Self-Medication in University Students from the City of Mansoura, Egypt

Prevalence of self-medication practices with antibiotics and associated factors among students in five colleges in Eritrea: a cross-sectional study

BACKGROUND

Despite their significant contribution to reducing mortality and morbidity from infectious diseases, antibiotics face challenges due to their inappropriate use, one of which is self-medication. This study assessed the prevalence of|| self-medication with antibiotics among Eritrean college students and its associated factors.

METHODS

An analytical cross-sectional study evaluated the prevalence of self-medication with antibiotics among students from five colleges from September 2019 to February 2020. Participants were selected through simple random sampling, and each participant completed a structured questionnaire covering socio-demographic characteristics, knowledge and attitudes toward antibiotics, and self-medication practices. Logistic regression analysis was employed to identify factors associated with self-medication with antibiotics.

RESULTS

The study distributed 380 questionnaires, with 375 returned, yielding a response rate of 98.68%. Findings revealed that 80.3% of participants were familiar with antibiotics. Additionally, 18.8% agreed with non-prescription antibiotic use for simple ailments. Of the 252 respondents who answered, 67.1% reported self-medication with antibiotics. Within the preceding six months, the prevalence of such self-medication was 34.3%. Factors associated with self-medication included college affiliation, with participants from the College of Science (COS) exhibiting lower odds (AOR = 0.38, 95% CI: 0.16-0.91, p = 0.03) compared to the College of Business and Social Sciences (CBSS) students. Those living in dormitories had 2.4 times higher odds (AOR = 2.42, 95% CI: 1.7-5.02, p = 0.017) to self-medicate compared to those living with family. Moreover, individuals unaware of antibiotic resistance had higher odds (AOR = 2.41, 95% CI: 1.24-4.7, p = 0.009) of self-medication. Attitude score was also significantly associated with self-medication (AOR = 0.88, 95% CI: 0.8-0.98, p = 0.027).

CONCLUSIONS

These results highlight the necessity for tailored educational programs to advocate for appropriate antibiotic utilization and mitigate the prevalent misuse of antibiotics among college students. Initiatives focused on increasing knowledge about the dangers linked with self-medication and advocating for conscientious antibiotic usage are essential in combating the escalating challenge of antibiotic resistance and safeguarding public health.

Self-medication, self-assessment and knowledge of dental medicine students about analgesics

Background

The objective of this study was to investigate the rate of self-medication among dental students and any differences and/or associations between self-medication, self-assessment and knowledge among students in later years of the same study.

Material and Methods

The study was conducted between April and July 2020 at the School of Dental medicine, University of Zagreb. All students were given access to an online survey to learn more about their self-medication habits, pharmacological knowledge and analgesic self-assessment. The experimental research group consisted of 120 third- to sixth-year students (n = 120), while the control group consisted of 30 first- and second-year students who had not taken any pharmacology courses.

Results

Even 110 students (91.67%) reported self-medication, with ibuprofen being the most prevalent analgesic (70%). Fifth-year students showed a statistically significant difference in all knowledge-related questions compared to third- and fourth-year students (p=0.0015 and p=0.002, respectively). In addition, in the self-assessment statements across all study years, a statistically significant difference (p<0.05) was also noticed. The feeling of willingness to prescribe analgesics behaved according to the increasing pattern over the years of study.

Conclusions

A statistically significant difference in self-medication, self-assessment and knowledge among dental students over the years, with the alarmingly high prevalence of self-medication among them, was observed. Because effective dental practice requires a thorough knowledge of pharmaceuticals, it is vital to continually expand and refine students' understanding of the use of analgesics in dentistry throughout their undergraduate studies. Key words:Analgesics, Self Medication, Self-Assessment, Knowledge, Dentistry, Students.

Clinical Toxicology of OTC Cough and Cold Pediatric Medications: A Narrative Review

Cough and cold symptoms (CCS) are common pediatric conditions often treated with over-the-counter (OTC) medications. However, the available knowledge regarding the safety and toxicity of these medications in children is inadequate. Therefore, understanding their clinical toxicology is crucial for safeguarding children's well-being. This narrative review highlights the importance of clinical toxicology in evaluating the safety and toxicity profile of OTC medications for treating CCS in pediatric patients. The pharmacology, clinical features, and adverse effects of various drug classes commonly found in cough and cold medications are briefly discussed. Pharmacokinetic and pharmacodynamic parameters are also examined to understand the interactions between these drugs and the body. OTC cough and cold medications often contain active ingredients such as antihistamines, decongestants, antitussives, expectorants, and analgesics-antipyretics. The combination of multiple ingredients in these products significantly increases the risk of adverse effects and unintentional overdoses. Several case studies have reported significant toxicity and even fatalities associated with the use of these medications in children. This review underscores the critical importance of clinical toxicology in evaluating the safety and toxicity profile of OTC medications employed for treating CCS in pediatric patients. The findings highlight the significance of informed clinical practice and public health policies to ensure the well-being of children using OTC cough and cold medications.

Knowledge attitude and convenience on self-medication practices among university students in Bangladesh exploration using structural equation modeling approach

Self-medication is a prevalent practice among university students globally and is a significant public health concern. However, previous research has been limited in scope, focusing primarily on adolescents or the general public, leaving a gap in understanding the causal relationships associated with self-medication; thus, this study aimed to investigate the factors influencing self-medication practices among university students in Bangladesh by developing a comprehensive causal model. Data from 417 students across five public universities were collected using the simple random walk technique by a team of 10 members. The study utilized constructs of knowledge, attitude, and convenience related to self-medication as independent variables, while self-medication practice as the dependent variable. One-way ANOVA and structural equation modeling (SEM) were employed to develop a causal model of self-medication practice among university students in Bangladesh. The findings revealed that students with better medication knowledge and adverse drug reactions (ADRs) were more likely to practice self-medication. A positive attitude towards self-medication and ADRs was also significantly associated with higher self-medication practice scores. Additionally, those who perceived self-medication as convenient and prescribed medication as inconvenient had higher self-medication practice scores. The attitude towards self-medication had the most substantial negative effect on self-medication practice, followed by the inconvenience of prescribed medication and the convenience of self-medication. The model explained 87% of the variance in self-medication practice, indicating a good fit for the data. University students in Bangladesh possess intermediate knowledge of medication and primary knowledge of ADRs. They exhibit a positive attitude towards self-medication and ADRs. Physical convenience favors self-medication, while the inconvenience of prescribed medication contributes to its lower preference. Policymakers should focus on evidence-based guidelines to reduce the extent of unnecessary self-medication practice and to enhance the quantity and accessibility of prescribed medications to address the issue effectively.

Prevalence and predictors of self-medication to prevent or treat COVID-19 among undergraduate students in Southern Brazil

Self-medication (SM) is the practice of consuming medicines without a prescription. Despite being a potentially dangerous action, SM is practiced globally and has been highlighted during the COVID-19 pandemic. The aim of this study was to evaluate SM for the prevention or treatment of COVID-19 and the factors associated with this practice among undergraduate students in Southern Brazil. A cross-sectional study was conducted between July and November 2020 using an electronic questionnaire to collect information about the practice of SM and the associated sociodemographic characteristics, health perception, and lifestyle. We collected 1,553 responses and identified a prevalence of 14.9% for SM. The risk factors for SM were earning between BRL 2,101 and BRL 5,250, studying at a public university, and studying a distance undergraduate course. The protective factors were age above 30 years, female sex, working or participating in internships, occasionally recommending their own medications to other people, and worsening health during the pandemic. The main drugs or products used were ivermectin, vitamins C and D, tea, azithromycin, zinc, and propolis. Our data could help in the development of health education measures to reduce SM among undergraduate students and guide the population regarding the risks of this practice.

Dispensing Errors and Self-medication Practices-Pharmacists' Experience in Tabuk: A Cross-sectional Study

Background

Community pharmacists are engaged in various professional activities starting from drug dispensing to promoting the well-being of patients. They dispense medications as stated in the prescription and are also licensed to prescribe over-the-counter (OTC) medications. Self-medication is widely practiced in various countries, which may lead to irrational drug use. The objectives of this study were to identify the factors associated with dispensing errors, to find ways to minimize dispensing errors, to identify patients' reasons for self-medication, and to find the drugs commonly utilized by patients as OTC medications and the sources of their drug information.

Methods

A cross-sectional survey of a convenience sample of 286 registered community pharmacists all over Tabuk was conducted using a self-administered questionnaire.

Results

Physician's unclear handwriting in the prescription was the major factor for dispensing error (2.6 out of 3) and writing the prescription clearly by the physician or using a printed form of prescription was an important factor in minimizing dispensing errors (2.91 out of 3). Previous similar complaints in the past were the main reason for self-medication (2.45 out of 3) with analgesics and antipyretics being the commonly dispensed drug groups dispensed as OTC medications (2.95 out of 3).

