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Kirubarajan A, Lam A, Yu A, Taheri C, Khan S, Sethuram C, Mehta V, Olivieri N. Knowledge, Information Sources, and Institutional Trust of Patients Regarding Medication Use in Pregnancy: A Systematic Review. J Family Reprod Health 2021; 15:160-171. [PMID: 34721607 PMCID: PMC8536826 DOI: 10.18502/jfrh.v15i3.7133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: The objective of our study is to characterize the knowledge, information sources, and institutional trust of patients regarding medication use in pregnancy. Materials and methods: We conducted a review of three databases: MEDLINE, EMBASE, and CINAHL. We included observational studies and knowledge assessments that examined the knowledge, attitudes, beliefs or information sources of pregnant patients related to medication use during pregnancy. Extraction was completed by two independent reviewers, outcomes were summarized descriptively, and appraisal was conducted. Results: Of the 1359 search results, 34 studies met inclusion criteria. Thus, our systematic review encompasses the beliefs of 11,757 pregnant participants. In most studies, participants described apprehension regarding potential risks to the fetus and the inadequacy of safety information. Across the 23 knowledge assessments, the majority of studies reported patient misconceptions about prescription medication in pregnancy. The most preferred information source was a healthcare provider. However, many participants expressed frustration, mistrust, and skepticism regarding physician knowledge. A common source of mistrust was due to perceived physician self-interest as well as a lack of education tailored to pregnancy. Consequently, informal sources of information were also popular. Conclusion: There is a need to improve the health literacy and trust among pregnant patients regarding drug prescribing. There are modifiable risk factors for mistrust that require further attention.
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Affiliation(s)
- Abirami Kirubarajan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Lam
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amy Yu
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Cameron Taheri
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shawn Khan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Claire Sethuram
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vikita Mehta
- Arts and Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nancy Olivieri
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Division of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Prevalence and Associated Factors of Self-Medication among Pregnant Women on Antenatal Care Follow-Up at University of Gondar Comprehensive Specialized Hospital in Gondar, Northwest Ethiopia: A Cross-Sectional Study. Int J Reprod Med 2020; 2020:2936862. [PMID: 33062663 PMCID: PMC7545459 DOI: 10.1155/2020/2936862] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 09/08/2020] [Accepted: 09/21/2020] [Indexed: 11/17/2022] Open
Abstract
Background Self-medication is being prevalent throughout the globe. Although pregnant women are among the most vulnerable group of the population for drug-induced adverse effects on their fetus and themselves, many pregnant women use self-medication without adequate safety precautions. Objective This study was aimed at assessing the prevalence and associated factors of self-medication among pregnant women on antenatal care follow-up at University of Gondar Comprehensive Specialized Hospital. Methods A cross-sectional study was employed among 400 pregnant women attending antenatal care clinic at the University of Gondar Comprehensive Specialized Hospital between February 01 and May 30, 2019. A structured interviewer-administered questionnaire was used for data collection. Data were analyzed using SPSS® (IBM Corporation) version 22. Descriptive statistics were presented using frequency and proportion. Binary logistic regression was used to identify factors associated with self-medication with a 95% confidence level and p value of 0.05. Results Among 400 respondents, the prevalence of self-medication during the current pregnancy was 44.8% (95% CI = 40.5-50). Among all respondents (400), 38.0% (95% CI = 33.3-42.8) and 12.5% (95% CI = 9.5-15) used herbal and conventional medicine, respectively. Self-medication showed a significant association with a previous history of self-medication and monthly income. Conclusions The prevalence of self-medication among pregnant women is considerably high. The previous history of self-medication and monthly income showed a significant association with self-medication. Awareness creation should be done for reproductive-age women on the potential risks of self-medication.
