1.Dr.Noor Akbar 2Dr.Muhammad Awais Khan 3.Dr.Adil Jalil Leghari
Abstract:
INTRODUCTION:
Self-medication
is the use of medication by people without prescription, orientation or
supervision of physician or dentist using their own initiative. It includes
acquiring medicines without prescription, taking medication on recommendation
of relatives or consuming leftover medicines already at home.
Objective:
Our study focuses on the prevalence of self-medication among medical
students of Allama Iqbal Medical College, Lahore and the effects that maybe
caused by that.
Method:
A cross-sectional study was done and
data was collected by the distribution of 300 structured questionnaires using
the convenient sampling technique. The data was analyzed by using SPSS v17.0
and results were generated.
Results:
A total of 300 medical students were included in
the study. Most of the students (75%) used self-medication to not to bother
about minor illness. Males most commonly used antibiotics (63%), while females
most commonly used pain-killers (91%). Drugs were obtained mostly from the
pharmacies (68.33%). (37%) used it for fever and pains while (42%) used it for
flu, diarrhea and constipation in addition to fever and pains. Most of the
students were well aware of the risks of self-medication and (66%) didn’t
complain of any complications.
Conclusions:
Self-medication is quite prevalent. Unauthorized
use of drugs might cause complications. Thinking of ailments as minor mostly
caused self-medication. Drugs are easily available without prescription.
Key words:
Self-medication,
medical students.
INTRODUCTION:
Self-medication is the use of
medication by people without prescription, orientation or supervision of
physician or dentist using their own initiative1,2. It includes
acquiring medicines without prescription, taking medication on recommendation
of relatives or consuming leftover medicines already at home3. When
it comes to their own health, doctors and medical students behave irrationally
towards self-medication4.
Self-medication is a global
phenomenon. It is quite prevalent in both developed and developing countries.
Its incidence, however, is higher in developing countries. This trend is due to
the educational background of the countries5. Medical students
practice self-medication due to their increased medical knowledge4.
The prevalence of self-medication in medical students globally is, 92.3% in
Slovenia6, 86.4% in Brazil1, 67.4% in Germany7,
76% in Greece4 and 70% in Ghana5.
The facts and figures in Asian
countries show that self-medication is pretty common in these countries.
Students consult their text-books facilitated by the easy availability of drugs8.
It is also influenced by factors such as family, society, law and exposure to
advertisements9. The main indications for self-medication was
respiratory problems (73.3%), headache and fever, cough and cold, GIT
infections and mouth and throat infections10,11. Prevalence of
self-medication in Egypt was 55%12, 80.9% in Malaysia13,
47.8% in China14, 76.6% in Iran9, 92% in India8
and 86% in Sharjah15. Penicillins, especially amoxicillin, were most
commonly used all over. Females practiced it more commonly7,16. Drug
resistance is being reported 15. Acetaminophen and Codeine were most
commonly used in Iran with Amoxicillin2.
Use of self-medication in Pakistani students is alarmingly high. In
Pakistan, the problem is magnified by the fact that almost all prescription
only medications are also available over the counter without doctor’s
prescription2. The prevalence in Islamabad students was 40%2.
Commonly used medicines were analgesics (88.3%), antipyretics (65.1%) and
antibiotics (35.2%). Eighty seven percent of students thought self-medication
could be harmful and 82.5% students thought that it was necessary to consult a
doctor before taking a new medicine3. WHO has stated that
responsible self-medication can help prevent minor ailments and common illnesses3,17.
Self-medication was most commonly used for headache, flu and fever3.
Pain-killers and sleeping-pills are commonly used20. Prevalence of
self-medication is high in the educated youth, despite majority being aware of
its harmful effects17. Prevalence of self-medication in students of
Karachi was 76%3. Although, resistant bacteria are increasing day by
day and practice of self-medication should be discouraged, but, still an
optimistic approach is not hazardous; when one knows for what complaint which
medicine is to be used17.
OBJECTIVES:
The objective of this study is
to explore the practices of self-medication prevailing among the medical
students of Allama Iqbal Medical College and to determine different attitudes
and behaviors of students regarding this practice. This study also aims at
determining different sources of drugs and their complications and hazards
found in the students.
OPERATIONAL DEFINITION:
Self-Medication: Self-medication is a human behavior in which an individual uses a
substance or any exogenous influence to self-administer treatment for physical
or psychological ailments.
