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PubMed1998

Drug-related hospitalization at a tertiary teaching center in Lebanon: incidence, associations, and relation to self-medicating behavior.

OBJECTIVE: In Lebanon there is very limited restriction on drug use. Accordingly, self-medication is highly prevalent. This study examined the influence of these factors on the development of drug-related illnesses that lead to hospitalization. METHODS: Patients admitted to the medical and pediatric wards of a tertiary teaching center in Beirut, Lebanon, over a period of 6 months were interviewed and their charts were reviewed. Admissions attributable to adverse drug reactions or therapeutic failures were identified and characterized with respect to demographic factors, medical history, drug intake, and self-medicating behavior. The influence of these variables on the development of drug-related illnesses was examined by logistic regression. RESULTS: Of 1745 adults and 457 children, there were 177 (10.2%) and 36 (7.9%) drug-related illnesses, respectively. Adverse drug reactions accounted for 7.0% and 5.7% and therapeutic failures for 3.2% and 2.2% of adult and pediatric admissions, respectively. Self-medication was commonly practiced (52.6% of adults and 41.6% of children). Logistic regression analysis revealed that female sex increased the risk of adverse drug reaction in adults, whereas self-medication decreased the risk. In children, the risk of adverse drug reaction was increased in lower socioeconomic groups, whereas the risk of therapeutic failure was increased by a positive history of atopy or drug reaction. CONCLUSIONS: These results provide the first detailed analysis of the problem of drug-related illnesses in a developing country and identify a number of related or risk factors. Despite the lack of regulation of drug dispensing and the unchecked access to drugs in Lebanon, the incidence of drug-related illnesses is not different from that in Western nations. This finding may have relevance to policies of drug regulation in other countries.

Adolescent↗
PubMed1991

[Self-medication with analgesics. A study on odontalgia].

BACKGROUND: Odontalgia is a painful condition which is frequently associated to self-medication with analgesics. The purpose of the present study was to evaluate the main characteristics of self-medication on these patients. METHODS: A total of 226 patients who requested medical care for odontalgic problems at ambulatory level were evaluated. A case from was completed for each patient, considering diagnostic syndrome, pain characteristics and self-medication. RESULTS: Pain was present in 59% of the patients with a mean duration of near 20 days. Its intensity was mainly from moderate to severe, but one third of the patients referred very severe or excruciating pain. Near seventy percent of all patients with pain complaints were self-medicating with analgesics, 55% of them with one drug, 36% with two and 8% with three. A clear trend to use more drugs when pain intensity was higher was observed. The most frequently used drugs were paracetamol (39%), acetilsalicylic acid (24%) and metamizol (17%). The majority of patients selected themselves the drug and only a small number were advised by pharmacist or non health professionals. CONCLUSIONS: The present study shows a high frequency of self-medication in patients with odontalgia suggesting that this type of pain might be useful as a model to study self-medication with analgesic drugs.

Adolescent↗
PubMedDate not supplied

[Self-medication: Is regulation needed...from whom?].

The participants attending the 1999 French Clinical Pharmacological meeting in Giens eventually reached a consensus about the necessity to set up a clear policy regarding self-medication products in France. Despite a wish by French people to take more responsibility for their own health care, self-medication products' use and development in France have been held back for many years for the reasons reported below. However, self-medication could be developed while respecting or even improving public health care by applying the following key principles: (1) the acknowledgement of a consensual definition. 'A self-medication drug is a drug (the guarantees for which are provided by marketing authorization approval and dispensation and advice of a pharmacist) specifically suitable for use without any physician's prescription'; (2) the advertising of self-medication products to the general public is authorized; (3) the safe use of self-medication products is linked to the selected indications and the relevance of the information provided to the general public; (4) the self-medication drug approval procedure could be simplified, managed by a specific AFSSAPS unit; (5) the role of the pharmacist involved, as well as suitable pharmacovigilance, is mentioned; (6) more than 1000 previously marketed drugs without any clear status, the so called 'grey zone drugs', should be taken into consideration. According to the participants at the meeting, it is possible to set up a new clear and dynamic policy for self-medication products in France in conformity with EU requirements.