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Tuha A, Faris AG, Mohammed SA, Gobezie MY. Self-Medication and Associated Factors Among Pregnant Women Attending Antenatal Care at Kemisie General Hospital, North East Ethiopia. Patient Prefer Adherence 2020; 14:1969-1978. [PMID: 33116440 PMCID: PMC7584511 DOI: 10.2147/ppa.s277098] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/06/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Self-medication is an important part of daily self-care, without the supervision of health professionals. It is commonly practiced by pregnant women all over the world and may result in maternal and fetal risks. Hence, this study assessed self-medication practices and associated factors among pregnant women attending Kemisie General Hospital. METHODS A facility-based cross-sectional study was conducted using a structured questionnaire on pregnant women who were attending antenatal care at Kemisie General Hospital. A simple random sampling technique was employed to select the study participants. Descriptive and inferential statistics were computed using the Statistical Package for Social Sciences version 20. RESULTS Among 223 pregnant women, 60 (26.9%; 95% CI: 20.9%, 32.9%) and 111 (48.9%; 95% CI: 43%, 58%) practiced self-medication on conventional and herbal medicine, respectively. The predictors of self-medication of conventional medicine among pregnant women were prior experience to the drug (P-value: 0.00, AOR=126.04, 95% CI: 32.55-488.04) and no pervious history of abortion (P-value: 0.00, AOR=0.01,95% CI:0.002-0.04), while college educational level (P-value: 0.00, AOR=13.45,95%, CI: 3.58-50.5), history prior herbal medicine use (P-value: 0.00, AOR=9, 95% CI: 3.32-24.39), Ruta chalepensis (P-value:0.001,AOR=193.7,95% CI:8.64-4342.1) and Ocimum lamiifolium type of herb use (P-value: 0.004, AOR=12.72, 95% CI: 2.27-71.38), and 5-10km health facility distance (P-value:0.022, AOR=0.1, 95% CI: 0.01-0.73) were predictors for self-medication practice of herbal medicines among pregnant women. CONCLUSION Nearly one-third and two-third of pregnant women practiced self-medication on conventional and herbal medicine, respectively. Prior experience to the drug and no previous history of abortion associated with self-medication of conventional medicine, while college educational level, history prior herbal medicine use, Ruta chalepensis and, Ocimum lamiifolium type of herb use, and 5-10km distance were predictors for self-medication practice of herbal medicines. Improving health service coverage and awareness creation on rational medication use is recommended to prevent fetal and maternal risks.
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Affiliation(s)
- Abdu Tuha
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Abebe Getie Faris
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Solomon Ahmed Mohammed
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
- Correspondence: Solomon Ahmed MohammedDepartment of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie1145, EthiopiaTel +251910504378 Email
| | - Mengistie Yirsaw Gobezie
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Self-medication practice and associated factors among pregnant women in Addis Ababa, Ethiopia. Trop Med Health 2018; 46:10. [PMID: 29743807 PMCID: PMC5928590 DOI: 10.1186/s41182-018-0091-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/14/2018] [Indexed: 11/10/2022] Open
Abstract
Background Self-medication which is the act of obtaining and using one or more medicines without medical supervision is a common practice among pregnant women. Unless proper caution is taken, it may result in maternal and fetal adverse outcomes. In Ethiopia, information on self-medication practice during pregnancy is scanty. Hence, this study aimed to assess self-medication practice and associated factors among pregnant women in government health centers in Addis Ababa. Methods An institution-based mixed study design using a sequential explanatory approach was employed among 617 pregnant women and nine key informants in Addis Ababa from May 8, 2017, to June 30, 2017. Multi-stage sampling technique was used to select study participants, and purposive sampling technique was used to select the key informants. The quantitative data were collected using a structured interview questionnaire and analyzed using Statistical Product and Service Solutions (SPSS) version 23.0 whereas semi-structured questionnaire was used for in-depth interviews. Binary logistic regression was used for quantitative data analysis, and thematic analysis method was used for qualitative data. Results The prevalence of self-medication practice was 26.6%. Previous medication use (Adjusted odds ratio (AOR) = 4.20, 95% CI 2.70-6.53), gestational period (AOR = 0.63, 95% CI 0.41-0.98), education on self-medication (AOR = 0.36, 95% CI 0.21-0.62), previous pregnancy and delivery related problems (AOR = 1.71, 95% CI 1.06-2.76), and knowledge about risk of self-medication (AOR = 0.64, 95% CI 0.42-0.97) were significantly associated with self-medication practice. Lack of attention and priority of program designers, absence of strategies and guidelines; weak screening mechanisms, and regulatory enforcement were cited by the key informants as contributing factors for self-medication practices. Conclusions Considerable proportion of pregnant women practiced self-medication, including medicines categorized to have high risks. Gestational period, previous medication use, education on self-medication, previous pregnancy- and delivery-related problems, and knowledge were significantly associated with self-medication practice. In addition, there are correctable gaps in program designing, screening of pregnant women, regulatory enforcement, and strategies and guidelines. Hence, necessary measures at all levels must be taken to reduce risks of self-medication during pregnancy.
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Ebrahimi H, Atashsokhan G, Amanpour F, Hamidzadeh A. Self-medication and its risk factors among women before and during pregnancy. Pan Afr Med J 2017; 27:183. [PMID: 28904710 PMCID: PMC5579420 DOI: 10.11604/pamj.2017.27.183.10030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 06/04/2017] [Indexed: 11/17/2022] Open
Abstract
Introduction Self-medication can cause significant challenges for the individuals and community, especially in women during pregnancy. This study was aimed to compare the prevalence of self-medication before and during pregnancy among women in Iran. Methods in this cross-sectional study, a total of 384 pregnant women were evaluated for the prevalence of self-medication and its associated factors before and during pregnancy. Stratified random sampling was used as the sampling method. Descriptive statistics and chi-square and logistic regression tests were used for statistical analysis of data. Results The results showed that the prevalence of self-medication, in women who had become ill at least once, was 63.9% before pregnancy and 43.5% and during pregnancy. Variables such as lack of insurance, high school education and not having a child increased odds ratio of self-medication before pregnancy, while the variables of lack of insurance, not having a child or fewer number of children and no history of abortion increased the odds ratio of self-medication during pregnancy. Conclusion Although the prevalence of self-medication during pregnancy was less than that before pregnancy, but this prevalence during pregnancy was still significant. Therefore, it seems necessary to provide public trainings for all women of reproductive age and train them about the dangers and side effects of self-medication.
