed by emergency need (93 [43.25%]) were the most common cited reasons for self-medication practice. Advertisement and friend's advice were the most (182 [84.7%]) cited sources of information for self-medication usage [Table 3].
|Table 3: Reasons and source of information for self-medication use (n=215)|
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A very good percentage (206/215 [95.8%]) of the survey respondents mentioned that their health condition improved after self-medication. While eight (3.7%) respondents mentioned no improvement and one respondent reported worsening of their disease condition after self-medicating. Among the nine respondents who mentioned worsening and no improvement of the disease condition, majority (4/9 [44.4%]) consulted the pharmacist, two each consulted physician and nurse (2/9 [22.2%]) and one respondent (11.1%) waited to resolve the condition on its own.
Perception and experiences regarding safety of self-medication practice
It is interesting to note that good proportion (265/413 [64.1%]) of the respondents considered self-medication practice as safe. Only a small number (19/215 [8.8%]) of the respondents mentioned that they experienced side-effects or complications after self-medicating. Allergic skin rashes were the most (4/19 [21%]) common side effect reported by the study respondents [Table 4].
|Table 4: Perception and experiences regarding safety of self-medication use|
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Association between sociodemographic variables and self-medication usage
Gender (χ2 = 5.91; P = 0.015) and employment status (χ2 = 9.62; P = 0.022) were significantly associated with self-medication usage. Female respondents were 1.3 times (confidence interval [CI] 95% 1.037–1.725 [P = 0.024]) more likely to self-medicate compared to male respondents. Also respondents from working (RR = 0.772, CI 95% 0.603–0.988 [P = 0.040]) and nonworking group (RR = 0.600, CI 95% 0.362–0.995 [P = 0.048]) were less likely to self-medicate compared to student respondents [Table 5].
|Table 5: Association between sociodemographic variables and self-medication usage|
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| Discussion|| |
The prevalence of self-medication in our study was 52.1%, which is very close to the prevalence rate reported (53%) from a meta-analysis assessing the prevalence and cause of self-medication in Iran. A study conducted by Keshari et al. in rural part of India and another community-based survey conducted at Karachi, Pakistan, reported the prevalence rates of self-medication as 69.6% and 84.4%, respectively., Many other studies conducted across the globe provides a range of prevalence rate varying between 4% and 87%. This huge difference in the prevalence rate could be due to varying study designs, definition of self-medication used by investigators, inclusion and exclusion criteria adopted, and most importantly the recall period of self-medication by the respondents.
Headache was the most common clinical condition, for which our study respondents reported self-medication practice. Studies conducted by Corrêa Da Silva et al. in Brazil and Sawalha in Palestine also reports that majority of the respondents in their studies took self-medication to manage headache., In many published literatures, the various medical conditions or symptoms such as abdominal pain, fever, headache, common cold, cough, muscle pain, diarrhea, menstrual cramps, and nausea. were reported to be managed by self-medication practices, and these observations are very much similar in our study as well.,,,, There may be differences in the frequencies of the respondents in managing these medical conditions depending on the type of respondents (adults/females/elderly) included in different studies. But in all most all the studies, the medical conditions managed through self-medication practices were reported to be “minor” and “common.”,,,
Familiarity, emergency need, low cost, lack of health insurance, and lack of time to visit physician were the reasons for self-medication practices among our respondents. Few other studies also reported the same reasons for the self-medication practices among their study population.,, In one study, respondents felt that the medical conditions were too mild that it did not require doctors consultation, in addition, they also felt that even if they visit the doctor they will also prescribe the same medication hence they opted self-medication practices. The common sources of information for self-medication reported by our study respondents are advertisement, previous experiences with medication, advice from family members and friends. These findings are very much similar to the opinions of participants of other published studies.,,,
It is the uniqueness of our study that we assessed both positive and negative outcomes of self-medication practices among our study participants. The majority (206/215) of the respondents who self-medicated reported that their health condition was improved. Nineteen among 215 respondents who self-medicated reported that they experienced side effects after self-medicating. A study conducted in Egypt, by El Ezz and Ez-Elarabreported 16.9% of their study respondents experienced side-effects following self-medication practices. In a study conducted by Sharif et al., 62% of the study respondents avoided self-medication due to risks of side effects. In another community-based survey, 19.2% of the study participants experienced the side effects due to self-medication.
