Premlila Vithaldas Polytechnic, S. N. D. T. Women's University, Sir Vithaldas Vidyavihar, Juhu Tara Road, Santacruz (West), Mumbai 400049
Email: vanitasaharan@yahoo.co.in
Received: 14 Apr 2015 Revised and Accepted: 21 May 2015
ABSTRACT
Objective: This study was undertaken to describe and examine the self medication pattern in Mumbai.
Methods: Self prepared, pre-tested and validated questionnaire were employed as a tool for data collection. Questionnaire, containing open-ended and close-ended questions, was administered to the subjects. 40 different localities which cover various parts of Mumbai-city and Mumbai-suburbans were targeted. A sample of 400 families was randomly selected for the study. Data were analyzed and the results expressed as counts and percentages.
Results: The study showed that 85% respondents practice self medication which reflects high prevalence of self medication. The respondents found self medication to be time-saving, economical, convenient and providing quick relief in common illnesses. The most common indications for self medication were headache, body ache, cough, cold, sore throat, dysmenorrhea, fever. Analgesics, antipyretics, antibiotics use was high in numbers. Chemist/Pharmacist and internet were the major source of information followed by friends and old prescriptions.
Conclusion: Knowledge about appropriate self-medication was poor; practice of self medication was quite high and inappropriate. Self-medication is an area where government and health authorities needs to ensure that it is done in a responsible manner, ensuring that safe drugs are made available over the counter and the consumer is given adequate information about the use of drugs. Pharmacist can play an important role in educating the people for the same and dispensing the medication only on a valid prescription.
Keywords: Self-medication, Questionnaire, Mumbai, Pharmacist.
INTRODUCTION
According to WHO (World health organization) self-medication is the selection and use of medicines [1] by individuals to treat self-recognized illnesses or symptoms. This broadly includes referring old prescription, referring prescription of family members, acquiring medication without prescription, consulting friends, relatives, neighbors, social group, sharing medicines etc [2]. Self-medication practices cannot be considered as entirely harmful. Drugs classified as “over the counter” (OTC) can be purchased without the prescription and many a times might save time and money for the patients [3]. The reasons for self medication mentioned in the literature are mild illness, previous experience of treating similar illness, economic considerations and a lack of availability of health care personnel. The most common medications used for self medication are analgesics and antimicrobials [4, 5]. Another study on self medication shows that it is influenced by many factors such as education, family, society, law, availability of drugs and exposure to advertisements [6, 7]. But people go for OTC drugs like antibiotics, antidepressants, antacids, laxatives, etc. for symptomatic relief. This could invite all sorts of unforeseen troubles such as drug resistance, addiction, and allergies for patients. Self-medication may cause severe medical complications posing a potential risk to the patient’s life.
There are lots of public and professional concerns about the irrational use of drugs, but still internationally self medication has been reported as being on the rise [1, 8]. Various studies have shown that the use of self medication is twice as common as that of the prescribed medication. Moreover prescribed medication and self medication are used together [9].
Novelty
The study was an eye-opening for the budding pharmacist which helped them to:
1) Identify factors influencing self medication, potential adverse effects of self medication
2) Describe the scope of self-medication in the prevention and treatment of diseases, indicating their advantages and disadvantages or limits
3) Identify the responsibilities and functions of pharmacists towards consumers/patients
4) Define the key functions for community pharmacists in self-care and self-medication
5) Identify the ethical and regulatory issues relating to the role of pharmacists in self-medication
Objective
The survey was done as a part of the curriculum of Diploma in Pharmacy offered in the Department of Pharmacy, P. V. Polytechnic, S. N. D. T. Women’s University, Mumbai. The survey was done by the students of final year under supervision.
The study was taken up with the objectives
1) To study the prevalence of self medication in people of Mumbai
2) To understand the reason for self medication and in which disease condition people go/prefer for self medication
3) To educate people about the perils of self medication and the measures to curb this potentially life-threatening practice
4) To develop the concept of family pharmacist
5) To curb the self dispensing pattern of medicines (common cause of self medication reported) it’s very important to make students aware of the potential risk of self medication pattern
6) To stimulate the ethical aspect of our future budding pharmacist that they play important role in the health care sector and hence not get indulge in self medication practice
7) To develop the concept that role of the pharmacist is not only dispensing medications, patient counselling goes hand in hand.
