International Journal of Pharmacy and Pharmaceutical Sciences

Print ISSN: 2656-0097 | Online ISSN: 0975-1491 Vol 16, Issue 6, 2024

Original Article
SELF-MEDICATION FOR PREVENTION AND TREATMENT OF DISEASES DURING COVID-19
PANDEMIC-A CROSS SECTIONAL SURVEY IN GENERAL POPULATION

SARITA PANIGRAHY1 , DEEPANJANA DASS2 , SUNIL KUMAR PANDEY1 , DAMERA MEHER SHEENA1*
1Gayatri Vidya Parishad Institute of Health Care and Medical Technology Visakhapatnam-530048, Andhra Pradesh, India. 2MGM Medical
College, Kamothe, Navi Mumbai, Maharashtra-410209, India
*Corresponding author: Damera Meher Sheena; *Email: mehersheena84@gmail.com

Received: 02 Feb 2024, Revised and Accepted: 09 Apr 2024

ABSTRACT
Objective: The goal of this study was to assess the pattern and reasons for self-medication during the COVID-19 pandemic.
Methods: The present study was an exploratory cross-sectional survey. The questionnaire was meant to be filled up by those who were older than
18 y and could read and write English. The questionnaire (related to socio-demographic status, pattern, and reasons for self-medication) was
designed and validated by a committee of faculties in the department of pharmacology through a peer review process and sent through mail,
WhatsApp, and other means of social media. A non-parametric Chi-square test was used to test relationships between categorical variables.
Results: The responses of 557 participants were analyzed; among them, the majority were females as compared to males. There was a significant
difference (*p = 0.02) in the pattern of self-medication between the males (38%) and females (62%), and most of the participants used self-
medication as a preventive measure for COVID-19 (39%). Fear of going out (13%) during COVID-19 was the main single reason for self-medication.
Arsenic Album 30 was the most frequently used homeopathic formulation (26%).
Conclusion: This study showed that apprehension, coupled with the COVID-19 pandemic, was the main impulse for self-medication.
Keywords: COVID-19, Prevention, Self medication pattern
© 2024 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/)
DOI: https://dx.doi.org/10.22159/ijpps.2024v16i6.50520 Journal homepage: https://innovareacademics.in/journals/index.php/ijpps