Conclusion

Self-medication practices and dispensing errors are widespread in Tabuk. Antibiotics were dispensed as OTC medication, which may lead to more chance of irrational drug use. Writing the prescription clearly and legibly would reduce dispensing errors. It is the community pharmacists' responsibility to increase awareness regarding the appropriate use of drugs to the public.

Unravelling the dilemma of self-medication in Egypt: a cross-sectional survey on knowledge, attitude, and practice of the general Egyptian population

BACKGROUND

Self-medication (SM) is a rising public health issue, especially in developing countries. It can be associated with various problems such as the delayed seeking of medical advice, drug interactions, and serious events such as antimicrobial drug resistance. We aimed to evaluate the Egyptian general population's knowledge, attitudes, and practices of SM.

METHODS

We employed a cross-sectional design between February 7th and March 8th, 2023 using a self-administered questionnaire available in Arabic. The questionnaire was developed based on previous studies and included four domains: sociodemographic data, knowledge, attitude, and practice of SM. We utilized both online (Google Forms) and paper surveys, utilizing convenience and snowball sampling methods. Data were analyzed using R Statistical Software (v4.1.3; R Core Team 2022).

RESULTS

1630 Egyptian individuals (838 females and 792 males) from the seven provinces were enrolled, with a median age of 25 years (IQR: 22-40). Around 55.97% and 48.28% of the participants had good knowledge and favorable attitudes regarding SM respectively, while 62.8% had practiced SM in the previous three months. The most frequently used medications were painkillers (60.74%) followed by antibiotics (32.13%) and antipyretics (28.61%). The pharmacist's recommendation was the source of SM for 53.61% while 31.53% used old medications at home. Most participants (59.08%) practiced SM because they thought they had simple or minor symptoms. The multivariate regression analysis revealed that females had significantly higher knowledge of SM than males (aOR: 2.10; 95%CI: 1.64-2.71; p-value < 0.001), with no significant differences in practice (aOR: 1.24; 95%CI: 0.99 - 1.56; p-value = 0.065). Individuals working or studying in the medical field were significantly more knowledgeable about SM (aOR: 4.30; 95%CI: 3.27-5.69; p-value < 0.001) and more likely to practice SM (aOR: 1.65; 95%CI: 1.26-2.17; p-value < 0.001). The odds of SM decreased with favorable attitudes (aOR: 0.44; 95%CI: 0.36-0.55; p-value < 0.001) while surprisingly, knowledge level was not significantly contributing to SM practice (aOR: 1.15; 95%CI: 0.90-1.48; p-value = 0.268).

CONCLUSIONS

SM is prevalent in Egypt, highlighting the importance of raising awareness and encouraging physician consultation as a priority. Governments, healthcare organizations, and educational institutions need to collaborate to provide the necessary support and resources.

The magnitude and predictors of self-medication amongst street dwellers in Ethiopia: a multicentre study

Background

Low levels of living standards amongst street dwellers worldwide limit their access to conventional healthcare services, resulting in self-medication use for the treatment of an illness. Nevertheless, self-medication use has risks, including adverse drug reactions, increased polypharmacy, drug resistance, drug dependence, drug interactions and incorrect diagnosis. Ethiopia has a large street-dwelling community; however, there are no studies conducted in Ethiopia assessing self-medication use amongst street dwellers. This study provides insight into self-medication use and predictors amongst street dwellers in Ethiopia.

Methods

A community-based, multicentre cross- sectional study was conducted amongst street dwellers from 1 September 2022 to 1 February 2023 at community drug-retail outlets in the three major cities in the Amhara region of Ethiopia. The data were obtained using an interviewer-administered questionnaire. Frequencies and percentages of descriptive statistics were calculated. Bivariable and multivariable logistic regression analyses were employed to indicate predictors of self-medication use. To determine statistical significance, a 95% confidence interval with a p value below 0.05 was utilized.

Results

The prevalence of self-medication use was 67.4%. Time and financial savings were reported as the reasons for most self-medication use. The most commonly reported illnesses for which people sought self-medication were gastrointestinal diseases. Low monthly income (adjusted OR 3.72, 95% CI 2.34-5.91) and residing near sewage areas (adjusted OR 3.37, 95% CI 2.03-5.58) were significantly associated with self-medication use.

Conclusion

Street dwellers had a high rate of self- medication use. Residing near sewage areas and having a low level of income were factors in self-medication use. Gastrointestinal diseases, respiratory ailments and dermatological conditions were the most frequently reported complaints, whereas antimicrobials and anthelmintics were the most commonly used medications. We recommend that healthcare services enhance outreach programmes to the most vulnerable people, such as street dwellers, especially those with lower monthly incomes and who live near sewage areas, to reduce self-medication rates.

Comparison of knowledge, attitude, practice and predictors of self-medication with antibiotics among medical and non-medical students in Tanzania

Introduction: Self-medication with antibiotics (SMA) is a widespread problem in developing nations, including Tanzania. Methods: This study compared knowledge, attitudes, practices, and factors influencing antibiotic SMA among medical and non-medical students. Results: The prevalence of SMA among medical students was 49.1% and 59.2% among non-medical students, respectively. The mean knowledge score of medical students (6.4) was significantly higher (p-value <0.001) than that of non-medical students (5.6). The main factors influencing SMA practices were the availability of antibiotics without a prescription, easy access to pharmacies, and a lack of knowledge about the risks of SMA. This experience was pivotal in influencing medical students to take antibiotics, with a substantial proportion of 67.5% as opposed to 59.4% of non-medical students. Medical students were 1.6 times more likely to self-medicate with antibiotics than non-medical students (Adjusted Odds Ratio (AOR): 1.6; 95% Confidence Interval (CI): 1.2-2.3, p-value = 0.004). Age was also associated with self-medication, with an AOR of 1.1 (95% CI: 1.04-1.2, p-value = 0.006) per year increase in age. Additionally, attitude was associated with self-medication, with an AOR of 1.05 (95% CI: 1.04-1.1, p-value = 0.001) per unit increase in attitude score. Discussion: No significant associations were found between sex, marital status, having children, year of study, knowledge score, and self-medication with antibiotics. This study emphasizes the importance of educational interventions and public awareness campaigns to promote antimicrobial stewardship, appropriate antibiotic use, and preventing pharmacies from dispensing antibiotics without a prescription.

Self-medication and medication storage practices among Lira University students in Lira city, Northern Uganda

Background

Self-medication (SM) is a global public health concern, particularly prevalent in developing nations. It involves the consumption of drugs without professional guidance, encompassing both over-the-counter and prescription medicines. Responsible SM can alleviate healthcare burdens, reduce costs, and empower individuals to manage minor ailments independently. However, improper SM practices can lead to adverse effects, contribute to antimicrobial resistance, and pose various health risks. This study aimed to evaluate the prevalence of SM and related practices of storing medications among students at Lira University, located in Lira City West Division, Northern Uganda.

Methods

This study adopted a quantitative cross-sectional design, focusing on students from various faculties. The sample size comprised 422 students, determined using the Kish Leslie formula. Data collection involved the administration of self-administered questionnaires, and subsequent data analysis was performed using SPSS version 25.

Results

The study involved participants from Lira University, primarily women (51.2%) with an average age of 23.82. A majority were Christians (59.7%) and single (87.9%). Most were from the Faculty of Health Sciences (63.7%), with third-year students being the largest group (48.3%). Regarding SM, 74.2% practiced SM, with antibiotics (69.2%) and tablets (69.2%) being commonly self-administered. In terms of medication storage, 93.4% kept medicines at home, mostly in cupboards (76.5%), but many were unsure about proper storage practices. Participants exhibited good knowledge of SM's risks and measures to reduce them. There was a significant association between the faculty of study and SM practices (p = 0.015), while other demographic factors showed no significant associations.

Conclusion

This study sheds light on the prevalent SM practices among students at Lira University in Northern Uganda. Notably, antibiotics were frequently self-medicated, raising concerns about antibiotic resistance. Additionally, medication storage practices emphasize the need for proper education on storage guidelines. However, the participants exhibited good knowledge of the risks associated with SM, suggesting the potential for effective awareness campaigns. The study recommends targeted health education programs, stricter regulations on medication sales, improved healthcare access, proper medication disposal, further research on the factors driving SM, collaborative efforts, and monitoring of antibiotic use to address this public health issue effectively.

A Comparative Study to Assess the Prevalence, Knowledge of Impact, and Practice of Self-Medication Among Adults in Urban and Rural Communities in Bangalore

BACKGROUND

Self-medication is the act of consuming medicines at the individual's own suggestion or recommendation by a family member, a friend, or untrained or unqualified health care personnel. Practice of self-medication differs among individuals and is influenced by several factors like age, educational status, gender, family monthly income, level of knowledge, and non-chronic illness.

AIM

This study aims to compare the prevalence, knowledge of impact, and practice of self-medication among adults in urban and rural communities.

