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Audet C, Bertrand C, Martel MO, Pinard AM, Bérubé M, Lacasse A. Self-Medication Paths: A Descriptive Study Unveiling the Interplay Between Medical and Non-medical Cannabis in Chronic Pain Management. Clin J Pain 2024; 40:00002508-990000000-00202. [PMID: 39192773 PMCID: PMC11462876 DOI: 10.1097/ajp.0000000000001241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/12/2024] [Accepted: 08/15/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVES Cannabis is used by one-third of people living with chronic pain to alleviate their symptoms despite warnings from several organizations regarding its efficacy and safety. We currently know little about self-medication practices (use of cannabis for therapeutic purposes without guidance), mainly since the legalization of recreational cannabis in countries such as Canada has expanded the scope of this phenomenon. This study aimed to describe legal cannabis self-medication for pain relief in people living with chronic pain and to explore perceptions of the effectiveness and safety of cannabis. METHODS A cross-sectional descriptive study was performed among 73 individuals living with chronic pain and using cannabis (Quebec, Canada). Data collection using telephone interviews occurred in early 2023. RESULTS Results indicated that 61.6% of participants reported using cannabis without the guidance of a healthcare professional (self-medication). Surprisingly, among those, 40.0% held a medical authorization. Overall, 20.6% of study participants were using both medical and legal non-medical cannabis. Different pathways to self-medication were revealed. Proportion of women vs. men participants self-medicating were 58.2% vs. 70.6% (P=0.284). In terms of perceptions, 90.4% of the sample perceived cannabis to be effective for pain management; 72.6% estimated that it posed no or minimal health risk. DISCUSSION Cannabis research is often organized around medical vs. non-medical cannabis but in the real-world, those two vessels are connected. Interested parties, including researchers, healthcare professionals and funding agencies, need to consider this. Patients using cannabis feel confident in the safety of cannabis, and many of them self-medicate, which calls for action.
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Affiliation(s)
- Claudie Audet
- Département des sciences de la santé, Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn-Noranda
| | - Christian Bertrand
- Département des sciences de la santé, Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn-Noranda
| | - Marc O. Martel
- Department of Anesthesiology, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal
| | - Anne Marie Pinard
- Département d'anesthésiologie et de soins intensifs, Université Laval, Quebec City
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Université Laval, Quebec City
| | - Mélanie Bérubé
- Faculté des sciences infirmières, Université Laval, Quebec City
- Centre de recherche du CHU de Québec, Axe Santé des Populations et Pratiques Optimales en Santé, Traumatologie-Urgence-Soins Intensifs, Quebec City, Quebec, Canada
| | - Anaïs Lacasse
- Département des sciences de la santé, Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn-Noranda
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Zheng Z, Feng Z, Zhang D, Sun X, Dong D, Luo Y, Feng D. Does self-medication reduce medical expenditure among the middle-aged and elderly population? A four-wave longitudinal study in China. Front Public Health 2023; 10:1047710. [PMID: 36711405 PMCID: PMC9874163 DOI: 10.3389/fpubh.2022.1047710] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Self-medication has a high prevalence in the middle-aged and elderly population in China. Despite the published evidence demonstrating the economic benefits of self-medication, limited research has addressed the relationship between self-medication and individual medical expenditures, especially within the Chinese population. This study examined the effect of self-medication on individual medical expenditures in China and analyzed the heterogeneity between outpatient and inpatient cases. Methods We conducted a panel data analysis using data from four waves of the China Health and Retirement Longitudinal Study (CHARLS). Two-part mixed-effect models were implemented to estimate the effect of self-medication on total outpatient and inpatient expenses and out-of-pocket (OOP) costs, where mixed-effects logit regression was used as the first part, and generalized linear mixed models with log link and gamma distribution was used as the second part. Results We identified 72,041 responses representing 24,641 individuals, of which 13,185 responses incurred outpatient expenses and 9,003 responses incurred inpatient costs. Controlling for all covariates, we found that self-medication behaviors were significantly associated with a higher probability of outpatient service utilization (OR = 1.250, 95% CI = 0.179 to 0.269; P < 0.001), but displayed no significant association with outpatient expenses. Respondents who had taken self-medication were less likely to use inpatient services (OR = 0.865, 95% CI = -0.201 to -0.089; P < 0.001), and their inpatient expenses were significantly reduced by 9.4% (P < 0.001). Inpatient OOP costs were significantly reduced by 10.7% (P < 0.001), and outpatient OOP costs were significantly increased by 11.3% (P < 0.001) among respondents who had self-medicated. Conclusions This study allowed us to identify the economic value of self-medication among the middle-aged and elderly population in China. Future work should guide the middle-aged and elderly to take responsible self-medication to reduce their economic burden.
