Self-prescribed drugs usage and its effects on general

population

Submitted to:
Dr Sardar Shabbir
Supervisor:
Ms. Sana A. Qayyum
Submitted by:
Batch D (46-60)
Department of Community Medicine, Poonch
Medical College, Rawalakot.
 APPROVAL SHEET

Self-prescribed drugs usage and its effects on

general population
Approved by:
Dr Sardar Shabbir
(Head of Department of Community Medicine)
Ms. Sana A Qayyum
(Clinical Psychologist/Research Supervisor
Community Medicine)

Research Group: Batch D (46-60)

 ACKNOWLEDGEMENTS

The authors would like to express our gratitude to the Community Medicine Department of
Poonch Medical College Rawalakot for ethical approval. We also would like to thank the
supervisors and all respondents for their willingness to participate in the study.
 Table of Contents
Sr no. Content

1- Abstract
2- Introduction
3- Literature review
4- Methodology
5- Data Analysis
6- Results
7- Limitations
8- Suggestions
9- Conclusion
10- Reference
Abstract:

This research is aimed to find relationship between use of self-prescribed drugs Among general
population with lack of basic healthcare facilities. Also, what other factors have a influence on
this behaviour of self-prescription. To find that we asked 50 random people between age 15 to
55 to answer certain questions that were given to them in the form of printed Questionnaire. The
methodology used was Maslach burnout scale. Questionnaire used was paper questionnaire.
The present narrative review showed that the prevalence of self-medication is very high.
According to this research 73.3% of general population uses self-prescribed drugs. Females use
more self-prescribed medication than males. 60% of the persons involved in this research range
in age from 15 to 35 years. A very small percentage of population know about the harmful
effects of self-prescribed drugs. Nuberol is more frequently used as self-medication. According
to this research its use is 66.7% as compared to paracetamol which is 33.3%. By spreading
awareness among people and by changing behaviour of doctors and hospital staff 71% of people
think that it can change the people to stop use self-prescribed drugs. About 44% of people
involved in this research have two different brands of same medication without knowing about it.
71% of people involved in this research think the use of self-medication is acceptable.
The data analysis and results don’t support the proposed hypothesis but limitations such as urban
setting and small group of people involved doesn’t completely invalidate the hypothesis so
further research on large scale is required.

INTRODUCTION:

Self-medication is described as an act of procurement and conception of medical drug without

the advice of medical physician for diagnosis prescription and surveillance of treatment.
It is common for people to feel unwell and human beings have an inherent tendency to use herbs,
potions, medication, etc. For treating themselves. Every day people throughout the world act on
their own for their health, they practice self-care. In some instances, they do so through self-
medication which is now increasingly being considered as a component of self- care. Some
governments are increasingly encouraging self-care of minor illnesses. Encouragement of self-
care is seeing giving a patient every opportunity to take responsibility and build confidence in
their ability to manage their own health. Self-medication is defined as use of medication whether
modern or traditional for self-treatment. Studies done on self- medication revels that it is of fairly
common practice, especially in economically deprived communities. It is a growing trend of self-
care which has its positive and negative aspects.
In Pakistan it has not yet document how frequently the uses is what are the associated factors and
what the problem is regarding knowledge, attitude and practice. The most common medication
are analgesics and antimicrobial.

Literature Review:

To determine the frequency and causes of self-medication among medical students of Federal
Medical College, Islamabad.
This was a descriptive cross-sectional study conducted on 292 medical students at Federal
Medical College, Islamabad from August to October 2020. Pretested validated tool was used to
collect data via random sampling. SPSS version 25 was used for data analysis. Chi-square test
was used to determine the association between different study years and self-medication.