Drug: A
medicine or other substance which has a physiological effect when ingested or
otherwise introduced into the body.
Minor Illness: It is any condition which is self-limiting and does not prevent the
patient from carrying out their normal functions for more than a short period
of time.
Pharmacy:
A store where medicinal drugs are dispensed and sold.
Risk: A
situation involving exposure to danger.
Complications: A secondary disease or condition aggravating an already existing one.
Allopathy:
The treatment of disease by conventional means, i.e., with drugs having
opposite effects to the symptoms.
MATERIAL
AND METHODS:
STUDY DESIGN:
It is a cross-sectional study.
STUDY SETTING:
Allama
Iqbal Medical College and Jinnah Hospital, Lahore
DURATION OF STUDY:
Three months
SAMPLE SIZE:
300
students
SAMPLING TECHNIQUE:
Non probability convenient sampling
SAMPLE SELECTION:
Inclusion criteria:
- Medical student of AIMC
- Both genders
- Both boarder and day-scholars
Exclusion criteria:
The students absent at the time
of data collection and the students already taking prescribed medication.
DATA COLLECTION PROCEDURE:
The data was collected from 300
medical students of AIMC through the distribution of a structured
questionnaire.
DATA ANALYSIS PROCEDURE:
Data was analyzed using SPSS
v17.0 and frequency tabulation and percentages were generated for variables.
RESULTS:
A cross-sectional study was
conducted amongst the medical students of Allama Iqbal Medical College (AIMC),
Lahore. The number of students participated in our study was 300. All the
students participated were 18-25 years of age. They included from 1st
year to final year medical students.
Students when asked about why they
used self-medication answered by saying mostly ((75%) males and (73%) females),
they did so to not to bother about minor illness followed by to save time
((39%) males and (30%) females). More of the male students did it to save money
(21% in comparison to 8% of females). Nearly equal proportion did it to avoid
seeing a doctor.
When asked about what type of
drugs they used commonly the results were quite amazing among males and
females. Most of the males admitted using pain-killers (55%) in comparison to
(91%) of the females. Antibiotics use was (63%) in males while (22%) in
females. Use of anti-allergics was more in males (30%) than in females (11%). A
small percentage of students also admitted using anti-depressants (7% in males
while 5% in females).
Most of the students got those
drugs from pharmacy (68.33%), while (14.33%) of students admitted getting the
drugs from their friends followed by (9.67%) from street shops and (7.67%) of
students got their drugs from relatives.
On inquiring about for what
they used self-medication, students had varying replies. (37%) used
self-medication for fever and pains, (15.67%) of students used self-medication
for flu, diarrhea and constipation, while (42%) of the students said they used
self-medication for all the above indications. (5.33%) of students admitted
using drugs for anxiety and depression.
This study indicates (37%) students
were well aware of risks of self-medication, (32.7%) knew a little bit about
risks, (19.7%) were not sure about the risks and (11.00%) did not know about
the risks corresponding to Table 1.
It was indicated in our study that
(66%) students didn’t complain of any complication, (18%) said that it caused
complications sometimes, (7.3%) often complained of complications, while (8.7%)
always had complications corresponding to Table 2.
Table 1:
Are you aware
of the possible risks of self-medication?
|
Construct
|
Frequency
|
Percentage
|
|
Yes
A little bit
Not sure
No
Total
|
111
97
59
33
300
|
37.0
32.3
19.7
11.0
100.0
|
Table
2:
Does
self-medication cause you any complications?
|
Construct
|
Frequency
|
Percentage
|
|
No
Sometimes
Often
Always does
Total
|
198
54
22
26
300
|
66.0
18.0
7.3
8.7
100.0
|
DISCUSSON:
Our study explored the
practices of self-medication among the medical students of Allama Iqbal Medical
College, Lahore. It is indicated in our study that students preferred doing
self-medication on advice of friends and relatives (17.32%) in comparison to
(16%) indicated in a study done in Islamabad. Students preferred treating
themselves when they thought of their problem as minor ailment (74%) in comparison
to (34%) as indicated in the study done in Islamabad. Most commonly used mode
of self-medication was allopathic (72%) in comparison to (94%) in the study
done in Islamabad. So, our results were quite consistent with the study done on
medical students in Islamabad.