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Affiliation(s)
- Zehao Zheng
- School of Pharmacy, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Donglan Zhang
- Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, NY, United States
| | - Xiaobo Sun
- School of Statistics and Mathematics, Zhongnan University of Economics and Law, Wuhan, China
| | - Dong Dong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China
| | - Youxi Luo
- School of Science, Hubei University of Technology, Wuhan, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Da Feng ✉
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Kifle ZD, Mekuria AB, Anteneh DA, Enyew EF. Self-medication Practice and Associated Factors among Private Health Sciences Students in Gondar Town, North West Ethiopia. A Cross-sectional Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211005188. [PMID: 33759621 PMCID: PMC7995453 DOI: 10.1177/00469580211005188] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Self-medication is the most common practice worldwide and it may lead to irrational use of drugs. Therefore, this study aimed to assess the prevalence of self-medication practice and its associated factors among health science students. A cross-sectional study was conducted on 600 health science students in Gondar town. The data regarding self-medication practice and its associated factors were collected using a face-to-face interview on a structured questionnaire. SPSS −24 was used for data analysis and explained with univariate, and multivariate logistic regression analysis to determine the factors associated with self-medication practice (sex, age, religion, marital status, residence, department, year of study, monthly income, access to pharmacy, and peer/family pressure). A total of 554 students responded to the questionnaire with a response rate of 92.3%. Out of 554 respondents, 78.2% were practiced self-medication. Headache/fever 37.88% (n = 164) was reported as the most common complaint to practice self-medication. Among the reasons for self-medication practice, similarity of symptoms with past illness 33.49% (n = 145) was the most frequently reported. In current study, Females (AOR = 3.11, 95% CI = 1.55, 6.25), Muslim followers (AOR = 2.78, 95% CI = 1.30, 5.91), Protestant followers (AOR = 4.25, 95% CI = 1.38, 13.07), pharmacy students (AOR = 3.72, 95% CI = 1.97, 9.30), clinical nursing students (AOR = 2.88, 95% CI = 1.87, 14.48), monthly income (>500ETB) (AOR = 2.49, 95% CI = 1.12, 5.56), distance of health institution (<30 min) (AOR = 2.79, 95% CI = 1.39, 5.61), and accessibility of pharmacy (AOR = 4.85, 95% CI = 2.08, 11.29) were the independent predictors of self-medication practice. Self-medication is common in health science students in Gondar town. Health professionals should educate students on the risks and benefits of self-medication to encourage responsible self-medication. National guidelines on medicine access should be developed and strong measures should be implemented to halt the selling of medications without a proper prescription.
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Mekuria AB, Birru EM, Tesfa MT, Geta M, Kifle ZD, Amare T. Prevalence and Predictors of Self-Medication Practice Among Teachers' Education Training College Students in Amhara Region, Ethiopia: A Cross-Sectional Study. Front Pharmacol 2021; 11:593764. [PMID: 33603664 PMCID: PMC7884827 DOI: 10.3389/fphar.2020.593764] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/23/2020] [Indexed: 01/17/2023] Open
Abstract
Background: Self-medication practice is the use of medications without healthcare professional requests. It can lead to inappropriate medication usage, wastage of resources, increased chance of microbial resistance, and adverse drug reactions. Therefore, this study aimed at assessing the prevalence and associated factors of self-medication practice among teachers' education training college students in the Amhara region, Ethiopia. Methods: A multicentre cross-sectional study was conducted on 344 teachers' education training college students in the Amhara region, Ethiopia, from January 1 to February 28, 2020. Data on sociodemography, the practice of self-medication, and factors associated with self-medication practice were collected through a self-administered structured questionnaire. Systematic random sampling was used to select participants. Descriptive statistics and univariate and multivariate logistic regression analyses were done to determine various variables and factors associated with self-medication practice. Results: Out of the 344 respondents, 234 (68.0%) practiced self-medication. The most commonly cited indication for self-medication practice was headache (75, 32.05%), followed by abdominal discomfort (53, 22.6%). The respondents who were older than 26 years of age (AOR: 2.47, 95% CI: 1.18-3.94), were in the third year of study (AOR: 3.14, 95% CI: 1.94-5.79), lived in urban residence (AOR: 2.97, 95% CI: 1.06-3.64), had accessibility to a nearby pharmacy (AOR: 2.12, 95% CI: 1.43-4.46), and had peer/family pressure (AOR: 2.34, 95% Cl: 1.53-3.56) were significantly associated with self-medication practice. Conclusion: More than two-thirds of the study participants practiced self-medication. Being from an urban area, having access to a private pharmacy, and higher year of study positively affect self-medication practice.