Although the number and percentage of participants who experienced side effects vary between the studies, it is evident that self-medication has always resulted in high incidence of side effects, compared to individuals who take medications under supervision of a health-care member. This increase in the incidence of self-medication use is probably due to most of the people believe that self-medication practice is safe (as opined by 265 respondents in our study), which may not be always true or they may not be aware of risks associated with self-medications as reported in a study conducted by Parmar et al.
In this study, the factors such as gender and occupation status were significantly associated with self-medication practices. In a study conducted in Portuguese, the observations were similar with respect to the association between self-medication practices and younger age group. However, the study also reports the strong association between male and self-medication practices which is contradicting to association found with homemakers (usually females) in our study. This could be due to availability of medications at home, and this finding is very much similar to the observations of a study conducted by Corrêa Da Silva et al. However, a review conducted by Jerez-Roig et al. describes that few studies reported positive and few other reported negative associations with self-medication practices and age, gender, and socioeconomic status of the study participants.
Females respondents of our study were more likely to self-medicate than male and student respondents were more likely to self-medicate themselves compared to working and nonworking group, respectively. This could be due to majority of the respondents in the student group believed that self-medication practices are safe compared to any other group of respondents. This observation was similar to the findings of Lukovic et al. female gender as one of the variables associated with self-medication practice. A study conducted by Sodhi et al. reports health science students as one of the variable associated with self-medication practice. This finding is similar to observations in our study, where majority of the student respondents of our study population were with health sciences background. This could be one of the important factors influencing self-medication practice.
The major limitations of our study were we did not analyze the actual use of self-medication by the respondents. Since it was a questionnaire-based study, the information with regard to self-medication usage by the respondents was to the best knowledge and believes of the respondents. Furthermore, the respondents representing this study were not truly the representative sample of the emirate of Ras Al-Khaimah as the survey was conducted only in the limited areas of the emirate.
| Conclusion|| |
Self-medication practice was prevalent in slightly more than half of the survey respondents. Headache followed by fever were the most common medical conditions, treated by self-medication practice. Family and friends were the most common source of advice for self-medicating. Variables such as younger age group and occupation status (homemaker) were significantly associated with self-medication practice.
Our sincere thanks to Dr. B. G. Nagavi, dean, RAKCOPS for all the support. Our heartfelt thanks to Dr. Gurumadhva Rao, vice chancellor of RAKMHSU for all the support and encouragement.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Abay SM, Amelo W. Assessment of self-medication practices among medical, pharmacy, and health science students in Gondar University, Ethiopia. J Young Pharm 2010;2:306-10.
Phalke VD, Phalke DB, Durgawale PM. Self-medication practices in rural Maharashtra. Indian J Community Med 2006;31:34-5. [Full text]
Corrêa da Silva MG, Soares MC, Muccillo-Baisch AL. Self-medication in university students from the city of Rio Grande, Brazil. BMC Public Health 2012;12:339.
Pagán JA, Ross S, Yau J, Polsky D. Self-medication and health insurance coverage in Mexico. Health Policy 2006;75:170-7.
Loyola Filho AI, Lima-Costa MF, Uchôa E. Bambuí project: A qualitative approach to self-medication. Cad Saude Publica 2004;20:1661-9.
Ruiz ME. Risks of self-medication practices. Curr Drug Saf 2010;5:315-23.
Galato D, Galafassi LM, Alano GM, Trauthman SC. Responsible self-medication: Review of the process of pharmaceutical attendance. Braz J Pharm Sci 2009;45:625-32.
Shehnaz SI, Khan N, Sreedharan J, Issa KJ, Arifulla M. Self-medication and related health complaints among expatriate high school students in the United Arab Emirates. Pharm Pract (Granada) 2013;11:211-8.
Sharif SI, Ibrahim OH, Mouslli L, Waisi R. Evaluation of self-medication among pharmacy students. Am J Pharmacol Toxicol 2012;7:135-40.