MATERIALS AND METHODS

A non-experimental comparative study was conducted among adults in urban and rural communities practicing self-medication. In this study, the target population is aged between 21 and 60 years. The sample size is 50 urban adults and 50 rural adults. A convenient sampling technique method was used. The prevalence was assessed through a survey questionnaire. The self-structured questionnaire was used to assess the knowledge of impact, and a non-observational checklist was used to assess the practice which was adopted by the research investigator.

RESULTS

The present study results showed that the majority had inadequate knowledge (88%) regarding consuming self-medication in rural adults, there was overuse of self-medication practice (64%) in rural adults, and there was moderate usage of self-medication practice (64%) in urban adults. There was a statistically significant difference between knowledge and practice regarding self-medication among adults in urban and rural communities which was highly significant at p<0.05.

CONCLUSION

In the present study, comparison of the results of knowledge of impact and practice of self-medication among urban and rural adults revealed that urban adults have better adequate knowledge of impact of self-medication which helps them to practice moderate usage of self-medication.

Evaluating self-medication practices in Ethiopia

BACKGROUND

Self-medication with antibiotics has become an important factor driving antibiotic resistance and it masks the signs and symptoms of the underlying disease and hence complicates the problem, increasing drug resistance and delaying diagnosis. This study aimed to assess the extent of self-medication practice with antibiotics and its associated factors among adult patients attending outpatient departments (OPD) at selected public Hospitals, in Addis Ababa, Ethiopia.

METHODS

Facility-based cross-sectional study was employed. A systematic random sampling technique was used to include the study participants. Self-administered with structured questionnaires were applied among patients who visited outpatient departments at selected public Hospitals, in Addis Ababa. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 26. Descriptive statistics such as frequencies and percentages were used for the present categorical data. The data are presented in pie charts, tables, and bar graphs. Furthermore, bivariable and multivariable binary logistic regression analyses were used to identify significant associations. Statistical significance was declared at p value < 0.05.

RESULTS

Out of 421 respondents interviewed, 403 (95.7%) participants completed questionnaires. Among the respondents, 71% had generally practiced self-medication. Among these, 48.3% had self-medication with antibiotics, while 51.7% had used other drugs. The most commonly cited indication for self-medication practice was abdominal pain 44.9%, followed by Sore throat 21% commonly used antibiotics are amoxicillin (57%), ciprofloxacin (13%), amoxicillin/clavulanic (10%), erythromycin (8%), cotrimoxazole (7%), and doxycycline (5%).

CONCLUSIONS

Self-medication with antibiotics was common among the study participants. The prevalence of general self-medication was 71%, whereas that of self-medication with antibiotics was 48.3%. In general, the potentially dangerous effects of SMP seem to be underestimated by patients with OPD patients.

Prevalence and influencing factors of self-medication during the COVID-19 pandemic in the Arab region: a multinational cross-sectional study

BACKGROUND

The novel coronavirus pandemic (COVID-19) has begun with a wave of misinformation and fear of infection. This may have led people to self-medicate inappropriately. The World Health Organization describes self-medication (SM) as utilizing medicines to relieve symptoms or health conditions without consulting a physician. Inappropriate drug use is a burden on both health resources and patient health in the Arab region. This study aimed to detect the prevalence and influencing factors of self-medication among the general Arab population during the COVID-19 pandemic.

METHODS

A multinational cross-sectional study was conducted among the general population of ten Arab countries from early August to late October 2021. Participants aged 18 years or older could join the study via social media platforms. A convenience sampling technique was used. A developed and validated web-based questionnaire was used to collect data on self-medication practice, associated influencing factors, information sources, commonly used medications, and commonly treated conditions. Descriptive, univariate, and multivariate regression analyses were applied using IBM SPSS v 26 and R v 4.0.0 software.

RESULTS

A total of 8163 participants completed the questionnaire, and 518 participants were excluded from the analysis due to inconsistencies in their data. Almost two-thirds (62.7%) of participants reported practicing self-medication during the COVID-19 pandemic. At the country level, Egypt had the highest prevalence of self-medication practice (72.1%), while Palestine had the lowest prevalence (40.4%). The most commonly used drugs were analgesics, antipyretics, and vitamins (86, 65.1, and 57.1%, respectively), while antitussives and antibiotics scored 47.6 and 43.3%, respectively. Experience with similar health conditions (74.6%) and urgency of the problem (47.2%) were the most frequent factors that led to self-medication. Additionally, 38.2% of the self-medicated participants (SMPs) used drugs as prophylaxis against COVID-19. Pharmacist consultation was the most common source of information about self-medication (66.7%). Multivariate analysis showed that predictors of self-medication were older age (p = 0.008), presence of chronic illness (p = 0.015), and having monthly income or medical insurance that does not cover the treatment cost (p = 0.001, p < 0.001, respectively).

CONCLUSION

Self-medication is considered a common practice across the Arab population. It is necessary to regulate policies and raise awareness among the public about self-medication.

A Comparative Piloting of Determinants of Self-Medication Among University Students in the MENA Region; UAE and Jordan as an Example

PURPOSE

Unsupervised self-medication (SM) is a global public health concern. University students are particularly vulnerable due to misperceptions of improved academic performance and thus are at risk of dependence, addiction, and drug overdose. Past studies have shown an alarming prevalence of SM among university students in the Middle East and North Africa (MENA) region. However, there is a scarcity of reports from the region dissecting determinants of SM. Therefore, this study aimed to determine the prevalence and epidemiological correlates of SM among university students and its perceived impact on their academic performance.

METHODS

Two countries in the MENA region were surveyed in a cross-sectional design; UAE and Jordan. Through a stratified sampling technique, undergraduate students in both healthcare and non-healthcare majors of study were recruited to participate. A structured, self-administered questionnaire developed for the purpose of this study was distributed to consented participants via the university's official email. Statistical analyses were performed using SPSS. Descriptive and inferential statistics were used to analyze data. A p-value <0.05 was considered statistically significant.

RESULTS

A total of 362 students participated in the study (74% were females, 60% were from the UAE, and 59% were in healthcare majors). Significantly higher prevalence rates and adjusted odds of SM were found among females, students from Jordan, and those in healthcare majors, particularly for paracetamol (90.2% of females [p=0.001], 88.3% from Jordan [p=0.03], 92.5% in healthcare majors [p=0.001]) and antibacterial drugs (48.9% of females [p=0.01], 60.7% from Jordan [p=0.001], 53.3% in healthcare majors [p=0.001]). Majoring in healthcare fields was the most consistent determinant of such practice, while social influences of family and friends represented the chief source of recommendation. Only 21% of respondents assumed SM boosts their academic performance.

CONCLUSION

Our pilot study underlines the predominant determinants of SM among university students in the MENA region, namely female gender, students from Jordan, and those in healthcare majors. Informed data-driven awareness campaigns to mitigate such practice should be designed to focus on these susceptible populations.

Self-Medication Prevalence and Factors Associated with Knowledge and Attitude Towards Self-Medication Among Undergraduate Health Science Students at GAMBY Medical and Business College, Bahir Dar, Ethiopia

Background

Reports indicate that health science students are among the frontline of self-medication practitioners. The main objective of this study was to evaluate the self-medication (SM) practice and associated factors with knowledge and attitude of undergraduate health science students at GAMBY Medical and Business College, Bahir Dar, Ethiopia.

Methods

An institutional-based cross-sectional quantitative study was conducted using a self-administered questionnaire from May to July, 2022. A stratified random sampling method was applied to collect the data. The collected data were checked, and exported into SPSS 26. Descriptive statistics and regression analysis were performed to determine the results and the associated factors. Variables with p < 0.05 were regarded as significant.

Results

301 students (31 medicine, 163 pharmacy, and 107 medical laboratory students) responded (99% response rate). 68.1% of the respondents had practiced SM at least once within the last six months. 58.8% had good knowledge, while 55.5% have a positive attitude towards SM. Headache (33.7%) and cough (29.8%) were the primary disease conditions for SM. Analgesics (37.1%) and antimicrobials (29.8%) are most frequently self-consumed agents. Being a medicine student (AOR = 3.872; 95% CI: (1.263-11.866); p = 0.018), not having health insurance (AOR = 2.431; 95% CI: (1.383-4.274); p = 0.002), and not having a known medical illness (AOR = 2.241; 95% CI: (1.226-4.127); p = 0.010) were independently associated with good knowledge. While, living in an urban area was significantly associated with a positive attitude (AOR = 3.593; 95% CI: (1.404-9.197); p = 0.004).

Conclusion

The SM rate in GAMBY is significantly higher. Besides, not more than half the students had acceptable knowledge and attitude towards SM. The college and the surrounding regulatory authorities should consider ways of controlling and recapitalizing SM practices by the students.