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Affiliation(s)
- Hossein Ebrahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Giti Atashsokhan
- Department of Midwifery, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Farzaneh Amanpour
- Department of Epidemiology and Biostatistics, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Azam Hamidzadeh
- Department of Midwifery, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Khalifeh MM, Moore ND, Salameh PR. Self-medication misuse in the Middle East: a systematic literature review. Pharmacol Res Perspect 2017; 5. [PMID: 28805984 PMCID: PMC5684864 DOI: 10.1002/prp2.323] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 04/13/2017] [Indexed: 11/10/2022] Open
Abstract
Regulations usually distinguish between prescription‐only (POM) and over‐the‐counter (OTC) medicines. The former requires medical prescription; the latter are available for SM of common minor or easily treated ailments. However, in the Eastern Mediterranean countries, theoretical prescription medicines can easily be purchased without a prescription, as self‐medication (SM) resulting in potential misuse and unnecessary risk for patients. The magnitude of this activity is uncertain. The aim of this article, therefore, is to undertake a comprehensive review to identify the different types of medicines that can easily be purchased as SM in Middle East and recognized as misused. An extensive review of the published literature (1990–2015) was conducted using Pubmed, web of science, Cochrane, and Google Scholar databases, for OTC medicine misuse in the Middle East. A total of 72 papers were identified. Medicines involved in misuse included: codeine containing products, topical anesthetics, topical corticosteroids, antimalarial, and antibiotics. Self‐medication misuse of medicines seemed widespread. Individual treatment patterns were not clearly identified. Studies were not standardized, limiting the comparability between studies and the estimation of the scale of misuse. Pharmacists, friends, or parents were found to be the main sources of SMs. Knowledge and attitudes are an important contributing factor in the misuse of these medications. Strategies and interventions to limit misuse were rarely identified in literature. In conclusion, a massive problem involving a range of medicines was found in Middle East. Standardization of studies is a prerequisite to the understanding and prevention of misuse of self‐medication.
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Affiliation(s)
- Malak M Khalifeh
- INSERM U 1219 - Pharmaco-épidémiologie et évaluation de l'impact des produits de santé sur les populations, University de Bordeaux, Bordeaux, France.,Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Nicholas D Moore
- INSERM U 1219 - Pharmaco-épidémiologie et évaluation de l'impact des produits de santé sur les populations, University de Bordeaux, Bordeaux, France
| | - Pascale R Salameh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
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Niknam R, Mousavi S, Safarpour A, Mahmoudi L, Mahmoudi P. Self-medication of irritable bowel syndrome and dyspepsia: How appropriate is it? J Res Pharm Pract 2016; 5:121-5. [PMID: 27162806 PMCID: PMC4843581 DOI: 10.4103/2279-042x.179576] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective: Self-medication is common among patients with gastrointestinal (GI) symptoms. This study was performed to evaluate self-medication among patients who fulfilled irritable bowel syndrome (IBS) and dyspepsia diagnostic criteria and to investigate the appropriateness of self-medication with chemical and herbal drugs. Methods: A prospective, descriptive cross-sectional study was conducted in outpatient's GI clinics at Shiraz from November 2011 to May 2012. A GI specialist visited the patients and recruited those who had IBS (base on Rome III adapted criteria) or functional dyspepsia. We surveyed self-medication among these patients, using a questionnaire containing specific questions about self-medication. Findings: One thousand four hundred and forty-seven patients visited by the GI specialist during the study period. Seven hundred and forty-seven patients had the inclusion criteria, 337 of them fulfilled criteria for IBS, with IBS-mixed (52%) being the most prevalent subtype, and 410 patients had dyspepsia. Overall, 78.8% of the total participants had recently sought medical attention for their GI complaint. Twenty-eight percent of patients selected inappropriate medication for their GI complaints. The H2-blockers class were most common medicines reportedly used. We did not find any significant relationship between age, gender, level of education, marital status, and self-medication frequency. Conclusion: Patients who fulfilled criteria for IBS had a high tendency to self-treat their GI symptoms, use of acid-suppressive agents was common among patients. Around one-third of patients self-treated GI symptoms inappropriately. Consequently, the concept of self-medication among patients has to be revised. We recommend conduction of educational programs to improve self-medications selection and attitude among patients to reduce the burden on other health care resources.
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Affiliation(s)
- Ramin Niknam
- Gastroenterohepatology Research Center, Shiraz, Fasa, Iran; Department of Internal Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Sarah Mousavi
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Laleh Mahmoudi
- Department of Clinical Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Paria Mahmoudi
- Pharmaceutical Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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