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Affiliation(s)
- Abebe Basazn Mekuria
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eshetie Melese Birru
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Teshome Tesfa
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mestayet Geta
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemene Demelesh Kifle
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsegaw Amare
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kandasamy G, Sivanandy P, Almaghaslah D, Khobrani M, Chinnadhurai M, Vasudevan R, Almeleebia T. Knowledge, attitude, perception and practice of antibiotics usage among the pharmacy students. Int J Clin Pract 2020; 74:e13599. [PMID: 32593188 DOI: 10.1111/ijcp.13599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/23/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Resistance to antibiotics causes negative impact on health of the patients. Antibiotic resistance is the major global concern that has to be nullified for the better health outcome. The knowledge on antibiotics is very essential for the students who undertake pharmacy and health science courses. Hence a study was aimed to assess the level of knowledge, attitude, perception and practice on antibiotics usage among the pharmacy students of King Khalid University, KSA. MATERIALS AND METHODS A prospective online questionnaire based survey was carried out among the pharmacy students about knowledge, attitude perception and practice of antibiotics using 5-point "Likert scale" and true/false responses. The responses range from strongly agree to strongly disagree, and always to never were recorded. The data were analysed by using simple descriptive statistics. RESULTS Out of 300 students approached 212 responded and the response rate was found to be 71%. In this study, most (95%) of the students were aware of the emerging problem of antibiotic resistance due to inappropriate use of antibiotics. Majority (89%) of the students agreed the inappropriate use of antibiotics can increase the overall cost of treatment. However, over half of the (54%) students were not aware of the antibiotic resistance that may be a nation-wide problem of Kingdom of Saudi Arabia. The net positive response (NPR) and net other response (NOR) of all items in perception on antibiotics received more or less equal responses. CONCLUSION The knowledge of antibiotics usage among the students are considerably good compared with previous studies. However, the attitude, perception and practice on antibiotics usage among the pharmacy students are very poor. It alarms the need of appropriate education to enlighten antibiotic awareness for the better disease prevention and health outcomes for the benefit of patient community.
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Affiliation(s)
- Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Palanisamy Sivanandy
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Dalia Almaghaslah
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Moteb Khobrani
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Maheswari Chinnadhurai
- Department of Pharmacy Practice, College of Pharmacy, Shaqra University, Shaqra, Saudi Arabia
| | - Rajalakshimi Vasudevan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Tahani Almeleebia
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
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Zhang J, Xu L, Sun L, Li J, Qin W. Gender difference in the association of frailty and health care utilization among Chinese older adults: results from a population-based study. Aging Clin Exp Res 2020; 32:1985-1991. [PMID: 31745830 DOI: 10.1007/s40520-019-01410-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/02/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Frailty is a public health concern in the ageing population. Little is known about the role of gender in the relationship between frailty and health care utilization in older adults. AIMS The study aims to examine gender differences in the association between different frailty status and health care utilization among Chinese older people. METHODS A total of 7070 older adults (60+) from Shandong Province, China, were enrolled in this study. Frailty was assessed by frailty index constructed using 45 health deficits. Multivariate logistic regression models were employed separately for men and women to examine the impact of frailty on self-care, outpatient, and inpatient utilization. RESULTS Overall, the prevalence of frailty was 7.9% in older adults, with 7.1% and 8.3% in men and women, respectively. 49.4% respondents reported they had self-care in the previous 2 weeks, and women were more likely to have self-care than men. Being pre-frail and frail was significantly associated with utilization of all types of health care among older men and women, and the relationship was stronger in the frail groups than that in the pre-frail groups except for self-care. Respective odds ratios for outpatient utilization were higher in men than that in women. CONCLUSIONS Frailty is a frequent condition in Chinese older adults. The association between frailty and health care utilization (except outpatient) tended to be stronger in women than men. The gender differences should be considered when designing the preventing or delaying the installation of frailty and geriatric care plans.
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Affiliation(s)
- Jiao Zhang
- School of Public Health, Shandong University, Jinan, 250012, China
- NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012, China
| | - Lingzhong Xu
- School of Public Health, Shandong University, Jinan, 250012, China.
- NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012, China.
| | - Long Sun
- School of Public Health, Shandong University, Jinan, 250012, China
- NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Jiajia Li
- School of Public Health, Shandong University, Jinan, 250012, China
- NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012, China
| | - Wenzhe Qin
- School of Public Health, Shandong University, Jinan, 250012, China
- NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012, China
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Fereidouni Z, Najafi Kalyani M. A model to explain self-medication by Iranian people: a qualitative grounded theory study. BMC Public Health 2019; 19:1609. [PMID: 31791310 PMCID: PMC6889693 DOI: 10.1186/s12889-019-7953-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/15/2019] [Indexed: 11/10/2022] Open
Abstract
Background Self-medication (SM) is a common and global health problem. The process of attempting SM is still unclear. Exploration of SM and its contributing factors would help policymakers design and develop preventive programs. This qualitative study aimed to explore the process of attempting SM among Iranian people. Methods This grounded theory (GT) study was conducted among people with the experience of attempting SM (n = 17) and medical staff (n = 9) in Iran selected via semi-structured interviews. The recorded and transcribed interviews were analyzed using open, axial, and selective coding based on Strauss and Corbin’s (1998) approach. Results The study results revealed that people sought to deal as simply and quickly as possible with their illnesses/symptoms according to their attitudes towards and perceptions of illnesses/symptoms as well as their economic and social problems. This simple and quick approach was the participants’ main concern, resulting in taking decision-making strategies as SM facilitators. SM, in turn, provided short-term improvement and temporary satisfaction as a predominant outcome. Overall, “to avoid being trapped in the vortex of illness” was the central category, which covered and connected all the other categories developed in this study. Conclusions The elements of this model could be used as a guide for healthcare policymakers to design preventive programs and to plan for increasing people’s knowledge about the complications and consequences of SM. In addition, identification of barriers to referral to physicians and treatment of illnesses through the right way as well as reducing the health system’s problems would help reduce SM.