Self-Medication in Rural Northeastern Romania: Patients' Attitudes and Habits

In recent years, many healthcare systems, along with healthcare professionals, have provided services in a patient-centered manner, in which patients are key actors in the care process. Encouraging self-care creates responsible patients, but it must be practiced responsibly. This study aims to analyze the tendency towards self-medication for patients from a rural area in Northeastern Romania. Data were collected using a questionnaire, which consisted of 25 questions, that has been developed by the research team. Student's T test or one-way ANOVA was used, and the reliability of the questionnaire was calculated using Cronbach's alpha coefficient. Fifty-eight patients agreed to participate and were interviewed. The results of the study suggest that respondents practice self-medication, which they resort to when their condition cannot be treated with natural remedies or herbs and when it impairs their ability to do their daily activities. Self-medication could be explained by the lack of self-care services as well as the trust patients have in the specific treatment. Patients prefer asking the pharmacist for drugs instead of visiting a physician, which could be due to higher accessibility and time-efficiency, while also being prone to stock up on certain medications due to limited access to healthcare.

Factors Associated with Self-Medication during the COVID-19 Pandemic: A Cross-Sectional Study in Pakistan

Self-medication (SM) is characterized by the procurement and use of medicines by bypassing primary healthcare services and without consulting a physician, usually to manage acute symptoms of self-diagnosed illnesses. Due to the limited availability of primary healthcare services and the anxiety associated with the COVID-19 pandemic, the compulsion to SM by the public has increased considerably. The study aimed to assess the characteristics, practices, and associated factors of SM by the public during the COVID-19 pandemic in Sargodha, Pakistan. χ2-tests and univariable analyses were conducted to explore the identification of characteristics and the potential contributing factors for SM during COVID-19, while multivariable logistic regression models were run to study the effect of variables that maintained a significant association. The study was performed during July−September 2021, with n = 460 questionnaires returned overall (response rate: 99.5%). The majority of respondents were males (58.7%, n = 270) who live in the periphery of the town (63.9%, n = 294), and most of the respondents belonged to the age group of 18−28 years (73.3%, n = 339). A large number, 46.1% (n = 212), of the participants were tested for COVID-19 during the pandemic, and among them, 34.3% (n = 158) practiced SM during the pandemic; the most common source of obtaining medicines was requesting them directly from a pharmacy (25.0%; n = 127). The chances of practicing SM for medical health professionals were 1.482 (p-value = 0.046) times greater than for non-medical health personnel. The likelihood of practicing SM in participants whose COVID-19 test was positive was 7.688 (p-value < 0.001) times more than who did not test for COVID-19. Allopathic medicines, acetaminophen (23.6%), azithromycin (14,9%), and cough syrups (13%), and over the counter (OTC) pharmaceuticals, vitamin oral supplements, such as Vitamin C (39.1%), folic acid (23.5%), and calcium (22.6%), were the most commonly consumed medicines and supplements, respectively; being a healthcare professional or having a COVID-test prior showed a significant association with the usage of Vitamin C (p < 0.05 in all cases). Respondents who mentioned unavailability of the physician and difficulty in travelling/reaching healthcare professionals were found 2.062-times (p-value = 0.004) and 1.862-times (p-value = 0.021) more likely to practice SM, respectively; SM due to fear of COVID was more common in individuals who had received COVID-tests prior (p = 0.004). Practices of SM were observed at alarming levels among our participants. Consciousness and understanding about the possible adverse effects of SM must be established and validated on a continuous level; in addition, on a commercial level, collaboration from pharmacists not to sell products (especially prescription-only medicines) without a certified prescription must be developed and implemented.

Prevalence and associated risk factors of self-medication with over-the-counter medicines among university students in the United Arab Emirates

Background

Proper self-medication with Over the Counter (OTC) medicines can benefit both the patient and the healthcare sector. Although OTC medications are considered relatively safe, their improper use can lead to serious health risks and implications. This study investigates the self-medication practices with OTC medicines among medical and non-medical students at different universities in the United Arab Emirates.

Methods

A cross-sectional study was carried out over six months (January-June 2021). The desired confidence level was set at 95%, and the precision level was 0.03. A three-step cluster sample method was employed. A self-administered questionnaire that assessed predisposing, enabling and need factors associated with the use of OTC medicines was developed based on Andersen's behavioural model.

Results

A total of 2355 students completed the study questionnaire. The mean age was 20.94, and 76.3% were female. More than half of the participating students (57.5%) reported using OTC medicines during the past 90 days of conducting the study. A good proportion (67.8%) reported performing a high level of self-care. Student's perceived health (p<0.0001), educational background (p=0.003), use of left-over drugs (p=0.002), relies on informal sources for drug information (p=0.0001) and reading drugs information leaflets (p<0.0001) were all significantly associated with whether students sought medical advice or not.

Conclusion

Many university students were observed that they never sought pharmacist advice when taking OTC medications. The likelihood of consulting a pharmacist when using an OTC medication was lower among medical students than non-medical students and among those who do not read the drug information leaflets. The proactive role that a pharmacist can play can have paramount importance in promoting the proper and safe use of OTC drugs.

Risk factors associated with self-medication among the indigenous communities of Chittagong Hill Tracts, Bangladesh

Background

In developing countries like Bangladesh, self-medication has become a predicament associated with health risks and clinical complications. To date, no studies have been conducted on the practice of self-medication among the indigenous population living in Chittagong Hill Tract (CHT).

Objectives

This study was aimed to determine the prevalence of self-medication and analyzing the factors associated with it among the indigenous population in CHT.

Methods

This cross-sectional study was conducted from late October to early December 2020; among different indigenous group populations residing in the three districts of CHT aged 18 or more. A pre-tested and semi-structured questionnaire was developed to collect data on socio-demographic characteristics, health status, frequency of self-medication, reasons for self-medication in last one year, as well as other variables. Multivariate logistic regression was performed to assess associated factors with self-medication.

Results

A total of 1350 people from different indigenous populations were interviewed, among whom 49.9% practiced self-medication. The rate of self-prescribed antibiotics usage (80.9%) was significantly higher compared to other drugs. Self-prescribed medications were mostly used for diarrhea and food poisoning (60.6%), cough, cold and fever (51.4%), and headache (51.4%). A common source of self-prescribed medicines was community or retail pharmacy and the most reported reason for self-prescribed medication was the long-distance of healthcare facilities from home.

Conclusion

The prevalence of self-medication is substantially high among indigenous people and the effect is alarming. Particular concern is the misuse of antibiotics and analgesic drugs. Increasing awareness among the population of the negative effect of self-medication and implementation of proper policies and actions are urgently needed to prevent self-medication among indigenous population in Bangladesh.

Influence of Medical Education on Medicine Use and Self-Medication Among Medical Students: A Cross-Sectional Study from Kabul

Objective

To compare the prevalence of self-medication among first- and fifth-year medical students at Kabul University of Medical Sciences.

Methods

A cross-sectional study was conducted with the participation of all first- and fifth-year medical students by using a short, self-administered questionnaire. The prevalence of self-medication was estimated in the entire study population and also in those who had used medicines in the preceding one week.

Results

Of the total 302 students, the prevalence of medicine use was 38%. The prevalence of self-medication in all study population was 25.16%, whereas in those who had used medicines was 64.9%. Prescription-only medicines consisted of 59.2% of self-medication. The practice of self-medication and the use of prescription-only medicines were more prevalent among students in their fifth year and among males. While the prevalence of medicine use was the same among males and females, it differed between students in the fifth and first year. Paracetamol, anti-infectives, and non-steroidal anti-inflammatory drugs (NSAIDs) were more frequently used medicines.

Conclusion

The use of medicines, self-medication and the use of prescription-only medicines were more prevalent among fifth-year students compared to those in the first-year. This apparently reflects the effect of medical education and training. More specific studies are required to address the issue in more detail and to facilitate interventions. The estimation of the prevalence of self-medication by using a short acceptable recall period, confined in those who had used medicines, seems to be more reasonable and accurate than by using a longer recall period in the entire study population. The prevalence of prescription-only medicines in self-medication could also be a useful indicator.

A comparative analysis of pattern and attitude towards self-medication among pharmacy and non-pharmacy students in University of Ghana

Introduction

self-medication involves the use of medicines without the input of health professionals. Available studies are not entirely conclusive on self-medication among health science versus non-health science university students. The current study therefore sought to investigate relevant aspects of self-medication among pharmacy and non-pharmacy students.

Methods

this quantitative cross-sectional research was conducted among undergraduate pharmacy and non-pharmacy students of the University of Ghana from October 1^st 2019 to December 6^th 2019. Using a questionnaire, interviews were conducted to assess the pattern and attitude towards self-medication among respondents within the last 2 months.

Results

a total of 337 (163 pharmacy and 174 non-pharmacy) students filled and completed questionnaires. The prevalence of self-medication was 55.2% for pharmacy and 51.1% for non-pharmacy students. Both pharmacy and non-pharmacy students were either accepting or ambivalent towards self-medication. Painkillers were the major class of medications that were self-medicated by both pharmacy (38.5%) and non-pharmacy students (30.7%). The most common reason for self-medication among pharmacy (62.2%) and non-pharmacy (56.2%) students was the need for rapid relief from an illness. Majority of the participants who were self-medicated (27.6% among non-pharmacy and 36.8% among pharmacy students) demonstrated ambivalent attitude towards self-medication. An increase in the study level reduced the likelihood of self-medication in both pharmacy and non-pharmacy students: OR=0.442, CI = 0.266-0.736 for pharmacy students and OR=0.671, CI = 0.456-0.987 for non-pharmacy students.