France↗
PubMed2006

Self-medication practices in Khartoum State, Sudan.

OBJECTIVE: The aim of this study was to estimate the prevalence of self-medication with proprietary medicines and herbs in Khartoum State, Sudan, and to evaluate factors associated with self-medication. METHODS: A pre-piloted questionnaire was used to collect data from a sample of 1,200 individuals, selected from all three cities of Khartoum State using a multistage stratified clustered sampling. RESULTS: The response rate was 83.3%. Medicines, including herbs, were used by 81.8% of the respondents without a medical consultation within 2 months prior to the study period. Proprietary medicines alone were used by 28.3% (CI: 25.6-31.2), herbs alone by 20.7% (CI: 18.3-23.4), while 32.8% (CI: 29.9-35.8) had used both. Self-medication with proprietary medicines was least common with the middle-aged (OR: 0.12; 0.09-0.17), the elderly (OR: 0.29; 0.20-0.42) and low level of education [illiterate (OR: 0.26, 0.18-0.37) and primary/intermediate school (OR: 0.07, 0.04-0.11)]. It was most associated with low (OR: 5.3; 3.8-7.4) and middle income (OR: 4.3; 3.1-5.9), but no gender difference was found (P>0.05). Self-medication behaviour with herbs was most associated with middle-age (OR: 1.7; 1.3-2.2), female gender (OR: 2.2 (1.7-2.8) and lowest income earners (OR: 2.5; 1.9-3.5). CONCLUSIONS: The prevalence of self-medication with medicines including herbs in urban areas of Khartoum State is high. Self-medication behaviour varies significantly with a number of socio-economic characteristics. Our findings have major public health policy implications for countries like Sudan.

Age Factors↗
PubMed1988

Self-medication among primary care patients in Farazdak Clinic in Riyadh.

Four hundred and thirty new adult patients were interviewed using a questionnaire for their attitudes and practices regarding self-medication. 69% of the patients were males and 40% were Saudis. 58% of the patients attempted self-medication due to the triviality of their symptoms or to save time and money. They used mostly analgesics, vitamins, tonics and oral antibiotics. 41.6% of the patients did not practise self-medication because of lack of information about the drugs or for fear of complications. Self-medication was associated with literacy and morbidity. Literate patients self-medicated significantly more than illiterates. Patients who perceived their symptoms as minor self-medicated significantly more than those who perceived them as major. No association was found between self-medication and age, sex or occupation.

Adolescent↗
PubMed1996

Self-medication in acute surgical wards.

Self-medication of oral drugs is not current practice on surgical wards. We have introduced a system for suitable patients in which they give to themselves all their oral medication while in hospital. This was introduced in stages to gain the confidence of staff. Many patients wish to self-medicate; this system allows better use of the drugs that they bring into hospital from home; more appropriate timing when in hospital and speed up discharge procedures, as the patient is already familiar with, and has a supply of, their drugs to take home.

Clinical Nursing Research↗
PubMedDate not supplied

Self-medication for elderly patients.

This paper describes the introduction of a self-medication programme for elderly in-patients using action research. The programme was initiated by a steering group which met regularly to implement and monitor self-medication. Ward staff were interviewed to assess their learning needs before the start, meetings were held as the project advanced, and a final staff evaluation questionnaire was administered. Patients' opinions were also monitored. Self-medication was successfully introduced and minor problems were rapidly solved by participating staff. Patients were highly satisfied with the new independence and self-esteem they had gained through taking their own medications. Nurses shared these feelings, but also felt that self-medication was more time consuming than previous drug rounds. Suggestions for further research and development are given.

Aged↗
PubMedDate not supplied

The self-medication hypothesis of substance use disorders: a reconsideration and recent applications.