INTRODUCTION A meta-analysis of self-medication shows its prevalence at 53.5% in

India [7]. Adverse effects are very common in all forms of medicine, like
Self-medication remains an important issue to look at, especially hypothalamic-pituitary-adrenal axis suppression, hypertension, Cushing
in developing countries. The prevalence of self-medication differs features [9], nausea, vomiting, abdominal pain, allergic reactions,
significantly in urban, suburban, and rural India and varies with inflammation, dependency [10], and vesico-bulbar eruptions [11].
different types of medicines [1]. As per recorded data, it may
account for as little as 11.7% and as much as 92% across the globe In relation to Ayurvedic medicines, serious adverse effects like
[2]. The term "Over-the-counter (OTC)" medicine is widely used for Steven-Johnson syndrome followed by fatal toxic epidermal
medicines that can be self-medicated. Self-medication has a low risk necrosis [12], transient atrioventricular dissociation, and
if done correctly. Factors like education, general knowledge, and hypotension [13] have also been reported. Adverse effects like
socioeconomic status, media and the Internet, and increased bradycardia, reversible pan conduction defect, and syncope
advertising of pharmaceuticals [1] are a few influencers of self- with hemorrhage have also been reported after the self -
medication. Costly consultation at private hospitals, poor quality of medication of homeopathic medicines [14].
care and long queues, mild illness in government hospitals [3], and
an old prescription are the few reasons for self-medication [3, 4]. Only a few articles show any data on self-medication during any
These days, it has become an integral part of self-care [5]. epidemic. Mortality and severe adverse effects like haemorrhagic
duodenitis due to self-medication of Ibuprofen and Steven Johnson
Most of the medications are being constantly reclassified from a syndrome due to self-medication of Paracetamol and Codeine
prescription only medication to medications available over-the- combination have been reported during epidemics [15]. During
counter [5]. As per the definition of WHO, “self-medication is the the ongoing COVID-19 pandemic, self-medications for prevention
use of medicinal products by consumers to treat self-recognized and treatment have been reported [16]. Deaths due to Coronavirus
disorders or symptoms or the intermittent or continued use of infection have been reported in the United States as well as in
medication prescribed by a physician for chronic or recurring India [17].
diseases or symptoms" [5]. It involves the use of medications for
family members as well, especially where the treatment of The Ministry of Health and Family Welfare, India, has
children or the elderly is involved [5, 6]. recommended the use of ayurvedic and homeopathic medicines
like chyawanprash, turmeric, and arsenicum album-30 [18, 19].
Where there are potential benefits of self-medication like direct and The present study is designed with the thought that there may
rapid access to treatment, convenience, and price, there are also be an increase in the practice of self-medication during the
many risks involved, like incorrect diagnosis, incorrect choice of lockdown due to the COVID-19 pandemic. Non-accessibility of
treatment, adverse effects, worsening of the underlying disease, hospitals and doctors, non-acceptability by the doctors and
interactions, dependency, and resistance [5]. History of the disease, hospital, unavailability of transport, and lockdown terms and
distrust of doctors, having no access to doctors, and low cost are a conditions may be the primary causes of self-medication during
few of the top reasons for self-medication [7]. this pandemic. Since there are almost no publications related to
self-medication during the pandemic, the present study was
Self-medication is common not only in allopathy but also in other designed to assess the pattern and variety of self-medication, the
alternative systems of medicine like Ayurveda, homeopathy, and adverse effects of self-medication, and the reasons thereof
Unani [8]. during the COVID-19 pandemic.
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The objective of this study was to assess the pattern of self- The collected data was manually fed directly into SPSS v.20, where
medication among males and females and to identify the reasons frequency analysis was run. A non-parametric Chi-square test was
for self-medication during the COVID-19 pandemic. also run to test the relationships between variables.
MATERIALS AND METHODS RESULTS
Study design, population and method A sample size of 540 was set for the study. Although by the end of the
study, 573 responses were received, only 557 were analyzed, as the
The present study was an exploratory cross-sectional survey. The remaining had missing data. The mean age of participants was found
questionnaire was designed and validated by a committee of faculty to be 35 y, with a minimum age of 18 y and a maximum age of 82 y.
in the department of pharmacology and through a peer review The mean age for females and males was 32 y and 39 y, respectively.
process. The pre-validated questionnaire, comprising questions The ratio of females to males was 1.3:1 (321/236), as shown in fig. 1.
related to socio-demographic status and questions related to the
pattern and reasons for self-medication, was sent through mail, There was a significant difference in the education level of males and
WhatsApp, and other means of social media. females. Except for the above-postgraduate level of education, the
percentage of school dropout was higher among females (73% vs.
Inclusion criteria 27%), and the same held true for graduation (64% vs. 36%) and
post-graduate level of education (55% vs. 45%), as shown in table 1.
Participants living in India (whether temporarily or permanently)
who were older than 18 and could read and write English were Overall, 61% of participants reported a history of self-medication
included in the study. with allopathic//homeopathic/ayurvedic medicines or any
combination of these during the study period or the past 3 mo
Exclusion criteria (COVID period), as shown in fig. 2. There was a significant difference
Illiterate people and those less than 18 y of age were excluded from (p = 0.02) in the pattern of self-medication between the males (38%)
this study. and females (62%). Self-medication was found to be more common
in the 18–30 and 31–43 age groups, as shown in fig. 1.
Sample size
Among all the participants who had reported self-medication in the
The sample size was calculated using online software with a last three months, the majority of them said that self-medication was
confidence level of 95% and an error of 5%, with a chance of an for the purpose of preventing COVID-19 (39%), followed by both
unlimited reachable population. prevention and treatment (19%), as shown in fig. 3. Once again,
there was a significant difference between males and females, as
The total sample size calculated was 385. By the end of the study, a shown in table 2.
total of 573 responses had been received.
Fear to go out (13%) during COVID-19 was the main single stimulus
Statistical analysis that surfaced for self-medication, as shown in fig. 2.

Table 1: Educational status of males and females (p-value =0.001; p≤ 0.05 is considered significant)
Education Male (n=236) Female (n=321)
Count % Within gender % Within education Count % Within gender % Within education
School dropout 3 1.3 27.3 8 2.5 72.7
Graduation 101 42.8 36.1 179 55.8 63.9
Post graduation 95 40.3 45.5 114 35.5 54.5
Above PG 30 12.7 65.2 16 5.0 34.8
Anyother 7 3.0 63.6 4 1.2 36.4

Table 2: Reasons for self-medication among males and females (p-value =0.05; p≤ 0.05 is considered significant)

Male (n=236) Female (n=321)

Reason for self-medication Count % Within % Within reason Count % Within % Within reason for
gender for self-medication gender self-medication
For prevention 86 36.5 40 129 40.2 60
For treatment of symptoms of corona 6 2.5 27.3 16 5 72.7
For both treatment and prevention 39 16.5 36.8 67 20.9 63.2
Neither for prevention nor for cure 105 44.5 49.1 109 34 50.9