Out of 292 students, 36% were males and 64% females. The frequency of self-medication was
80.9% and 92.1% used allopathic medicine while 5.1% used herbal medicines. 86% of students
of age between 22-25 years self- medicated in the last 6 months while only 77% of students of
age between 18-21 years did the same. Fever (70%), headache (69%) and body ache (48%) were
the most common indications for this practice. Paracetamol (89%), antibiotics (49%),
NSAID's(49%) and antihistamine (45.5%) were the most commonly used drugs. Major factors
favouring self-medication were quick relief (52%), time saving (46%), convenience (41%),
physician will prescribe the same (38.5%) and emergency use (34%).
Conclusion: Self-medication is highly prevalent among medical students. This practice may
contribute to adverse health outcomes among them. [01]

To assess self-medication practices with antibiotics among health care professionals in selected
hospitals of Addis Ababa, Ethiopia.
Facility based cross-sectional study was conducted from April to May, 2017 among 317 health
care professionals. Convenient sampling technique was used to select study participants. Data
were collected through self-administered questionnaire and analyzed using Statistical Package
for Social Sciences software version 20. Binary logistic regression analysis was done to check
the relationship between the dependent variable (antibiotic self-medication) and selected
independent variables (sex, age, marital status, income, professional qualification and work
experience).

The prevalence of self-medication with antibiotics among health care professionals in one month
recall period was found to be 72 (22.7%). The main reasons given for this practice were being
familiar with the treatment options, 31 (43.1%) and need for rapid relief, 25 (34.7%). Respiratory
problems, 29 (40.3%) and gastro intestinal problems, 28 (38.9%) were the most common
illnesses for which self-medication with antibiotics was practiced while penicillin, 30 (41.6%)
and fluoroquinolones, 29 (40.3%) constituted the two most used antibiotics for the same. None
of the variables had significant association with the practice of self-medication with
antibiotics.[02]

The global increase in the utilization of non - prescribed antibiotics (NPA), is concerning, with
high persistence within the low and middle-income countries (LMICs). With a negative impact
on the health of individuals and communities the use of NPA paves the way to the propagation of
superbugs that potentially predisposes to changes in bacterial resistance patterns, antibiotic
resistance (AR) and antimicrobial resistance. The study is a systematic review and meta-analysis
which study protocol was registered in PROSPERO. The review used The Preferred Reporting
Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review included a
total of 11 cross-sectional studies, involving 5080 participants and conducted in LMICs from
Asia (India, Laos, Nepal, Pakistan, Sri Lanka and Yemen), Latin America (Guatemala), Africa
(Nigeria). All studies reported existing practices of SMA, with reported prevalence ranging from
50% to 93,8%. The pooled prevalence of SMA was 78% (95% CI: 65–89%). The main sources
of NPA were; pharmacies, family and friends, old prescriptions, home cabinet and leftover
antibiotics. This study revealed a high prevalence of utilisation of NPA in the studied LMICs,
these were found to be twice as high in women than men and those participants aged between 18
and 40 years old. [03]

Self-medication with antibiotics is a most rapidly emerging problem in Pakistan. To assess the
wrong practice of self-medication, or research was performed in public sector university of
southern Punjabi Inn 2021. I really dated questionnaire was used to collect data. The study was
included data from 900 students’ frequency of serve medication was found to be 57%. The
antibiotics more frequently used were Augmentin 33%, amoxycillin 23%. Based on this study, it
can be concluded that high proportion of students use antibiotics without prescription.[04]

Self-medication refers to self-prescription which includes diagnosing and treating one’s own
illness and prescribing for one’s self. Though appropriate self-medication relieves acute
symptoms, is time saving and economical, it should not be advocated because of more risks than
benefits. Self-medication practices were found to vary in medical students of Nepal and India.
This study was aimed to determine the prevalence of self-medication among medical students.
This descriptive cross-sectional study was conducted among 76 MBBS students. The study
involved the administration of the research questionnaire including demographic information,
practice of self-medication, type of illness, factors influencing self-medication, commonly self-
prescribed drugs, sources and strategies to reduce such practices. The data were analyzed using
Graph pad prism version 6.