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Affiliation(s)
- Zhila Fereidouni
- School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Majid Najafi Kalyani
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Sunpuwan M, Punpuing S, Jaruruengpaisan W, Kinsman J, Wertheim H. What is in the drug packet?: access and use of non-prescribed poly-pharmaceutical packs (Yaa Chud) in the community in Thailand. BMC Public Health 2019; 19:971. [PMID: 31331304 PMCID: PMC6647088 DOI: 10.1186/s12889-019-7300-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 'Yaa Chud' is a non-prescribed poly-pharmaceutical pack containing several types of drugs, including antibiotics and steroids, which can be purchased over the counter in Thailand for self-medication. Although it is illegal, it is still available at some community outlets. This study aimed to understand access to and use of Yaa Chud at the community level in order to raise awareness on its usage and to provide policy recommendations to address the problem. METHODS This study employed qualitative methods, including in-depth interviews with 18 drug suppliers and 16 community members, and six focus group discussions. It included inventories from 17 drug suppliers. Data were collected in selected communities of the Kanchanaburi Demographic Surveillance System, located in the western region of Thailand.Thematic analysis was based upon the Health Services Utilization Model and conducted using the Open Code qualitative software program. RESULTS Overcrowding, long waiting times, and a perceived unwelcoming environment at public health-care service outlets were identified as factors that drive people into the private sector, where loose regulation of drug laws facilitates access and use of Yaa Chud. Migrants and older people were most likely to seek and use Yaa Chud, especially for mild illness. Availability, easy access through a user's network, low cost, and perceived effectiveness were identified as factors that enable access and use of Yaa Chud. CONCLUSIONS Though illegal in Thailand, Yaa Chud is likely to remain available for self-medication by community members, due to the persisting demand by the elderly and migrant workers. There is an urgent need to replace these mixed medications with better choices. Safer Yaa Chud may be a preferred, first-line health-care option, which could help reduce congestion in the formal health-care setting. At the same time, enforcement of regulatory compliance needs to be continued in order to stop the supply of unsafe Yaa Chud.
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Affiliation(s)
- Malee Sunpuwan
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Sureeporn Punpuing
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand.
| | - Wipaporn Jaruruengpaisan
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - John Kinsman
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden
| | - Heiman Wertheim
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- The Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Clinical Microbiology and the Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, Netherlands
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Jember E, Feleke A, Debie A, Asrade G. Self-medication practices and associated factors among households at Gondar town, Northwest Ethiopia: a cross-sectional study. BMC Res Notes 2019; 12:153. [PMID: 30890186 PMCID: PMC6425615 DOI: 10.1186/s13104-019-4195-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 03/13/2019] [Indexed: 11/10/2022] Open
Abstract
Objective Self-medication practice is the selection and use of medicines by individuals or a member of the individual’s family without physician’s order to treat self-recognized or self-diagnosed conditions. It is highly prone to inappropriate use and wastage of resources, increase drug resistance pathogens and adverse reactions. Therefore, this study aimed to assess self-medication practices and associated factors among households at Gondar town, Northwest Ethiopia. Results This community based cross-sectional study was conducted among households at Gondar town from March to June, 2018. The overall prevalence of self-medication practices among households at Gondar town were 50.2%. The odds of self-medication practices among unmarried participants (AOR = 3.12; 95% CI 2.35, 5.34), influenced by peer (AOR = 3.58; 95% CI 2.89, 7.28), poor perceived quality of health care services (AOR = 4.67; 95% CI 2.56, 7.96) and access to pharmacy (AOR = 2.32; 95% CI 1.65, 6.76) were higher compared with their counterparts. In the contrary, the lesser odd was observed among knowledgeable participants about medications (AOR = 0.27; 95% CI 0.16, 0.39) compared with non-knowledgeable. Therefore, improving perception of participants about quality of services, conducting awareness creation and managing negative effects of peer may reduce self-medication practices. Electronic supplementary material The online version of this article (10.1186/s13104-019-4195-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ebabu Jember
- Department of Pharmacy, College of Medical and Business, Addis Ababa, Ethiopia
| | - Amsalu Feleke
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O.Box 196, Gondar, Ethiopia
| | - Ayal Debie
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O.Box 196, Gondar, Ethiopia.