MATERIALS AND METHODS
For the collection of data self-structured, pre-tested/pre-validated questionnaire was prepared. This questionnaire-based survey was undertaken between January to March 2015. The questionnaire consists of both open-ended and close-ended items. The questionnaire was adapted from the similar study conducted earlier [4].
The questionnaire includes questions pertaining to:
Identification of data
Head of family, no of men, women, children, old age, address, qualification, employment, income.
Data regarding self medication
Practice of self medication, commonly used medicines for self medication, disease condition in which self medication is practice, sources of self medication, age group in which self medication if preferred, reasons of self medication, indications of self medication, knowledge of the family regarding drug, dose, storage condition, length of the therapy, side effects in case self medication is practice. Knowledge regarding OTC products, source of drug information, allopathic, homeopathic, Ayurvedic systems of medicines. More than 40 different localities which cover various parts of Mumbai-city and Mumbai-Suburbans were targeted. 400 families were randomly selected by stratified sampling. The questionnaire was distributed with the prerequisites about the nature of the study, procedure of completing the questionnaire and the importance of the right information. In families who were not educated, the questionnaire was filled by the qualified assistant. The questionnaire was made in English. If the family members were not well versed with the language, again the data were translated into local language and filled by the qualified assistance.
The result is based upon the data obtained from 1478 (97%) respondents. The prevalence of self medication was reported as percentages. The survey was descriptive and data were summarized as counts and percentages, some of the questions had multiple options to choose from. Respondents have given multiple answers to some questions.
Data analysis
The data were analysed using SPSS version 16 and the results expressed as proportions.
Table 1: Pattern of self medication, Number of respondents (N)= 1478
| Parameters | Percentage (%) |
| Targets | |
| Male | 37 |
| Female | 38 |
| Old-age | 10 |
| Children | 15 |
| Awareness | |
| Self medication | 85 |
| Prescription | 40 |
| OTC products | 55 |
| Reason of self medication | |
| Cost saving | 34 |
| Time saving | 59 |
| Ease and Convenience | 20 |
| No need to visit a doctor for minor illness | 38 |
| Quick relief | 24 |
| Source of Information | |
| Recommendation by pharmacist | 56 |
| Suggestion/Opinion by family members, friends | 30 |
| Previous prescription | 42 |
| Advertisement | 8 |
| Books | 2 |
| Internet | 63 |
| Knowledge about the dose, duration of treatment | |
| Reading instruction given on the strip | 21 |
| Consulting Pharmacist | 54 |
| Suggestion/Opinion by family members, friends | 32 |
| Previous prescription experience | 43 |
| Internet | 64 |
| Side-Effects on Self medication encountered | 24 |
| Action taken on side effects after self medication | |
| Stopped taking the non-prescription medicine | 21 |
| Consulted doctor | 40 |
| Consulted Pharmacist | 34 |
| Took the advice of family/friends | 5 |
| Use of alternative therapy along with self medicated and prescribed medicine | 45 |
*All the results are rounded off to the nearest value
RESULTS
All the respondents (n=1520) responded to the questionnaire, of whom 42 was excluded in accordance with the exclusion criteria like incomplete information. Remaining 1478 (97%) respondent questionnaires were considered for evaluation. Out of 1478 respondents, 1254 (85%) practiced self medication and had a positive attitude towards it. The remaining 224 (15%) respondents preferred consulting a doctor. Self medication was seen in 47% of females and 42% of males and 11% in older people. The mean age of respondents was 38.9±1.7 years, with a range of 18-62 years. When asked about general awareness and understanding about various forms of medication more than 1282 (87%) felt that self medicated and OTC products are same. The most important advantages quoted for not consulting a doctor and reasons of self medication were saving time (59%), being economical (34%), ease and convenience (20%), no need to visit a physician for minor illness (38%) and providing quick relief (24%). (table 1)
The source of information for self medication were pharmacist, friends, doctors’ prescriptions for prior illness, advertisements, books and internet comprised 56%, 30%, 42% 8%, 2% and 63% respectively. Source for knowledge about the dose, duration of treatment were reading instruction given on the strip (21%), consulting pharmacist (54%), suggestion/opinion by family members, friends (32%), previous prescription experience (43%), Internet (64%).(table 1)
When asked about side effect encountered on self medication, 24% experienced side effects like nausea, dizziness, vomiting, loose motion, allergies was seen and measure taken by them were stopped taking the non-prescription medicine (21%), consulted doctors (40%), consulted a pharmacist (34%), advice taken from family/friends (5%). (table 1)
There were several indications for self-medication (table 2), the most common indications reported by the respondents were headache (96%), fever (84%), cough and cold (81%), acidity (67%) and dysmenorrhea (48%). Ongoing trends were observed towards the alternative medicines (27%), since people believe that they are free from side effects. The even high inclination is seen towards the use of food supplements and tonics (78%).