Conclusion

self-medication is common students of the University of Ghana. Prevalence of self-medication was higher among pharmacy students than non-pharmacy students. This study provides data for targeted education and sensitisation of self-medication among university students.

Prevalence, Perception, and Practice, and Attitudes Towards Self-Medication Among Undergraduate Medical Students of Najran University, Saudi Arabia: A Cross-Sectional Study

Background

Methods

Results

Conclusion

Prevalence of Over-the-Counter Cosmeceutical Usage and the Impact of a Health Education Intervention in Female Saudi University Students

Background‎

The reckless use of over-‎the-‎counter (OTC) cosmeceuticals among females is alarming due to possible health hazards, ranging from allergy to fatal anaphylaxis and toxicity.

Methods‎

In the current study, we investigated the prevalence of cosmeceutical use among female students at Princess Nourah bint Abdulrahman University (PNU) and tested the effect of a pilot health education program in improving their knowledge. A cross-sectional questionnaire-based study was performed with 515 participants.

Results‎

A significantly higher percent (81%) of participants used OTC cosmeceuticals than did not use them. The selection of OTC ‎‎cosmeceuticals was not affected by socioeconomic ‎status, chronic illness, cosmeceutical cost, or possible cosmeceutical side effects. Students from non-health colleges demonstrated poorer knowledge scores for the hazards of cosmeceuticals, which directed our attention to the importance of health education in this field. Therefore, a pilot interventional health education program was conducted with 54 participants to compare their ‎‎knowledge before and after the‎ intervention. At the end of the program, a higher‎ percentage of participants had improved their knowledge and realized the need to ‎consult a physician before using ‎OTC ‎‎cosmeceuticals.

Conclusion

The health education program had a significant impact on knowledge ‎concerning the use of cosmeceuticals, and it is recommended that such programs be included in ‎undergraduate extracurricular activity, especially for female students.‎.

Prevalence of Self-Medication in Portuguese Adolescents

Self-medication is considered one of the health-risk behaviours found among adolescents. The main objective of this study is to determine the prevalence of self-medication for Portuguese adolescents. An observational cross-sectional study was carried out. The sample comprised 420 adolescents, of whom 343 (81.7%; 95% CI: 77.8–85.2) had already self-medicated and 277 (66.0%; 95% CI: 61.4–70.5) self-medicated in the last 6 months. The main health problems that motivated self-medication were headache (76.7%), flu (70.6%), sore throat (56%), and fever (54.5%). Paracetamol was the most consumed drug (86.9%) followed by ibuprofen (83.1%). The pharmacy (87.8%) was the preferred place to purchase drugs; however, 221 adolescents (64.4%) reported that they self-medicated with the medicines they had at home. Of the adolescents who resorted to self-medication, only 59.6% sought additional information about the drug and 53.9% referred to the package leaflet of the medicinal product as the main source of clarification. A significant portion of the respondents (84.3%) believed that self-medication might be acceptable to treat minor illnesses. It was observed that self-medication is a very common practice among adolescents, making it an extremely important issue to carry out more studies on this section of the Portuguese population due to the scarcity of existing ones. These data can be used to define strategies for the dissemination of the rational use of the drug in the adolescent population.

University Students' Self-Medication Practices and Pharmacists' Role: A Cross-Sectional Survey in Hail, Saudi Arabia

Background: Self-medication is an important issue for health authorities around the world. It is also a common practice among university students. Objective: This study aimed to assess the prevalence of and reasons for self-medication among university students. Methods: A descriptive, cross-sectional community based survey design was adopted for the current study. All the students enrolled in Hail University, Saudi Arabia were selected to include in the study. Data was collected from February to April 2020 using a validated questionnaire and were analyzed using IBM SPSS Statistics, Version 22.0. Using convenient sampling technique, the total sample size calculated was 370 participants. A descriptive analysis was performed. Chi-square test and binary logistic regression was used for analyzing the data where statistical significance was set at p ≤ 0.05. Results: A total of 373 participants completed the questionnaire. The response rate was 84%. The overall prevalence of self-medication among the students was 98.2%. Of the 373 participants, 40.8% were men, and 59.2% were women. Furthermore, 56% were in fields other than health sciences, 23.1% were in preparatory foundation courses, and 20.9% were from the health and medical sciences. The most frequent medical condition that led to self-medication was headaches (92.85%), followed by coughs (37.5%), colic (31.9%) and influenza (30.3%). On univariate analysis, it is revealed that for both abdominal colic [OR 0.54 (0.34-0.86), p = 0.01] and constipation [OR 0.57 (0.32-1.02), p 0.05], female gender was observed significantly with low prevalence than male. However, for influenza, the self-medication prevalence [OR 1.86 (1.19-2.91), p = 0.006] observed was significantly higher in female participants than male. A significant association (p = 0.011) between the self-medication factors and gender was shown in the current study results. Conclusion: An alarming prevalence of self-medication among the students was recorded. Health care providers can increase awareness of the issue by educating individuals about the harmful effects of irresponsible self-medication.

Prevalence and predictors of self-medication among university students in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Self-medication of medicines is a global issue particularly among those with good access and familiarity with medications such as university students. It has a significant impact on drug resistance and medication-related complications. There are limited and inconsistent studies on self-medication practices in Ethiopia. The aim of this systematic review and meta-analysis was to estimate the pooled prevalence of self-medication and its predictors among university students in Ethiopia.

METHODS

A systematic review and meta-analysis was conducted to assess the prevalence and predictors of self-medication among university students in Ethiopia. Published articles from various electronic databases such as Medline, Hinari, Pub Med, Cochrane library, and the Web of Science were accessed. In addition, a manual search was performed including Google Scholar. Searching of articles were searched from January 1st to February 1, 2021. All observational studies conducted among university students in English language were included in the review. Two reviewers independently assessed articles before inclusion in the final review using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) instrument for critical appraisal. The I2 test was used to assess heterogeneity. Since the included studies exhibited high heterogeneity, a random-effects model was used to estimate the pooled prevalence of self-medication.

RESULTS

We found of 812 published and unpublished studies in our search. Finally, 31 full-text studies were reviewed, and 13 studies fulfilled the inclusion criteria and were included in the final meta-analysis. A total of 5377 study respondents from 13 studies were included in the study. The results of our study revealed that the pooled prevalence of self-medication among university students was 49.41% (95% CI 38.67%, 60.13%). The included studies had a sample size ranging from 250 to 792 with the lowest prevalence (19.87%) of self-medication from the University of Gondar, whereas the highest prevalence (77.01%) was recorded in a study conducted at Arsi University. From the pooled estimation, there was a significant association between self-medication and income (OR = 0.67: 95% CI 0.55-0.80). However, the association between self-medication and year of study and sex of participants was insignificant.

CONCLUSION

The pooled prevalence of self-medication among Ethiopian university students was relatively high compared to the current global health problem with an increase in anti-microbial resistance. Health professionals and concerned bodies should pay attention to raising awareness regarding the consequences of using medications without prescription.

Self-medication among medical students at the Copperbelt University, Zambia: A cross-sectional study

BACKGROUND

Self-medication is a common practice and cause for concern globally. There is a paucity of information regarding students' self‑medication in Zambia. Therefore, this study aimed at determining the self‑medication practices among the medical students at Copperbelt University.

METHODS

A descriptive cross-sectional study was conducted among 334 students. Data was collected using a semi-structured questionnaire, entered in excel, cleaned, and exported to SPSS version 21 for statistical analysis. Univariate analysis using Chi-Square or Fishers Exact test was performed. Independent predictors of self-medication practices were determined using logistic regression. Adjusted Odds ratios (AOR) and their 95% confidence intervals are reported.

RESULTS

A total of 334 medical students, with slightly more females (50.3%, n = 168), participated in the study. Of these 61.1% (n = 204) reported self-medicating. Reasons for self-medicating were the presence of long queues at health facilities and lack of time to visit the hospital. Only the year of study was independently associated with self-medicating with those in their 4th year of study being more likely to self-medicate [AOR:3.43, 95% CI: 1.52-7.73].

CONCLUSION

Students should be educated on the consequences of self-medication practices especially the rational use of antibiotics.

Self-Medication With Over-the-counter Medicines Among the Working Age Population in Metropolitan Areas of Thailand

Background and Objectives: Self-medication with over-the-counter (OTC) medicines is becoming an increasingly popular practice around the world. The global prevalence rate of self-medication ranges from 11.2% to 93.7%, depending on the target population and country. However, there is a lack of data on the prevalence and practices of self-medication among the working-age population, particularly in Thailand metropolitan areas. The current study describes the prevalence of self-medication practices, adverse drug reactions and severity, reasons for self-medication, and basic medication knowledge among people of working age in metropolitan areas in Thailand.