| | - Geta Asrade
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O.Box 196, Gondar, Ethiopia
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Fereidouni Z, Kameli Morandini M, Najafi Kalyani M. Experiences of self-medication among people: a qualitative meta-synthesis. ACTA ACUST UNITED AC 2019; 27:83-89. [PMID: 30680607 DOI: 10.1007/s40199-019-00244-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/15/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Self-medication is one of the major health-related problems in the world, which causes many problems for people and health systems. No comprehensive qualitative meta-synthesis has been done to understand the perceptions and experiences of self-medication among people. OBJECTIVES This study aimed to analyze, re-interpret, and synthesize the existing qualitative studies on perceptions and experiences of self-medication among people around the world. METHODS In this meta-synthesis, all published qualitative studies in PubMed, Scopus, CINAHL, and Web of Science databases were searched in May 2018. A total of 543 articles were screened in the primary stage and finally five articles that met the inclusion criteria were included in the meta-synthesis. The included studies were analyzed using Noblit & Hare approach. RESULTS Initially, 115 codes were identified. In the second stage, the codes were merged based on similarity and shared meanings. Finally, after checking by two authors, the following five themes were emerged: cost-effectiveness, affectivity, inefficiency of the healthcare system, previous experiences, and oversimplification. CONCLUSION The findings of this first meta-synthesis provided a comprehensive understanding of the perceptions and experiences of self-medication around the world. The findings showed that the experiences of self-medication could be classified into personal, social, organizational, and cultural categories. These findings could help policymakers address these perceptions and experiences in effective health planning.
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Affiliation(s)
- Zhila Fereidouni
- School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Majid Najafi Kalyani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Kassie AD, Bifftu BB, Mekonnen HS. Self-medication practice and associated factors among adult household members in Meket district, Northeast Ethiopia, 2017. BMC Pharmacol Toxicol 2018; 19:15. [PMID: 29636092 PMCID: PMC5894137 DOI: 10.1186/s40360-018-0205-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 03/26/2018] [Indexed: 11/26/2022] Open
Abstract
Background Self-medication practice (SMP) is the use of medication without the prescription of health care professionals. The major problems associated with self-medication practice have been drug resistance, drug side effects, wastage of resources, and serious health hazards including death. Thus, the main purpose of this study was to assess the prevalence of self-medication practice and its associated factors among adult household members in Meket District, Northeast Ethiopia. Methods A community based cross-sectional study was conducted among 722 adult household members in Meket District, from April 5 to May 5, 2017. The systematic random sampling method was used to select study participants. A pre-tested, structured questionnaire was used for data collection using an interviewer-administered technique. Epi-info version and SPSS version 22 were utilized for data entry and analysis, respectively. Univariate and multivariate logistic regression was used to identify association factors. Results The overall prevalence of self-medication was found to be 35.9%. Unmarried status (AOR = 2.17, 95% CI = 1.18, 4.01), previous experience of self-medication (AOR = 1.78, 95% CI = 1.22, 2.61), accessibility of pharmacies (AOR = 3.71, 95% CI = 1.31, 10.51), peer/family pressure (AOR = 2.88, 95% CI = 1.98, 4.18) and presence of medication at home (AOR = 1.80, 95% CI = 1.11, 2.92) were factors associated with self-medication practices. Conclusion More than one-third of the study participants practiced self-medication. Thus, strengthening communities awareness on drug side effects and integrated efforts of individuals, communities, health facilities, and regulatory bodies are highly necessary. Electronic supplementary material The online version of this article (10.1186/s40360-018-0205-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aster Desalew Kassie
- Boru Meda District Hospital, South Wollo Zone, Amhara Region, Southeast, Ethiopia
| | - Berhanu Boru Bifftu
- University of Gondar, College of Medicine and Health Science, School of Nursing, Gondar, Ethiopia
| | - Habtamu Sewunet Mekonnen
- University of Gondar, College of Medicine and Health Science, School of Nursing, Gondar, Ethiopia.
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Li J, Shi L, Liang H, Ding G, Xu L. Urban-rural disparities in health care utilization among Chinese adults from 1993 to 2011. BMC Health Serv Res 2018; 18:102. [PMID: 29426313 PMCID: PMC5807772 DOI: 10.1186/s12913-018-2905-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 01/31/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Despite economic growth and improved health outcomes over the past few decades, China still experiences striking urban-rural health inequalities. Urban and rural residents distinguished by the hukou system may experience profound disparities because of institutional effect. The aim of this study is to estimate trends in urban-rural disparities in self-care, outpatient care, and inpatient care utilization from a perspective of the hukou system. METHODS Data were extracted from the seven latest waves of the China Health and Nutrition Survey (CHNS). We used the hukou system to distinguish between urban and rural residents. Chi-square tests were performed to examine urban-rural gaps in self-care, outpatient care, and inpatient care utilization. Multinomial logistic regression was employed to confirm these disparities and to explore whether the urban-rural gaps have narrowed or widened from 1993 to 2011 once known determinants of utilization are taken into account according to Andersen/Aday's Health Behaviour Model. RESULTS The urban-rural disparities were evident after controlling for confounding variables: urban adults were 3.24 (p < 0.05), 2.23 (p < 0.1), and 4.77 (p < 0.01) times more likely to choose self-care vs. no care, outpatient care vs. no care, and inpatient care vs. no care than their rural counterparts, respectively. The results showed upward trends in self-care, outpatient care, and inpatient care utilization from 2004 to 2011. The urban-rural gaps in health care utilization gradually narrowed during the period of 1993-2011. The hukou distinctions of self-care, outpatient care, and inpatient care in 2011 were only 33.3%, 35.5%, and 9.6% of that in 1993, respectively. CONCLUSIONS Although rural residents were underutilizing health care when compared to their urban counterparts, the significant decrements in urban-rural disparities reflect the positive effect of the on-going health system reform in China. To maintain an equitable distribution of health care utilization, policy makers need to be aware of challenges due to aging problems and health expenditure increment.