Table 3: Stimuli for self-medication among males and females (p=0.35 p ≤ 0.05 is considered significant
Male (n=236) Female (n=321)
Stimuli for self-medication Coun % Within % Within stimuli for Count % Within % Within stimuli
gender self-medication gender for self-medication
None 6 2.5 35.3 11 3.4 64.7
Non-accessibility to doctors 11 4.7 57.9 8 2.5 42.1
Non-accessibility to hospitals 2 0.8 16.7 10 3.1 83.3
Non-acceptability by hospitals 3 1.3 60 2 0.6 40
Non-availability of transporters 1 0.4 20 4 1.2 80
Fear to go out in Lockdown 31 13.1 42.5 42 13.1 57.5
Economic 2 0.8 66.7 1 0.3 33.3
Any other 104 44.1 46 122 38 54
All 8 3.4 47.1 9 2.8 52.9
Multiple options 68 28.9 110 35

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For females, non-accessibility to hospitals, transportation problems, Among homeopathic self-medicating participants, arsenic album 30
and non-accessibility of doctors were the main stimuli for self- was the most frequently used formulation (26%). Whereas, among
medication during the COVID-19 period, whereas for males, ayurvedic self-medicating participants, most of them took all three, i.e.,
increased cost, non-acceptability by hospitals, and non-accessibility chyawanprash, herbal decoction, and golden milk, as shown in fig. 4.
to doctors were the three main stimuli, as shown in table 3.
The major source of knowledge for self-medication was from authorized
Most participants who took allopathic, homeopathic, or ayurvedic websites (28%) https://ayush.gov.in, https://nch.org.in [18, 20], news
medications did not report any adverse effects. channels, and social media (10.4%), as shown in table 4.

Table 4: Frequency distribution of sources of knowledge for self-medication

Sources of knowledge Frequency Percentage

Did not self-medicate 12 2.2
Social media 51 9.2
News channel 7 1.3
Word of mouth 53 9.4
Internet (unofficial) 15 2.7
Official websites 156 28.0
Any other 10 1.8
All 114 20.5
News channel+Word of mouth 22 3.9
News channel+Social media 58 10.4
Internet+official 50 9.0
News channel+official website 9 1.6

Fig. 1: Socio-demographic parameters of participants included in study

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Fig. 2: Percentage of population taking self medications and their stimuli

Fig. 3: Percentage showing reasons for self medication

Fig. 4: Percentage of population taking ayurvedic and homeopathic medicine

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DISCUSSION findings cannot be generalized. Another drawback of this study was

that the people were not questioned directly as this was a self-
Studies have reported varying prevalence among different states of answered questionnaire, which may result in recall bias and
India [3]. COVID-19 was one such situation where no definitive cure deviated responses as there was less scope for direct interaction.
or vaccines were accessible, and it was further fueled by the false
propaganda given by social media, leading to uncertainty and CONCLUSION
confusion in the public and a rise in the use of self-medication,
including home remedies. Fear of exposure during COVID-19 was the key factor linked to the
adoption of the behavior of self-medication. Self-medication is
In a study conducted by Grace et al. at Cameroon 13% of adult becoming more common in the younger population too. People turn to
participants use antibiotics as self-medication [6] as opposed to our self-medication mainly because of limited access to facilities and an
study, where antibiotic usage was only 1%. Also, in this study, the increase in the source of information during the pandemic. Better
reason for self-medication is due to the inaccessibility of health care strategies towards the availability of medical treatment for acute and
services, which was more common in females but in our study fear chronic infections should be the prime focus during any pandemic.
to go out in lockdown was the main stimuli for self-medication with
no significant difference between men and women. Grace also ACKNOWLEDGEMENT
concluded that an increased risk of self-medication was more among
middle-aged (40-59 y), which was not in agreement with our study Nil
as self-medication was more common in the age group of 18-30 y. FUNDING
Low literacy was the main reason for self-medication among women in a Nil
study by Karimy et al. [21] which was not in line with our study, where
women with higher education preferred self-medication more (96.3%). AUTHORS CONTRIBUTIONS
In a study by Gurmeet Kaur [10], the source of information for self
medication was only television, whereas in our study, both men and Dr. Sunil Kumar Pandey: Conduction of the project, data analysis and
women subgroups had multiple sources of knowledge (television, social interpretation, submission, revision, Dr. Sarita Panigrahy:
media, and websites) of self-medication and multiple chronic co- preparation of protocol, manuscript, data input, revision, Dr.
morbidities were the prime reasons for self-medication. Deepanjana Dass: Data collection and compilation, Dr. Meher
Sheena: Data collection and compilation.
In our study, about 61.9% used ayurvedic medicine as self-medication
during COVID, as compared to 22.5% in a study done by Priyanka [22]. CONFLICTS OF INTERESTS
Easy availability of ayurvedic home-made medicines and a lack of Declared none
adverse effects might be the reasons for their increased use. Also, we
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