Methods: We conducted an online cross-sectional study between December 2020 and January 2021. Descriptive statistics were used to analyze self-medication data. A chi-square test was used to assess the association between self-medication and sociodemographic characteristics.

Results: This study found high prevalence of self-medication among the working-age population in metropolitan areas of Thailand (88.2%). The most commonly used drug groups were NSAIDs (34.8%) and antibiotics (30.2%). Minor illness and easy access to pharmacies were the most common reasons for self-medication. Almost half of the participants&apos; illnesses (42.6%) for which they self-medicated were not always completely cured, necessitating treatment at a hospital or clinic. Although only a small number of participants (ranged from 0.6 to 6.6%) experienced adverse drug reactions as a result of self-medication, some had severe symptoms that disrupted their daily lives or required hospitalization. In terms of basic medication knowledge, we discovered that study participants misunderstood some antibiotic drug concepts.

Conclusions: According to the study findings, it is recommended that more information about the risks of self-medication, drug adverse reactions, antibiotic stewardship, more supervision of the prohibition of over-the-counter drugs and selling practices, and adequate facilities for peoples access to medical services be provided at the policy level.

Knowledge, Attitude, Practices and Viewpoints of Undergraduate University Students towards Self-Medication: An Institution-Based Study in Riyadh

Rational and responsible self-medication (SM) is not only the key to better health outcomes, but also key to limiting adverse drug events. This institution-based cross-sectional study utilized seven- and four-item scales to assess the knowledge and attitude towards SM. Similarly, SM practices were measured using eight scale questions consisting of SM practice during the last six months, type of drug consumed, reason and frequency of SM, and so on. Statistical analyses were performed using SPSS. Overall, 371 students completed the questionnaire. The students with a good level of knowledge and positive attitude towards SM were 60.64% and 66.8%, respectively. About 55.5% of students practiced SM during the last six months using antipyretics (37.7%), multivitamins (36.4%), sleeping aids (20.2%), and anti-histamines (18.6%). Headache (79.2%), fever (37.7%), pain (25.9%), and colds and coughs (25.3%) were the illnesses for which they sought SM. The students admitted that drug side effects (75%), drug resistance (33.7%), drug interaction (41.5%), and poor treatment outcome (28.3%) were the consequences of irrational SM practice. Students (87.6%) propose that extending SM awareness through the Ministry of Health (83%) and pharmaceutical companies (48%) as major platforms would improvise the rational practice. Since AlMaarefa University students will be future healthcare professionals, their perception must be considered and accordingly educated to practice rational SM.

Self-medication Survey among Pharmacy Students in Iraq

Background:

Self-medication (SM) is the self-administration of treatment without a medical prescription or consultation or guidance from a physician or a health-care provides.

Aim and Objectives:

This study aims at understanding the existing prevalence of self-medication (SM) and finding out underlying circumstances among pharmacy students of the two universities.

Materials and Methods:

A study was undertaken involving pharmacy students of two universities in Baghdad. The students' responses obtained from a self-administered questionnaire were analyzed to assess the prevalence and attitude of students toward SM.

Results:

The data obtained from a valid questionnaire form answered by 188 students revealed that 63.3% had indulged in SM, and 39.9% reported practicing on rare occasions. The majority (48.9%) relied on the information received from the pharmacist with 44.7% and 16% of them had used over-the-counter and prescription-only medicines, respectively. 54.8% of participants were against SM but reported that it could be used in rare situations.

Conclusions:

The prevalence of SM was high among study participants. Therefore, necessary steps are needed to create awareness about the irrational use of SM and prevent the sale of medicines without a prescription.

Prevalence, knowledge and perception of self-medication practice among undergraduate healthcare students

BACKGROUND

Globally, self-medication is a common practice, and an increasingly perceived necessity to relieve burdens on health services. However, inappropriate self-medication may result to reduced health outcomes, increased antimicrobial resistance and economic waste. Healthcare students are the future health professionals who will be consistently responsible for educating the public on rational use of medication. This study therefore aimed to assess the prevalence, knowledge and perception of self-medication practices among healthcare students.

METHODS

A cross-sectional study was carried out among 866 healthcare students in a Nigerian University, comprising medical, nursing and pharmacy students. Information was garnered from respondents using a self-administered questionnaire. Data were summarized with descriptive statistics, while Chi-square and logistic regression tests were used for categorical variables at p < 0.05.

RESULTS

Mean age was 21 ± 2.8 years, and female respondents were 447 (51.6%). Prevalence of self-medication among respondents was 473 (54.6%). A total of 288 (55.3%) demonstrated good knowledge of self-medication practices, comprising 250 (52.2%) among those who have previously self-medicated and 229 (47.8%) among those who had not. Reasons for engaging in self-medication practices were mentioned to include treatment of minor ailments (357; 32.4%), while 248 (22.5%) believed they had the medical knowledge of what to use. Analgesic (353; 30.1%), antimalarial (352; 30.0%), and antibiotics (182; 15.5%) were the commonest classes of medication used for self-medication. Headache (363; 18.4%), malaria (334; 16.9%), and cough (184; 9.3%) were the most frequently treated conditions. More than half (281; 59.4%) of the respondents' purchased their self-medicated drugs from the community pharmacy. Gender and respondents' disciplines were found to be the independent predictors for good knowledge of self-medication practice.

CONCLUSION

Prevalence of self-medication among the studied healthcare students is moderately high, while approximately half demonstrates good knowledge and perception of self-medication practices. Stimulation for self-medication practice largely arise from the perception of treating minor ailments. This underscores a need for advocacy on responsible self-medication practice during the formal training of these future health professionals, in order to avert its imminent/widespread negative consequences.

Prevalence and Predictors of Self-Medication with Antifungal Drugs and Herbal Products Among University Students: A Cross-Sectional Study from Egypt

Background and Purpose

Irrational use of drugs for self-medication (SM) is a worldwide public health problem which results in treatment failure, economic loss, and increased burden of morbidity and mortality. Thus, the purpose of this study was to explore SM with antifungal drugs and herbal products among university students in Egypt.

Methods

A cross-sectional sectional study was conducted over 7 months among 403 university students in Egypt. The students were invited to complete a self-administered questionnaire through an online Google form. Questionnaire items included socio-demographic characteristics of the students, practice of and attitude towards SM with antifungal drugs, and SM with herbal products.

Results

Prevalence of SM with antifungal drugs among students stood at 38.2%. The main reasons for SM with antifungal drugs were perceiving their health problem as being minimal, followed by having fears of a doctor’s visit. About 73% of the students thought that SM was not a safe practice. Older age (AOR = 1.5, 95% CI= 1.3–1.8), affiliation to a private university (AOR = 3.7, 95% CI= 2.2–6.4), and being a medical student (AOR =2.4, 95% CI= 1.3–4.5) were the significant predictors of SM with antifungal drugs. A high prevalence of SM with herbal products (70.7%) was reported, with most students having used some form of herbal weight loss preparation (64%). Being a Cairo resident (AOR= 2.4, 95% CI =1.5–3.8, P<0.05) and being a medical student (AOR= 2.1, 95% CI =1.3–3.4, P<0.05) were the significant predictors of SM with herbal products.

Conclusion

In the current study, SM was common among Egyptian university students. Providing counseling and public health education to university students with regards to SM is crucial. Implementing strict regulations and the full enforcement of excitant laws pertaining to the use of medication supplies is also needed. Herbal products should face the scrutiny of evidence-based medicine. Further studies are needed to evaluate the impact of SM among university students.

Self-medication Practice and Associated Factors among Private Health Sciences Students in Gondar Town, North West Ethiopia. A Cross-sectional Study

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.

Knowledge and Practice on Ecopharmacovigilance and Medicine Storage Amongst Medical and Dental Students in Lalitpur, Nepal

Background

Medicines may remain unused and often get expired. Unused medicines can promote self-medication. Unsafe and improper medicine disposal can cause significant environmental harm. Medical and dental students as future prescribers should be aware of the safe disposal of medicines, ecopharmacovigilance and self-medication. The present study examines knowledge and practice about unused and expired medicines and medicine disposal among undergraduate medical and dental students in Nepal.

Methods

The study was conducted during September 2020 using an online survey form. First to final year undergraduate students provided their consent and signed an integrity pledge electronically. Age, gender, program of study, year of study, whether staying with family or not, method of financing education, and whether they had used any allopathic medicines during the past 6 months were noted. The total knowledge score among different subgroups was compared. The frequency of responses regarding practice items and the free-text comments were also listed. Statistical analysis was performed using Mann–Whitney test and Kruskal–Wallis test.