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Affiliation(s)
- Jiajia Li
- School of Public Health Shandong University, Jinan, People’s Republic of China
| | - Leiyu Shi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Hailun Liang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Gan Ding
- School of Public Health Shandong University, Jinan, People’s Republic of China
| | - Lingzhong Xu
- School of Public Health Shandong University, Jinan, People’s Republic of China
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Lei X, Jiang H, Liu C, Ferrier A, Mugavin J. Self-Medication Practice and Associated Factors among Residents in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010068. [PMID: 29300318 PMCID: PMC5800167 DOI: 10.3390/ijerph15010068] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/06/2017] [Accepted: 12/22/2017] [Indexed: 11/18/2022]
Abstract
Background: This study aims to examine the prevalence and predictors associated with self-medication, and related consequences in Wuhan, China. Methods: Two-hundred-sixty residents were interviewed from randomly selected four districts of Wuhan, China. A modified version of Anderson’s health behavioral model was used in the survey to collect information of self-medication behavior. Multivariable logistic regression analyses were used to measure correlates of the prevalence of self-medication. Results: Nearly half of the respondents would select self-medication, and 39.1% would see a doctor if they felt sick. The most common self-medicated illnesses were cold and cough, cardiovascular disease and gastrointestinal disease. The main reasons for self-medication were that the illness was not severe (enough) to see the doctor (45%); the patient did not think that the trouble of seeing a doctor was worth the effort (23%); the patient had no time to see the doctor (12%), and the patient did not want to pay high medical costs (15%). Logistic regression results suggested that respondents tended to select self-medication if the illness was minor or short-term (less than seven days). Conclusions: Our findings suggest that more strict regulation on over-the-counter medicines may be required to reduce health risks related to self-medication. Targeted health education on the risks of self-medication should be considered.
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Affiliation(s)
- Xiaosheng Lei
- School of Management, Hubei University of Chinese Medicine, Wuhan 430065, China.
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia.
| | - Chaojie Liu
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.
| | - Adamm Ferrier
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.
| | - Janette Mugavin
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.
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Self-medication among the elderly in Iran: a content analysis study. BMC Geriatr 2017; 17:198. [PMID: 28863775 PMCID: PMC5580436 DOI: 10.1186/s12877-017-0596-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 08/22/2017] [Indexed: 12/03/2022] Open
Abstract
Background Self-medication is described as the use of drugs without a physician’s prescription to treat self-recognized illness or symptoms, and an important health issue among the elderly. Despite the wide range of different definitions, recognizing all forms of self-medication among older adults, particularly, in developing countries, help healthcare professionals and providers to reduce harmful effects of self-medication. The purpose of this study is to describe the practice of self-medication and its related factors among elderly people in Iran based on the experiences of people who are involved in this phenomenon. Methods This qualitative study was conducted using content analysis. Purposive sampling was used to select the participants and continued until saturation. The participants were the elderly, their care-givers, physicians, and pharmacists. Data was collected using semi-structured interviews, and analysis was done using an inductive approach. The theory of planned behavior was used as a framework to explain the role of the emerged factors in the occurrence of self-medication behavior. Results Based on the expressed experiences of the participants, factors related to the practice of self- medication among the elderly in Iran fit in these 5 categories: “patient’s attitudes towards disease, treatment, and physicians”, “living with disease”, “unfriendly environments”, “enabling health system”, and “influential others”. Conclusions Based on the results of this study, self-medication of the elderly in Iran has commonalities with many countries in regard to over-the-counter medications and complementary and alternative medicine; however, self-medication is also seen with drugs that require a prescription but can easily be obtained from pharmacies. Contributing factors, apart from the elderly themselves, include their families, caregivers, and social circle, the physical environment where they live, and the health system from which they receive services.