Table 2: Indications of self medication, Number of respondents (N)= 1478
| Indications | Percentage (%) | Average number of medications taken simultaneously±SD |
| Headache/bodyaches/Pain | 96 | 2.79±1.37 |
| Fever | 84 | 3.72±1.53 |
| Vomiting | 9 | 1.82±1.38 |
| Cold, Cough, sore throat | 81 | 3.47±1.30 |
| Stomach ache/heart burn/stomach problem burn | 30 | 4.04±1. |
| Antibiotics/antimicrobials | 62 | 3.89±1.38 |
| Skin problem | 23 | 3.89±1.38 |
| Eye problem | 7 | 2.27±1.71 |
| Ear problem | 4 | 1.72±1.30 |
| Acidity/Antacids | 67 | 4.28±1.38 |
| Diarrhoea/loose motion | 17 | 4.09±1. |
| Flatulence | 34 | 2.29±1.65 |
| Sleeping pills | 3 | NS |
| Indigestion/constipation/laxatives | 39 | 4.27±1.4 |
| Dysmenorrhea | 48 | 1.27±1.2 |
| Allergy or Sinusitis’s | 9 | 3.84±1.87 |
| Alternative medicine | 27 | 3.26±1.42 |
| Food Supplements and Tonics | 78 | 3.82±1.89 |
NS: Not Significant
The study has its own limitations. The influence factor among the family members could not be ruled out. This study was restricted to use of self-medication to allopathic drugs alone. There were many incidences where the respondents were not able to recall the frequency of self medication they have undertaken, so the study was limited to record pattern of drug use for last episodes alone.
DISCUSSION
The present survey was carried out with the objective to study the self medication pattern, so as to stimulate our budding pharmacist that they play an important role in the health care sector. All the above data highlights the trend towards self medication and the results are in similar lines with the earlier reports [10-12]. From the data it was clear that the pattern of self medication is high in women as compared to men. When asked for the same the main feedback was lack of time. The data clearly reflect the magnificent impact of internet on self medication, owing to shortage of time and general lack of awareness, people just go to the web to check their symptoms, and more often practice self-medication. The main reason for the self medication is time saving and then economical, doing away with the need to go to a doctor for minor illness and providing quick, easy and convenient relief. Respondents were not aware about the difference between OTC products and self medicated product. This is the area where patient counselling will play a major role where the consumers are given enough knowledge for the same.
The most important deterrents for self-medication (15%) were fear of adverse drug reactions, the risk of making a wrong diagnosis and risk of using a wrong drug. From the data, it is clear that self medication is practice for minor symptoms like headache, body ache, acidity, dysmenorrhea, cold and cough. Similar results were also reported earlier [10-12]. However, minor illness symptoms may cause major illness if not diagnosed properly as most of the fatal diseases have similar symptoms. There are lots of incidences of people having pain killers for a long time for minor illness, lands up with kidney failure. People with a long history of cough and taking cough preparation as self medication, mask underlying tuberculosis symptoms. Drug resistance is also a problem due to irrational use of antimicrobials/antibiotics [4, 5].
CONCLUSION
Self medication is a very serious yet a highly ignored issue in India. There are too many risks involved in self medication, especially when it turns out to be irresponsible self medication. Self medication is an area where government and health authorities need to ensure that it is done in a responsible manner, ensuring that safe drugs are made available over the counter and the consumer is given adequate information about the use of drugs and when to consult a doctor. It’s time we understand the perils of this practice and work towards adopting the best practices. This is the area where pharmacists can play an important role through patient counselling.
There is the concept of family physician, then why not family pharmacist.
Do we repair our furniture, television, computer, car? Then why health?
ACKNOWLEDGEMENT
The authors would like to thank the students for participating in this study.
CONFLICTS OF INTERESTS
The authors declare that they have no competing interests
REFERENCES