The prevalence of self-medication was 58 (76.6%), more common among first year students. The
common illness found was headache and common drug self-prescribed was analgesic-
antipyretic. The most common source of obtaining medicines for all three-year medical students
was pharmacy. Students were also prescribing medicines to family members, friends and juniors.
More than half of the students 52 (68.4%) reported that self- medication practices should be
encouraged.[05]

Self-medication, despite some benefits, carries many risks, especially when practiced by older
adults who are polymedicated. Information addressing the prevalence and associated factors of
self-medication in older age in a European context is scarce and sometimes contradictory. This
paper aims to estimate the prevalence of self-medication among older adults across Europe and
to identify its predictive factors.

Micro-data from the European Health Interview Survey (2006–2009) was used. The sample
comprised 31,672 community-dwelling individuals aged 65 and over living in private households
in 14 European countries. The analyses explored the use, over the last two weeks, of any
medicines, supplements, or vitamins that were not prescribed by a doctor. The mean self-
medication prevalence was 26.3 %, being the highest in Poland (49.4 %) and the lowest in Spain
(7.8 %). Greater odds of self-medication were found for women and for participants who were
younger, divorced, or presented a higher educational degree. The presence of long-standing
illness and physical pain or not using prescribed medication also significantly increased the
possibility of self-medication. A wide variation in the odds of self-medication between countries
was also observed (up to 8 times more for Poland, compared to Spain).[06]

To evaluate the perceptions and extent of practicing self-medication among undergraduate

pharmacy students. This cross-sectional, questionnaire-based study was conducted over a six-
month period (January to June 2016) among undergraduate pharmacy students in five reputable
public universities of Bangladesh. It involved face- to-face interviews regarding self-medication
of 250 respondents selected by simple random sampling. Self-medication was reported by 88.0%
of students. Antipyretics (58.40%) were mostly preferred for the treatment of fever and
headaches. The major cause for self-medication was minor illness (59.60%, p = 0.73) while
previous prescriptions were the main source of knowledge as well as the major factor (52.80%, p
= 0.94) dominating the self-medication practice. The results also demonstrated 88.80% of
students had previous knowledge on self-medication and 83.60% of students always checked the
information on the label; mainly the expiry date before use (85.60%). A significant (p < 0.05)
portion of the students (51% male and 43% female) perceived it was an acceptable practice as
they considered self- medication to be a segment of self-care.[07]

Methodology:

Maslach burnout scale

1. Setting: Rawalakot Azad Kashmir

2. Duration of Study: May 2022 to Sept 2022
3. Study design: Random
4. Data collection procedure: We collected data individually. We had copies of
questionnaire which were filled by individuals from general population
5. Data analysis: Data was entered and analyzed in IBM SPSS version 2.0
Operational definition:

Self-medication is described as an act of procurement and conception of medical drug Without

the advice of medical physician for diagnosis prescription and surveillance of treatment.

Hypothesis:
Lack of health care facilities renders people to go for self-prescribed drugs.

Independent variable:
Self-prescribed drug usage

Dependent variable:
Effects on general population

DATA ANALYSIS:

AGE
Options Percent
Frequency
15-25 13 28.9
25-35 14 31.1
35-45 9 20.0
45-55 9 20.0
Total 45 100.0
GENDER
Options Frequency Percent
MALE 16 35.6
FEMAL E 29 64.4
Total 45___________ 100.0
Use of self-prescribed drug
Options Frequency Percent
yes 33 73.3
no 12 26.7
Total 45 __________ 100.0
Why you use self-prescribed drugs?
Options Frequency Percent
availability 29 64.4
lack of trust in doctors 12 26.7
opinion of family members 4 8.9
Total 45 _____________
Advantages of self-prescribed drugs
Options Frequency. Percent
Timely treatment 17 37.8
no need to go to doctor 7 15.6
drugs are easily available without
11 24.4
prescription
no need to go to hospital 10 22.2
Total 45 100.0
What do you know about harmful effects of drugs?
Options Frequency Percent
not at all 22 48.9
a little bit knowledge 9 20.0
complete knowledge 5 11.1
others 9 20.0
Total 45 ______ 100.0
Do other people in family also use self-prescribed drugs?
Options Frequency Percent
yes 19 42.2
no 26 57.8
Total 45 100.0
What is the most use self-prescribed drug in your surroundings?
Options Frequency Percent
nuberol 30 66.7
paracetamol 15 33.3
Total 45 100.0
DO you use self-prescribed drug until you recovered completely?
Options Frequency Percent
yes 12 26.7
no 29 64.4
on certain times 4 8.9
Total 45 100.0
What makes people to go for self prescribes drugs?
Options Frequency Percent
doctors behaviour 14 31.1
remotely located health facilities 14 31.1
behaviour of hospital administration 15 33.3
doctors fees 2 4.4
Total 45 100.0
Have any incident taken place in your family due to self-prescribed drugs?
Options Frequency Percent
no 10 22.2
yes 1 time 22 48.9
multiple times 8 17.8
not that in my knowledge 5 11.1
Total 45 100.0
How can we stop use of self-prescribed drugs?
Options Frequency Percent
through social media 9 20.0
improve doctors and admin behaviour 16 35.6
by spreading awareness among
16 35.6
people
others 4 8.9
Total 45 100
Behaviour of DR and Admin makes people go for self-prescribed drugs?
Options Frequency Percent
yes 7 15.6
no 14 31.1
others 24 53.3
Total 45 100.0
How self-prescribed drugs can effect human body harmfully?
Options Frequency Percent
no harmful effect 4 8.9
minor harmful effects 24 53.3
dangerous effects 14 31.1
i have no knowledge 3 6.7
Total 45 100.0
Do you recommend self-prescribed drugs to people around you?
Options Frequency. Percent
yes 11 __ 24.4
no 16 35.6
sometimes 18 40.0
Total 45 100.0
For which complains you use self-prescribed medicines?
Options Frequency Percent
running nose 2 4.4
nasal polyp 8 17.8
cough 8 17.8
sore throat 6 13.3
fever 18 40.0
vomiting 3 6.7
Total 45 _____ 100.0
On which basis you use self-prescribed medicines?
Options Frequency Percent
on the recommendation of
6 13.3
community pharmacist
due to family opinion 21 46.7
due to opinion of friends 10 22.2
due to personal experience 8 17.8
Total 45 __________ 100.0
do yo ever read the instructions guide that comes with medicine
Options Frequency Percent
Yes always 15 33.3
yes sometimes 19 42.2
never 11 24.4
Total 45 __ 100.0
How do you know the dosage of drug?
Options Frequency Percent
by reading instruction label 8 17.8
from doctor 10 22.2
from pharmacist 20 44.4
from family and friends 6 13.3
from information sources 1 2.2
Total 45 ____________ 100.0
Did you ever change the dosage of drugs during self-prescribed treatment?
Options Frequency Percent
yes always 7 15.6
yes sometimes 22 48.9
never 16 35.6
Total 45 _____ 100.0
How many drugs did you take during your course of illness?
Options Frequency Percent
one 24 53.3
two 16 35.6
three 5 11.1
Total 45 _ 100.0
Doubt of using fake drugs.
Options Frequency Percent
yes too much 7 15.6
yes to some instant 13 28.9
never 25 55.6
Total 45_____________… 100.0
Do you read expiry date on package before purchase or use?
Options Frequency Percent
yes always 26 57.8
yes sometimes 14 31.1
no 5 11.1
Total 45 _______ 100.0
On whose recommendations you use certain brand of drugs?
Options Frequency Percent
pharmacist recommendation 7 15.6
doctors prescription 17 37.8
used by family and friends 8 17.8
advertisement 8 _______ 17.8
Past experience 5 11.1
TOTAL 45 100
Did you ever use one drug from two different brands for certain illness?
Options Frequency Percent
yes 20 44.4
no 25 55.6
Total 45 __ 100.0
Did you ever experienced side effect of self-prescribed
medicines?
Options Frequency. Percent
yes 15 33.3
no 30 66.7
Total 45 _____ 100.0
How do you view the use of self-prescribed medicines for betterment of health?
Options Frequency Percent
good exercise 11 24.4
acceptable 32 71.1
not acceptable 2 4.4
Total 45 ______ 100.0
Do you think that you can treat common diseases by self-
prescription of drugs ?
Options Frequency Percent
no 30 66.7
Total 45___ 100.0
RESULTS:

The present narrative review showed that the prevalence of self-medication is very high.
According to this research 73.3% of general population uses self-prescribed drugs. Females use
more self-prescribed medication than males.
60% of the persons involved in this research range in age from 15 to 35 years.

Use of self-prescribed drugs is more due to the easy availability of medicines. A very small
percentage of population know about the harmful effects of self-prescribed drugs. Nuberol is
more frequently used as self-medication. According to this research its use is 66.7% as compared
to paracetamol which is 33.3%. By spreading awareness among people and by changing
behaviour of doctors and hospital staff 71% of people think that it can change the people to stop
use self-prescribed drugs.

For different complaints people use self-medication. Fever was most treated by people by self-
medication. The percentage of there complications treated with self-medication are as follow:
About 44% of people involved in this research have two different brands of same medication
without knowing about it. 71% of people involved in this research think the use of self-
medication is acceptable.
Most people check the expiry date on the drug and most people read the instructions written on
medication. 46.7 % od people buy drugs on recommendation from a family member and 22.2 %
on the recommendation of a friend.

Limitations

1- Urban setting is the major limitation as the health care facilities are adequate in urban
areas.

2- Research was not performed in rural areas to access the effect of lack of health care
facilities on self-perception.

3- Limited number of populations being studied

4- Area selected for research was small

5- Multiple variables
6- Variables couldn’t be controlled
7- Male and female population was not equal.
SUGGESTIONS:

Research should be performed in rural areas to access the effect of lack of health care facilities
on self-perception.
Self-medication can be prevented by

1- spreading awareness about the risk factors of self-medication

2- building healthy therapeutic relationship between doctor and patient
3- improving the behaviour of hospital administration
4- Arranging seminars to educate general population about the complications of self-
medication.

CONCLUSION:

Self-medication is an alarming concept. This review focused on the self-prescribed drugs usage,
its side effects and reason for using it. The current study revealed that the prevalence of self-
medication practice among general population was high. The most common illness condition
was fever. The drug most commonly used was Nuberol. Gender, age and ease of availability of
drug were the main factors affecting self-medication. Therefore, by taking into account the high
magnitude, its impact and the associated factors, interventions that can halt the use of self-
prescribed drugs are crucial. Moreover, itis recommended that holistic approach should be taken
to prevent this problem, which includes proper awareness and education regarding the self-
medication and strictness regarding pharmaceutical advertising.

REFERENCE:
[01] Performed by Gul Mehar Javid Bukhari, Hareem Binte Saleem, Zafar Hayat Maken,
Shabana Saleem, Tayyaba Saleem, Hania Batool in Year 2022.

[02] Performed by Tsehay Kassa, TeferiGedif, TenawAndualem in Year 2022.

[03] Performed by Neusa F Torres, Buyisile Chibi.in Year 2021.
[04] Biological and clinical sciences Research Journal in Year 2021.
[05] Performed by Anjan Khadka and Kumud Kumar Kafle in Year 2020.
[06] Performed by Gabriela Range, Brando Laetitia, Oscar Ribeiro in Year 2020.
[07]: Performed by Omar raza Seam, Ritta Bhata, M. Shahabudin Atif Chaudri in Year 2018.