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Chung VCH, Wong SYS, Wang HHX, Wong MCS, Wei X, Wang J, Liu S, Ho RST, Yu ELM, Griffiths SM. Use of Traditional and Complementary Medicine as Self-Care Strategies in Community Health Centers: Cross-Sectional Study in Urban Pearl River Delta Region of China. Medicine (Baltimore) 2016; 95:e3761. [PMID: 27281074 PMCID: PMC4907652 DOI: 10.1097/md.0000000000003761] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/22/2016] [Accepted: 04/02/2016] [Indexed: 01/10/2023] Open
Abstract
In China, Community Health Centers (CHCs) are major providers of primary care services, but their potential in empowering patients' self-management capacity has not been assessed. This study aims to describe self-care practice patterns amongst CHC attendees in urban China.In this cross-sectional quantitative study, 3360 CHC patients from 6 cities within the Pearl Delta Region were sampled using multistage cluster sampling.Thirty-seven per cent had used with over-the-counter Chinese herbal medicines (OTC CHMs) in the past year and majority of respondents found OTC CHMs effective. OTC CHMs were more popular amongst those who needed to pay out of pocket for CHC services. Less than 10% used vitamins and minerals, and those with a lower socioeconomic background have a higher propensity to consume. Although doubts on their usefulness are expressed, their use by the vulnerable population may reflect barriers to access to conventional health care, cultural affinity, or a defense against negative consequences of illnesses. About 25% performed physical exercise, but the prevalence is lower amongst women and older people. Taiji seems to be an alternative for these populations with promising effectiveness, but overall only 6% of CHC attendees participated.These results suggest that CHCs should start initiatives in fostering appropriate use of OTC CHM, vitamins, and minerals. Engaging community pharmacists in guiding safe and effective use of OTC CHM amongst the uninsured is essential given their low accessibility to CHC services. Prescription of Taiji instead of physical exercises to women and older people could be more culturally appropriate, and the possibility of including this as part of the CHC services worth further exploration.
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Affiliation(s)
- Vincent C H Chung
- From the JC School of Public Health and Primary Care (VCHC, SYSW, MCSW, XW, SL, RSTH, ELMY, SMG); Hong Kong Institute of Integrative Medicine (VCHC, SYSW), The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR; School of Public Health (HHXW), Sun Yat-Sen University; School of Public Health (JW), Guangzhou Medical University, Guangzhou, Guangdong Province, China; and Institute of Global Health Innovation (SMG), Imperial College London, London, UK
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Liu C, Bryson SA. Why informally employed Chinese women do not go to the doctor. Health Promot Int 2015; 32:558-566. [DOI: 10.1093/heapro/dav104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dao A, Nichter M. The Social Life of Health Insurance in Low- to Middle-income Countries: An Anthropological Research Agenda. Med Anthropol Q 2015; 30:122-43. [DOI: 10.1111/maq.12191] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Amy Dao
- Department of Sociomedical Sciences; Columbia University
| | - Mark Nichter
- School of Anthropology; University of Arizona; Tucson
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18
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El-den S, Yee KC. Over-the-counter drugs for pre-menstrual syndrome: is the pharmacist still part of the picture? JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2014. [DOI: 10.1002/jppr.1025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sarira El-den
- Pharmacy Discipline, School of Psychological and Clinical Sciences, Faculty of Engineering, Health, Science and Environment; Charles Darwin University; Darwin Australia
| | - Kwang Choon Yee
- Pharmacy Discipline, School of Psychological and Clinical Sciences, Faculty of Engineering, Health, Science and Environment; Charles Darwin University; Darwin Australia
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Nga DTT, Chuc NTK, Hoa NP, Hoa NQ, Nguyen NTT, Loan HT, Toan TK, Phuc HD, Horby P, Van Yen N, Van Kinh N, Wertheim HFL. Antibiotic sales in rural and urban pharmacies in northern Vietnam: an observational study. BMC Pharmacol Toxicol 2014; 15:6. [PMID: 24555709 PMCID: PMC3946644 DOI: 10.1186/2050-6511-15-6] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 01/29/2014] [Indexed: 11/10/2022] Open
Abstract
Background The irrational overuse of antibiotics should be minimized as it drives the development of antibiotic resistance, but changing these practices is challenging. A better understanding is needed of practices and economic incentives for antibiotic dispensing in order to design effective interventions to reduce inappropriate antibiotic use. Here we report on both quantitative and qualitative aspects of antibiotic sales in private pharmacies in northern Vietnam. Method A cross-sectional study was conducted in which all drug sales were observed and recorded for three consecutive days at thirty private pharmacies, 15 urban and 15 rural, in the Hanoi region in 2010. The proportion of antibiotics to total drug sales was assessed and the revenue was calculated for rural and urban settings. Pharmacists and drug sellers were interviewed by a semi-structured questionnaire and in-depth interviews to understand the incentive structure of antibiotic dispensing. Results In total 2953 drug sale transactions (2083 urban and 870 rural) were observed. Antibiotics contributed 24% and 18% to the total revenue of pharmacies in urban and rural, respectively. Most antibiotics were sold without a prescription: 88% in urban and 91% in rural pharmacies. The most frequent reported reason for buying antibiotics was cough in the urban setting (32%) and fever in the rural area (22%). Consumers commonly requested antibiotics without having a prescription: 50% in urban and 28% in rural area. The qualitative data revealed that drug sellers and customer’s knowledge of antibiotics and antibiotic resistance were low, particularly in rural area. Conclusion Over the counter sales of antibiotic without a prescription remains a major problem in Vietnam. Suggested areas of improvement are enforcement of regulations and pricing policies and educational programs to increase the knowledge of drug sellers as well as to increase community awareness to reduce demand-side pressure for drug sellers to dispense antibiotics inappropriately.