The self-medication hypothesis of addictive disorders derives primarily from clinical observations of patients with substance use disorders. Individuals discover that the specific actions or effects of each class of drugs relieve or change a range of painful affect states. Self-medication factors occur in a context of self-regulation vulnerabilities--primarily difficulties in regulating affects, self-esteem, relationships, and self-care. Persons with substance use disorders suffer in the extreme with their feelings, either being overwhelmed with painful affects or seeming not to feel their emotions at all. Substances of abuse help such individuals to relieve painful affects or to experience or control emotions when they are absent or confusing. Diagnostic studies provide evidence that variously supports and fails to support a self-medication hypothesis of addictive disorders. The cause-consequence controversy involving psychopathology and substance use/abuse is reviewed and critiqued. In contrast, clinical observations and empirical studies that focus on painful affects and subjective states of distress more consistently suggest that such states of suffering are important psychological determinants in using, becoming dependent upon, and relapsing to addictive substances. Subjective states of distress and suffering involved in motives to self-medicate with substances of abuse are considered with respect to nicotine dependence and to schizophrenia and posttraumatic stress disorder comorbid with a substance use disorder.

Humans↗
PubMed1994

[Self medication in general pediatrics].

OBJECTIVE: Description and quantification of self medication in a general paediatric office. DESIGN: Descriptive and prospective study. SITE. Cervantes Health Centre (Guadalajara). PATIENTS: 387 cases of both sexes until 8 that attended to on demand consultation during the period of two months. MEASUREMENTS AND MAIN RESULTS: 36% of the patients were given drugs before attending to consultation and in 18.7% of these cases, the actuation was incorrect. Parents were, mainly the responsible of incorrect treatment. The most often registered pathology was common cold. We did not found relation between self medication and the next variables: child's age or sex, parents' age or studies, number of children in the family, number of consultation for the same pathologic event and mother working outside home. CONCLUSIONS: Self medication is a common practice. Parents should be instructed about management of the commonest pathologies and when they should ask the doctor.

Adult↗
PubMed1990

A community survey of self-medication activities.

The objectives of this research were to explore lay medication activities as an aspect of self-managed health care in the Canadian context and to identify the sociodemographic and sociomedical characteristics of those who engage in self-medication. Interview data were collected in 1983 from a random cross-sectional sample of 524 adult residents living in Winnipeg, Canada. Respondents were questioned about the types of medicines they keep in their home (both prescribed and nonprescribed), self-treated symptomatic conditions; recent medication activities, the use of prescribed medicine in self-treated illness episodes, and the use of home remedies. This study contributes to a growing body of international evidence that has demonstrated that self-medication is a vital part of daily self-care behavior. For the most part, the results are comparable to those reported by previous British and U.S. studies of self-medication. Winnipeg residents were found to be active self-care providers who engage in a variety of self-medication practices. The study also illustrates the fact that the altered use of prescribed drugs (particularly by those with higher levels of formal education) is an important aspect of self-medication behavior. These findings have clear implications for health care practitioners.

Cross-Sectional Studies↗
PubMed2006

[Self-medication with antibiotics in Poland].

UNLABELLED: Antibiotic resistance, the important public health threat, depends on antibiotic overuse/misuse. Self-medication with antibiotics is of serious medical concern. The aim of the study, as a part of SAR project (Self-medication with antibiotic in Europe) was to survey the incidence of this phenomenon. MATERIAL AND METHODS: In Poland among 938 respondents of the questionnaire 27% adults were treated with antibiotics at least once a year, 13% of the therapies were undertaken without medical consultation. The most frequently prescribed antibiotic was amoxicillin, the most often self-ordered--fusafungine. RESULTS: The main self-medicated symptoms were sore throat and common cold. The duration of self-ordered therapy was less then 5 days. The sources of antibiotics used for self-medication were leftovers and those given by friends or family. CONCLUSION: The results of the study confirmed that antibiotic self-medication is relatively frequent problem in Poland and interventions are required in order to reduce the frequency of antibiotics misuse.

Adult↗
PubMed2002

Drug utilisation and self-medication in rural communities in Vietnam.