The most common symptoms that led
students get indulged in self-medication were (fever and pains 37%), (flu,
diarrhea and constipation 15.67%), while (42%) responded with self-medication
involving any of the above symptoms. Two different studies done in Karachi also
show consistency with our study, with majority of the students using
self-medication in a relatively consistent number indicated in our study for
the given ailments.
Our study also indicates that
most of the students use self-medication when they think that the ailment is
minor (74%), to save time (35%) and to save money (15%). Two studies done
previously in Karachi also give quite consistent results.
CONCLUSION:
The practice of self-medication
is alarmingly high in medical students. Pharmacies remain the biggest source of
drugs. Painkillers and antibiotics are most commonly used drugs. A majority of
students use self-medication to not to bother about minor illness and to save
time. Most of the time self-medication does not cause complications in students
according to our study. Proper check and balance is needed to avoid any
complications and to avoid the excessive use of drugs.
REFERENCES:
1. Corrêa da
Silva et al.: Self-medication
in university
students
from the city of Rio Grande, Brazil. BMC
Public Health 2012
12:339.
2. Hussain A, Khanum A. Self medication among
university students of Islamabad, Pakistan- a preliminary study. Southern Med
Review (2008) 1; 1:14-16
3. Zafar SN, Reema S, Sana W,
Akbar JZ, Talha V, Mahrine S, Wajeeha Y, Saman S, Sarah S, Self-medication
amongst university students of Karachi: prevalence, knowledge and attitudes, J
Pak Med Assoc., 2008, 58, 214-17.
4. A. J. Montgomery, C. Bradley, A. Rochfort and E. Panagopoulou,
Occupational Medicine 2011;61:490–497 Advance Access publication on 4 July 2011
doi:10.1093/occmed/kqr098
5. Eric S. Donkor , Patience
B. Tetteh-Quarcoo, Patrick Nartey and Isaac O. Agyeman, Int. J. Environ. Res.
Public Health 2012, 9, 3519-3529; doi:10.3390/ijerph9103519
6. K-K.
Zalika, H. Ziga, K. Janko, Med Princ Pract 2010;19:395–401
DOI:
10.1159/000316380
7. A. G. Franke, C. Bonertz, M. Christmann, M. Huss,
A. Fellgiebel, E. Hildt , K. Lieb, Franke A G et al.
Non-Medical Use of Prescription … Pharmacopsychiatry 2011; 44: 60 – 66
8. Badiger S,
Kundapur R, Jain A,
Kumar A, Patanashetty S, Thakolkaran N,
Bhat, Ullal N. Selfmedication
patterns among medical students in South
India.
AMJ 2012, 5, 4, 217‐220.
http//dx.doi.org/10.4066/AMJ.2012.1007.
9. Sarahroodi S, Maleki-Jamshid A,
Sawalha
AF, Mikaili P, Safaeian L. Pattern of
self-medication with analgesics
among Iranian University students in
central Iran. J Fam Community
Med 2012;19:125-9.
10. K.V. Rohit, M. Lalit, P. Manisha, Vol.3
Issue 1, January‐March 2010
11. Nalini G. K.,
BJMP 2010;3(2):325
12. N.F.A. El
Ezz, H.S. Ez-Elarab, J
prev med hyg 2011; 52: 196-200
13. Ali SE, Ibrahim MIM, Palaian S.
Medication storage and self-medication behaviour amongst female students in
Malaysia. Pharmacy Practice
(Internet) 2010 Oct-Dec;8(4):226-232.
14. Pan H, Cui B, Zhang D, Farrar J, Law F, et al.
(2012) Prior Knowledge, Older Age, and Higher Allowance Are Risk Factors for
Self-Medication with
Antibiotics among University Students in
Southern China. PLoS ONE 7(7): e41314. doi:10.1371/journal.pone.0041314
15. I. S. Suleiman,
H. M. I.
Osama, M. Laila and M. Riham, American Journal of Pharmacology and Toxicology,
2012, 7 (4), 135-140
16. J. Henry,
Shailendra S. Handu, Khalid A.J. Al Khaja, O. Sameer,
Reginald
P. Sequeira, Med Princ Pract 2006;15:270–275
DOI:
10.1159/000092989
17. M. Yasmin, S. M. Ashraf Jahangeer, M. Tahira, Z.
Shahla, A. Sara, JLUMHS SEPTEMBER-DECEMBER 2011; Vol 10: No. 03