Results

Altogether 441 of the 668 students (66%) participated. The majority were below 23 years and female. Over 65% had used allopathic medicines during the last 6 months. The median knowledge score was 8 (maximum 10) and was significantly higher among older respondents, females and students in later years of study. Most kept unused medicines at home/hostel till expiry which were disposed of in the household garbage. Over 40% had educated their family members about safe medicine disposal. Knowledge scores were significantly different among subgroups according to respondents’ age, gender and year of study.

Conclusion

Respondents were aware of expiry of medicines and knew methods to safely dispose expired medicines. However, they practiced self-medication, stored medications at home and did not practice the safe disposal of medications. Understanding why respondents did not dispose medicines properly is important.

Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use:

https://youtu.be/-Cep9GAA5Aw

Self-Medication of Drugs in Nursing Students from Castile and Leon (Spain)

To determine the prevalence of self-medication in nursing students and their related factors, a transversal, descriptive study was performed on a sample of 378 nursing students. A total of 73.8% of the sample declared having used off-prescription drugs during the last month (2.84;2.26–3.58). A total of 28.9% said they did this because they are familiar with the health problem and its pharmacological solution and 25% deemed that it was a mild health problem. Drugs most commonly used off-prescription were analgesics in 88.91% (3.63;2.74–4.80) of occasions. They were mainly recommended by the students’ family (1.31;1.03–1.65) on 58.12% of the cases. Students keep analgesics they take off-prescription in their home first aid kit (4.47;3.28–6.08; p < 0.001). Unlike other studies, 53.2% obtained off-prescription drugs from the home first aid kit (1.13;0.89–1.43; p < 0.001). In addition, they gave advice and recommend drugs they have taken to other people with similar symptoms (1.97;1.59–2.44). A total of 85.72% kept excess drugs after a treatment (6.00;4.50–7.99). Self-medication is related to the storage of unused medicines and giving advice on the use of drugs to other people, among other things. Self-medication of drugs among nursing students is high. Thus, it appears necessary to review the training on rational the use of drugs and responsible self-medication in the discipline’s curriculum.

Prevalence and Predictors of Self-Medication Practice Among Teachers' Education Training College Students in Amhara Region, Ethiopia: A Cross-Sectional Study

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.

Study of Self-medication among First and Seventh Semester Medical and Dental Undergraduate Students of Tertiary Care Teaching Hospital in Nepal: A Descriptive Cross-sectional Study

Introduction:

Although appropriate self-medication can ease minor illness and is time and cost-effective, it can lead to irrational drug use and increased resistance, leading to prolonged morbidity. Inclined towards medical information and drug indices, medical students have an open arena for self-medication practice. This study was conducted to find the prevalence of self-medication among first and seventh semester medical and dental students in a tertiary care hospital.

Methods:

A descriptive cross-sectional study was conducted among medical and dental undergraduates from July 2020 to August 2020 after receiving ethical clearance from the Institutional Review Committee of Kathmandu University School of Medical Sciences (IRC Approval Number: 35/20). A questionnaire was responded to by participants through a google form. Participants were enrolled through the convenience sampling method. Data were collected and entered in Microsoft Excel and analyzed using Statistical Package for Social Sciences version 25.

Results:

Out of 199 respondents, the prevalence of self-medication was 100 (50.3%) (46.76-53.84 at 95% Confidence Interval). First semester medical 36 (73.5%) and dental undergraduates 24 (80%) had higher practice. Seventh-semester medical students 14 (51.9%) usually self-medicated within one day of onset of symptoms. Headache 47 (47%) was the most common indication. Analgesics 62 (62%) were most commonly used drugs procured most commonly from pharmacies 114 (57.3%). Dosage form was drug selection criteria for 120 (60.3%) students.

Conclusions:

Since self-medication is crammed with serious health hazards, proper exposure to the topic should be given to medical, dental students, and pharmacists. The implication of self-medication into the pharmacology syllabus is a must.

Knowledge, attitude, and practice of pharmacy and medical students regarding self-medication, a study in Zabol University of Medical Sciences; Sistan and Baluchestan province in south-east of Iran

BACKGROUND

Self-medication is defined as using medicinal products to treat the disorders or symptoms diagnosed by oneself. Although informed self-medication is one of the ways to reduce health care costs, inappropriate self-treatment can pose various risks including drug side effects, recurrence of symptoms, drug resistance, etc. The purpose of this study was to investigate the knowledge, attitude, and practice of pharmacy and medical students toward self-medication.

METHODS

This study was conducted in Zabol University of Medical Sciences in 2018. Overall, 170 pharmacy and medical students were included. A three-part researcher-made questionnaire was designed to address the students' knowledge, attitude, and practice. Statistical analysis was performed in SPSS 25 software.

RESULTS

According to the results, 97 (57.1%) students had carried out self-medication within the past 6 months. Overall, the students self-medicated on average 4.2 ± 2.9 times per year. Self-medication was more common in male students (65.4%, P = 0.043). Cold was the most common ailment treated with self-medication (93.2%), and antibiotics (74.4%) were the most commonly used drugs. The primary information sources used by the students were their previous prescriptions (47.4%). Pharmacy students had a higher level of drug information (P < 0.001). There was a statistically significant association between the level of drug information and the tendency for self-medication (P = 0.005). Disease recurrence was the most common negative complication of self-medication.

CONCLUSION

There is a need to educate pharmacy and medical students regarding self-medication and its side effects. The high prevalence of self-medication and the overuse of antibiotics can pose a significant risk of drug resistance.

Assessment of knowledge, perception, and awareness about self-medication practices among university students in Nepal

The objective of the present study was to assess the perceptions, knowledge, and awareness of self-medication practice among the university students in Nepal. This descriptive cross-sectional, questionnaire-based study was conducted on randomly selected 620 students from three different universities in Nepal. The study results revealed that 95.4% of students had reported self-medication, among which analgesics and antipyretic medications were mostly used (66 %); followed by anti-ulcerants (35.3%), antibiotics (33.9%), anti-allergic preparations (20%), and other categories (10.3%) of drugs. Study results also showed that, the major cause of self-medication was minor illness, and the prescriptions which were previously used to treat the similar disease conditions were the main source of motivation to do so. A significant portion of the respondents believed that self-medication might be acceptable to treat minor illness. Furthermore, students demonstrated variable responses regarding the doses, safety, toxicities, and health hazards towards self-medication without having appropriate knowledge of drugs. The findings of this study revealed the necessity of building awareness and strict implementation of the jurisdiction to minimize the practice of self-medication.

Assessment of community pharmacy management towards self-medication requests of tetracyclines for pregnant women: a simulated client study in Upper Egypt

Background Self-medication is a worldwide phenomenon of using medications without medical supervision. It is even more prevalent in low-income countries, where individuals seek community pharmacies because of accessibility and affordability. Although self-medication is associated with an increased risk of medication errors, few studies have been conducted to examine the quality of community pharmacy management towards self-medicating individuals of at-risk populations such as pregnant women. Objective We sought to investigate the quality of community pharmacies management of self-medication requests of tetracyclines for pregnant women. Setting The study was conducted in community pharmacies in Minya, Egypt. Methods A random sample of 150 community pharmacies was chosen from the urban areas of five districts of Minya, Egypt. To evaluate the actual practice, a simulated client was trained to visit pharmacies and purchase doxycycline for a pregnant woman. In a random subset of the sampled pharmacies (n = 100), interviews were conducted to evaluate pharmacy staff knowledge and attitudes regarding information gathering and dispensing practice. Main outcome measure Dispensing rate of doxycycline for pregnant women. Results From simulated client visits, almost all pharmacy staff (99.1%) dispensed doxycycline without requesting a prescription or collecting any information. About 25% of staff members did not abstain from dispensing even after knowing about pregnancy. On the other hand, most interviewed pharmacy staff (91.5%) reported that they ask about pregnancy before dispensing. Conclusion Our findings show that the current community pharmacy practice puts pregnant women at high risk of experiencing harmful self-medication outcomes. Therefore, strict legislative measures and pharmacy education programs should be considered in Egypt to lessen inappropriate dispensing rates in community pharmacies.

Socioeconomic Inequality in Self-Medication in Iran: Cross-Sectional Analyses at the National and Subnational Levels

Background

Self-medication (SM) is a public health concern globally. This study aimed to measure socioeconomic inequality in SM and identify its main determinants among Iranian households.

Methods

A total of 38,859 households from the 2018 Household Income and Expenditure Survey (HIES) were included in the study. Data on SM, household size, age, gender and education status of the head of household, monthly household’s expenditures (as a proxy for socioeconomic status), health insurance coverage and living areas and provinces were obtained for the survey. The concentration curve and the normalized concentration index (C_n) were used to quantify the magnitude of socioeconomic inequality in SM among Iranian households. The C_n was decomposed to identify the main determinants of socioeconomic inequality in SM in Iran.