Abasaeed A, Vlcek J, Abuelkhair M, Kubena A. Self-medication with antibiotics by the community of Abu Dhabi Emirate, United Arab Emirates. J Infect Dev Ctries 2009;3:491-7.
Lynn MR. Determination and quantification of content validity. Nurs Res 1986;35:382-5.
Kirkwood BR, Stern JA. Comparing two proportions. In: Essential Medical Statistics. 2nd
ed. Kirkwood BR, Stern JA, editors. Massachusetts, USA: Blackwell Science; 2003. p. 151-5.
Dancey CP, Reidy JG, Rowe R. Epidemiology. In: Statistics for the Health Sciences A Non-Mathematical Introduction. India: SAGE Publications India Pvt. Ltd.; 2014. p. 170-1.
Daniel WW, Cross CL. Analysis of frequency data: An introduction to the chi square distribution. In: Biostatistics-Basic Concepts and Methodology for the Health Sciences. 10th
ed. Singapore: Wiley; 2014. p. 643-5.
Azami-Aghdash S, Mohseni M, Etemadi M, Royani S, Moosavi A, Nakhaee M, et al.
Prevalence and cause of self-medication in Iran: A Systematic review and meta-analysis article. Iran J Public Health 2015;44:1580-93.
Keshari SS, Kesarwani P, Mishra M. Prevalence and pattern of self-medication practices in rural area of Barabanki. Indian J Clin Pract 2014;25:636-9.
Afridi MI, Rasool G, Tabassum R, Shaheen M, Siddiqullah, Shujauddin M, et al.
Prevalence and pattern of self-medication in Karachi: A community survey. Pak J Med Sci 2015;31:1241-5.
Sawalha AF. Assessment of self-medication among University students in Palestine: Therapeutic and toxicity implications. Islamic Univ J 2007;15:67-82.
Jerez-Roig J, Medeiros LF, Silva VA, Bezerra CL, Cavalcante LA, Piuvezam G, et al.
Prevalence of self-medication and associated factors in an Elderly population: A systematic review. Drugs Aging 2014;31:883-96.
Donkor ES, Tetteh-Quarcoo PB, Nartey P, Agyeman IO. Self-medication practices with antibiotics among tertiary level students in Accra, Ghana: A cross-sectional study. Int J Environ Res Public Health 2012;9:3519-29.
Parmar Z, Malhotra SD, Patel VJ. Prevalence and pattern of self-medication in elderly individuals. Int J Basic Clin Pharmacol 2015;4:1095-9.
Ali SE, Ibrahim MI, Palaian S. Medication storage and self-medication behaviour amongst female students in Malaysia. Pharm Pract (Granada) 2010;8:226-32.
Shankar PR, Partha P, Shenoy N. Self-medication and non-doctor prescription practices in Pokhara valley, Western Nepal: A questionnaire-based study. BMC Fam Pract 2002;3:17.
Berzanskyte A, Valinteliene R, Haaijer-Ruskamp FM, Gurevicius R, Grigoryan L. Self-medication with antibiotics in Lithuania. Int J Occup Med Environ Health 2006;19:246-53.
Awad A, Eltayeb I, Matowe L, Thalib L. Self-medication with antibiotics and antimalarials in the community of Khartoum State, Sudan. J Pharm Pharm Sci 2005;8:326-31.
El Ezz NF, Ez-Elarab HS. Knowledge, attitude and practice of medical students towards self medication at Ain Shams University, Egypt. J Prev Med Hyg 2011;52:196-200.
Ramalhinho I, Cordeiro C, Cavaco A, Cabrita J. Assessing determinants of self-medication with antibiotics among Portuguese people in the Algarve region. Int J Clin Pharm 2014;36:1039-47.
Lukovic JA, Miletic V, Pekmezovic T, Trajkovic G, Ratkovic N, Aleksic D, et al.
Self-medication practices and risk factors for self-medication among medical students in Belgrade, Serbia. PLoS One 2014;9:e114644.
Sodhi A, Tadiparthi J, Patil BA. Is the practice of self-medication more prevalent among health science students? A comparative questionnaire study. Indian J Med Res Pharm Sci 2016;3:44-7.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]