Reportedly 40-60% of people in Vietnam depend on self-medication. To assess the current situation of self-medication practices as compared with medication given by health professionals in rural areas in Vietnam, we conducted a cross sectional survey at household level. A total of 505 women with at least one child younger than 5 years of age were interviewed in their homes about their drug utilisation practices and attitudes toward medication, by using structured questionnaires. Of the 505 households, 138 stocked drugs for anticipated illness in the future. A total of 96 different antibiotics (in terms of generic type) were kept at 76 households. These antibiotics were kept mainly for coughs and diarrhoea. The self-medication group was twice as likely to use antibiotics than the other group. In addition, self-medication practice was increased when a mother kept medicines in the house. This study revealed that mistaken beliefs about medicines and undesirable attitudes toward medication were prevalent. Mothers used antibiotics as if such drugs were panaceas. In this context, there was insufficient public health education, no control over pharmaceutical promotion, and no efficient drug policy and regulation. More attention should be given to consumers and patients as the ultimate users of drugs so that they can access accurate information, assess the reliability of information and ask necessary questions.

Adult↗
PubMed2005

Advice-giving on self-medication: perspectives of community pharmacists and consumers in Singapore.

BACKGROUND: In Singapore, community pharmacists provide an advice-giving service to consumers who seek self-medication for minor ailments management. This service has not been studied formally from the perspectives of pharmacists and consumers. OBJECTIVES: The study aimed to identify (i) the approach taken by pharmacists in providing advice for self-medication and (ii) consumers' behaviour in self-treatment and their perception of the advice-giving role of the community pharmacist. METHOD: The pharmacists and consumers were surveyed independently using two structured questionnaires. RESULTS AND DISCUSSION: All community pharmacists who participated in the survey were confident in providing advice on self-medication. However, none of them recorded the consultations and only 17.5% of them had documented their general physician referrals. Most consumers (66.3%) would self-medicate and only consult a professional when the desired outcome was not achieved. Less than 10% of consumers would approach the pharmacists as the first option for advice. More than half of the pharmacists felt that the advice they rendered deserved a fee whereas only 28.4% of the consumers were willing to pay. Both parties thought the fee should not be more than S5 dollars (US3 dollars). CONCLUSION: Generally, there is congruence in the perspectives on self-medication between the advice-giving pharmacist and the consumer. The consumers still lack awareness that pharmacists can help them to self-medicate more safely and effectively. Therefore, more effort in public education is warranted. The current state of poor documentation of the advisory function of community pharmacists should be improved.

Adult↗
PubMed1993

Self-medication in three Orange Free State communities.

A study on self-care among whites, blacks and coloureds also focused on different forms of self-medication, including non-compliance. Large differences were found in the self-medication behaviour of the three groups. Different correlates of non-compliance were explored, but self-medication was not found to be a substitute for formal medical care.

Black or African American↗
PubMed2006

Use of alcohol and drugs to self-medicate anxiety disorders in a nationally representative sample.

This study examined the prevalence and correlates of self-medication of anxiety disorders with alcohol and drugs in a nationally representative sample (N = 5877). A modified version of the Composite International Diagnostic Interview was used to make DSM-III-R mental disorder diagnoses. Frequencies of self-medication ranged from 7.9% (social phobia, speaking subtype) to 35.6% (generalized anxiety disorder). Among respondents with an anxiety disorder, self-medication was significantly associated with an increased likelihood of comorbid mood disorders, substance use disorders, distress, suicidal ideation, and suicide attempts. Self-medication behavior remained significantly associated with an increased likelihood of suicidal ideation (adjusted odds ratio = 1.66; 1.17-2.36) as well as suicide attempts (adjusted odds ratio = 2.23; 1.50-3.31), even after adjusting for a number of sociodemographic and psychiatric variables. These results suggest that individuals with anxiety disorders who self-medicate their symptoms with alcohol or drugs may be at increased risk for mood and substance use disorders and suicidal behavior.