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Affiliation(s)
- Do Thi Thuy Nga
- Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam.
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Wang Y, Jiang Y, Li Y, Wang X, Ma C, Ma S. Health insurance utilization and its impact: observations from the middle-aged and elderly in China. PLoS One 2013; 8:e80978. [PMID: 24324654 PMCID: PMC3855696 DOI: 10.1371/journal.pone.0080978] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 10/15/2013] [Indexed: 11/18/2022] Open
Abstract
Objective In China, despite a high coverage rate, health insurance is not used for all illness episodes. Our goal is to identify subjects’ characteristics associated with insurance utilization and the association between utilization and medical expenditure. Methods A survey was conducted in January and February of 2012. 2093 middle-aged and elderly subjects (45 years old and above) were surveyed. Results Heath insurance was not utilized for 12.6% (inpatient), 53.3% (outpatient), and 72.6% (self-treatment) of disease episodes. Subjects’ characteristics were associated with insurance utilization. Inpatient and outpatient treatments were expensive. In the multivariate analysis of outpatient treatment expenditure, insurance utilization was significantly associated with higher treatment cost, lost income, and gross total cost. Conclusion Utilization of health insurance may need to be improved. Insurance utilization can reduce out-of-pocket medical expenditure. However, the amount paid by the insured is still high. Policy intervention is needed to further improve the effectiveness of health insurance.
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Affiliation(s)
- Yu Wang
- School of Statistics and The Center for Applied Statistics, Renmin University of China, Beijing, China
- School of Public Health, Yale University, New Haven Connecticut, United States of America
| | - Yan Jiang
- School of Statistics and The Center for Applied Statistics, Renmin University of China, Beijing, China
| | - Yang Li
- School of Statistics and The Center for Applied Statistics, Renmin University of China, Beijing, China
| | - Xiaojun Wang
- School of Statistics and The Center for Applied Statistics, Renmin University of China, Beijing, China
| | - Chi Ma
- Humanities and Social Science College, Beijing Institute of Petrochemical Technology, Beijing, China
| | - Shuangge Ma
- School of Statistics and The Center for Applied Statistics, Renmin University of China, Beijing, China
- School of Public Health, Yale University, New Haven Connecticut, United States of America
- * E-mail:
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Yan W, Cheng L, Tan L, Yu M, Nie S, Xu B, Palm L, Diwan V. Using Medications Sales from Retail Pharmacies for Syndromic Surveillance in Rural China. Online J Public Health Inform 2013. [PMCID: PMC3692793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective Introduction Methods Results Conclusions
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Affiliation(s)
- Weirong Yan
- Karolinska Institutet, Stockholm, Sweden;,Huazhong University of Science and Technology, Wuhan, China;,Weirong Yan, E-mail:
| | - Liwei Cheng
- Huazhong University of Science and Technology, Wuhan, China
| | - Li Tan
- Huazhong University of Science and Technology, Wuhan, China
| | - Miao Yu
- Fudan University, Shanghai, China
| | - Shaofa Nie
- Huazhong University of Science and Technology, Wuhan, China
| | - Biao Xu
- Fudan University, Shanghai, China
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Xu JW, Xu QZ, Liu H, Zeng YR. Malaria treatment-seeking behaviour and related factors of Wa ethnic minority in Myanmar: a cross-sectional study. Malar J 2012; 11:417. [PMID: 23237576 PMCID: PMC3529692 DOI: 10.1186/1475-2875-11-417] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 12/08/2012] [Indexed: 11/14/2022] Open
Abstract
Background In Southeast Asia, data on malaria treatment-seeking behaviours and related affecting factors are rare. The population of the Wa ethnic in Myanmar has difficulty in accessing formal health care. To understand malaria treatment-seeking behaviour and household-affecting factors of the Wa people, a cross-sectional study carried out in Shan Special Region II, Myanmar. Methods The two methods, questionnaire-based household surveys to household heads and in-depth interviews to key informants, were carried out independently. The proportion of treatment-seeking patterns was calculated. Logistic regression was used to determine affecting factors of treatment-seeking. Qualitative data were analysed by using Text Analysis Markup System. Results Overall, 87.5% of the febrile population sought treatment, but only 32.0% did so within 24 hours. The proportion accessing the retail sector (79.6%) was statistically significant higher (P<0.0001) than accessing the public sector (10.6%). Multivariable logistic regression analysis identified family income, distances from a health facility, family decision and patient characteristics being independently associated with delayed malaria treatment. Conclusion Malaria treatment-seeking behaviour is not appropriate, and affecting factors include health service systems, social and cultural factors in Wa State of Myanmar.
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Affiliation(s)
- Jian-Wei Xu
- Yunan Institute of Parasitic Diseases, Puer, 665000, China.
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