Adolescent↗
PubMed1995

Effects of self medication programme on knowledge of drugs and compliance with treatment in elderly patients.

OBJECTIVE: To determine whether a programme of self medication for inpatients improves compliance with treatment and knowledge of their drugs after discharge from hospital. DESIGN: Patients were prospectively recruited from four wards: two with a self medication programme and two acting as controls. Ten days after discharge the patients were visited at home. They were questioned about their drugs, and a tablet count was undertaken. SETTING: The pharmacy department and four medical wards with an interest in elderly patients at a district general hospital, and the patients' homes. PATIENTS: 88 patients discharged to their own homes who were regularly taking one or more drugs. INTERVENTION: A hospital self medication programme in which patients are educated about their medicines and given increasing responsibility for taking them in hospital. MAIN OUTCOME MEASURES: Compliance with and knowledge of the purpose of their medicines 10 days after discharge from hospital. RESULTS: The mean compliance score in patients taking part in the self medication programme was 95% compared with 83% in the control group (difference 12%, 95% confidence interval 4% to 21%; P < 0.02). Of the patients in the self medication group, 90% (38/42) knew the purpose of their drugs compared with 46% (17/37) in the control group (difference 44%, 26% to 63%; P < 0.001). CONCLUSION: A self medication programme is an effective aid for improving compliance with and knowledge of patients' drugs after discharge.

Aftercare↗
PubMed1999

A postpartum self-medication program: effect on narcotic use.

Our objective was to determine the impact of a self-medication program on postpartum narcotic use. We retrospectively studied narcotic use in patients who underwent vaginal delivery before and after implementation of a self-medication program in April 1997. Narcotic use was compared between patients who delivered in January 1997 (n = 263) and those who delivered in January 1998 (n = 254). Oral narcotic use was also analyzed with respect to type of vaginal delivery (spontaneous vs. operative), extent of episiotomy or laceration, and use of epidural analgesia during labor. Narcotic use was significantly reduced (p < 0.001) in postpartum patients who participated in the self-medication program. The reduction was consistent despite the type of vaginal delivery or use of epidural analgesia during labor. A more extensive episiotomy or laceration at delivery (fourth-degree episiotomy or vaginal sulcus tear) was associated with an increase in narcotic use, although there was still a statistically significant decrease in use in patients in the self-medication program. A significant reduction in postpartum narcotic use may be achieved through implementation of a self-medication program. As a result, substantial benefits are potentially gained by both the patients and the nursing staff.

Administration, Oral↗
PubMed2006

Antimicrobial self medication for reproductive tract infections in two provinces in Lao People's Democratic Republic.

OBJECTIVES: To describe antimicrobial self medication for reproductive tract infections (RTI) including sexually transmitted infections (STI), and to explore the understanding and use of health information among the adult population self medicating with antimicrobials for RTI/STI in two provinces of Laos. This could contribute to quality improvement of RTI/STI management. METHODS: Cross sectional community based study. Structured interviews (household survey) were conducted among 500 subjects aged 18 or more, who had used antimicrobials as self medication for RTI/STI during the past year. They were recruited among 3056 family members in Vientiane capital and Champasak province, divided equally between the two study sites, and between urban and rural areas. RESULTS: Among the 500 respondents reporting self medication for RTI/STI, 91% had bought the antimicrobials from local private pharmacies without a physician's prescription. 58% of those were advised to buy the drugs from drug sellers. Ampicillin (not recommended as syndromic treatment for RTI/STI) was used in 83% of all cases, in 28% combined with tetracycline. 79% of respondents used antimicrobials for a non-recommended duration of time. Most respondents had access to health messages for RTI/STI, largely from radio/television and drug sellers. However, only 17% of all respondents reported that they had ever used a condom. CONCLUSIONS: More than three quarters of respondents, self medicating for RTI/STI with antimicrobials, used inappropriate drugs bought from private pharmacies. There is a need to improve RTI/STI management, including health promotion, through interventions at community level, and to health providers, including private drug sellers.

Adult↗