Results

The results indicated that 18.2% (95% confidence interval [CI]: 17.7% to 18.5%) of households in Iran had SM practice in the past month. The results suggested a higher concentration of SM among the rich households (C_n= 0.0466; 95% CI= 0.0321 to 0.0612) in Iran. The concentration of SM among high SES households was also found in urban (0.0311; 95% CI=0.0112 to 0.0510) and rural (= 0.0513; 95% CI=0.0301 to 0.0726) areas. SM was concentrated among the rich households in Tehran, Qom, Esfahan, Ardebil, Golestan, and Sistan and Baluchestan provinces. In contrast, a higher concentration of SM was found among the poor households in Semnan, North Khorasan, Kerman, Bushehr, and South Khorasan provinces. The decomposition revealed SES of household, itself, as the main contributing factor to the concentration of SM among the wealthy households.

Conclusion

This study demonstrated that SM is more concentrated among socioeconomically advantaged households in Iran. Thus, effective evidence-based interventions should be implemented to improve awareness about SM and its negative consequences. Further studies are required to investigate the consequences of SM practice among people.

Consumption of Raw Herbal Medicines Is Associated with Major Public Health Risks amongst Ugandans

Background

Community consumption of herbal plants in developing countries is a common practice, however, scarcity of information on their physiochemical composition is a major public health concern. In Uganda, Vernonia amygdalina is of interest in rural communities due to its therapeutical action on both bacterial and protozoal parasites, however no studies have been conducted to assess the heavy metal concentrations in traditional plants used in alternative medicine. The aim of the study was to establish concentrations of heavy metals in Vernonia amygdalina, model the estimated daily intake (EDI), and assess both the non-cancer-related health risk using the target hazard quotient (THQ), and the risk related to cancer through the incremental lifetime cancer risk (ILCR) for the Ugandan population.

Methods

Leaves of Vernonia amygdalina were collected from 20 georeferenced villages and processed into powder in the laboratory using standard methods. These were then analyzed in the laboratory using an atomic absorption spectrometer for lead (Pb), chromium (Cr), copper (Cu), zinc (Zn), cobalt (Co), iron (Fe), cadmium (Cd), and nickel (Ni). Concentrations were compared against the World Health Organization (WHO) limits. The EDI, THQ, and ILCR were modelled and significance was measured at 95% confidence.

Results

The study showed that mean ± SEM concentrations of heavy metals were highest in the order of Cr, 121.8 ± 4.291 ppm > Ni, 84.09 ± 2.725 ppm > Zn, 53.87 ± 2.277 ppm > Pb, 40.61 ± 3.891 ppm > Cu, 28.75 ± 2.202 ppm > Fe, 14.15 ± 0.7271 ppm > Co, 7.923 ± 0.7674 ppm > Cd, 0.1163 ± 0.005714 ppm. Concentrations of Pb, Cr, Zn, Co, and Ni were significantly higher than the WHO limits. The EDI was significantly higher in children than in adults, demonstrating an increased risk of toxicity in children. The THQ and ILCR were over 1000 times higher in all Ugandans, demonstrating the undesirable health risks following oral consumption of Vernonia amygdalina due to very high Cr and Ni toxicities, respectively.

Conclusion

Consumption of raw Vernonia amygdalina was associated with a high carcinogenic risk, demonstrating a need to enact policies to promote physiochemical screening of herbal medicines used in developing countries against toxic compounds.

Knowledge, attitudes, and practices of Egypt's future physicians towards antimicrobial resistance (KAP-AMR study): a multicenter cross-sectional study

Antimicrobial resistance (AMR) is a growing threat that causes over 700,000 deaths per year worldwide. The goal of the current multicenter, cross-sectional study was to identify the knowledge and practice gaps in antimicrobial stewardship among Egypt's undergraduate medical students. Nine-hundred and sixty-three participants (375 male) from 25 medical schools responded to our self-administered questionnaire. Overall, the majority of students (96%) exhibited fair/satisfactory knowledge and attitude scores towards AMR. However, the most common misconceptions were that skipping one or two antimicrobial doses does not contribute to AMR (43%) and that antimicrobials are the drug of choice for the treatment of sore throat (38.8%). About 36% of the students thought that bacteria cause common cold and influenza. In terms of practices, about 62% of the students reported taking antibiotics when they have cough or sore throat and saving the remaining antibiotic for the next time. About 48% of the students reported that when they start feeling better, they stop the antibiotic course, and 41% stated that they often/sometimes discard the remaining leftover or share the leftover antibiotics with their friends. Interestingly, males had more frequently poorer levels of knowledge than females (p = 0.02). Moreover, students in the clinical science years (p < 0.001), living in urban areas (p = 0.02) or Cairo (p < 0.01) reported better practices than their counterparts. Educational programs about antimicrobial stewardship and the role of healthcare professionals in preventing AMR should be introduced early in medical curricula. Further, active educational techniques as clinical scenarios that simulate clinical settings and interactive learning workshops would be more efficient teaching methods.

Dispensing errors and self-medication practice observed by community pharmacists in Jordan

BACKGROUND

Drug dispensing is the major function of community pharmacists, the pharmacists should have the ability to counsel the patients and be aware of dispensing errors. Self- medication is a universal phenomenon that is widely practiced in developing countries and it may lead to irrational usage of drugs.

OBJECTIVES

The objectives of this study were identifying the factors that associated with dispensing errors and how to minimize them and identifying patients' reasons for self-medication, drugs purchased as Over-The-Counter drugs, patients' source of drug information.

METHODS

A cross-sectional survey of a stratified random sample of three hundred registered community pharmacists in all Jordanian regions (north, middle and south). Statistical analysis was done by using SPSS software version 17.0.

RESULTS

The majority of respondents were female (72.7%). Poor doctor's handwritten prescription was the major identified factor that associates with despising errors (3.78 out of 5) and improving doctor handwritten or using printed prescription was the most appreciated factor in reducing these errors (4.62 out of 5). Regarding community pharmacists' opinions toward self-medication practice, the majority said that it is not acceptable (4.12 out of 5) and most of the time it leads to bad sequences. Financial problem was the major reason behind self-medication (4.72 out of 5), analgesics/antipyretics were most drug groups that dispensed as OTC drugs (4.85 out of 5) and the pharmacists were a major source of patient' drug information.

CONCLUSION

Drugs dispensing errors and self-medication practices are widespread in Jordan and they should be regulated and restricted throughout applying strong policies and laws. They should be strictly enforced among pharmacies and there is a great responsibility to increase community awareness regarding appropriate drugs using.

Patterns and Practices of Self-Medication Among Students Enrolled at Mbarara University of Science and Technology in Uganda

Purpose

Self-medication is drug use without advice from a medical professional. Proper self-medication can reduce health expenses and physician waiting time. However, prescription or over-the-counter drugs are considered unsafe when used irrationally. Presumably, university students can make informed decisions regarding their lives. However, there are limited studies documenting self-medication in Ugandan universities. This study sought to document the prevalence, patterns and factors associated with self-medication among students enrolled at Mbarara University of Science and Technology (MUST).

Patients and Methods

A descriptive cross-sectional study was done on 385 medical and non-medical students. Data were collected by interviewer-led semi-structured questionnaires and analyzed using the Statistical Package for Social Sciences (SPSS) version 20. The statistical significance was considered as p < 0.05 for both univariate and multivariate analyses.

Results

This study showed a 63.5% prevalence of self-medication. Self-medication reasons were classifying illnesses as minor (33%), time-saving (15%), having old prescriptions (11%) and high consultation fees (9%). Not self-medicating reasons included risk of using wrong drugs (19%), insufficient knowledge (17%), fear of side effects (15%), wrong drug use (15%) and misdiagnosis (14%). Respondents accessed drugs from pharmacies (56%), friends/family (17%) or private clinics (15%). Headache relievers, pain relievers and antibiotics were most commonly self-medicated. In adjusted analysis, being female, existing allergies, and being in advanced years of study were associated with increased odds of self-medication. No statistically significant difference existed between medical and non-medical students regarding self-medication. Self-medication likelihood increased with a lack of access to medical services.

Conclusion

There is a high rate of self-medication amongst female students, those in advanced years of study and those with existing allergies. Medical services access significantly reduced the chances of self-medication. Vital medical services need to be extended to the university students to receive information on medicines, diagnosis, prescription and treatment. More studies should evaluate the impact of a high rate of self-medication among these students.

Self-Medication Practice and Associated Factors Among University of Gondar College of Medicine and Health Sciences Students: A Cross-Sectional Study

PURPOSE

Self-medication is the use of medicines by individuals to treat self-recognized illnesses or symptoms without any medical supervision. Such practices may cause antimicrobial resistance, which causes treatment failure, economic loss, serious health hazards, missed diagnosis, delayed appropriate treatment, drug dependency, and adverse drug effects. However, empirical evidence is limited to the current status of its practices and associated factors among university students. Thus, the aim of this study was to assess the magnitude and associated factors of self-medication practices among medicine and health science students at the University of Gondar.

METHODS

An institution-based cross-sectional study was employed from February to March 2017. A total of 792 randomly selected students were surveyed with a self-administered structured questionnaire. Epi Info version 7 and SPSS version 20 were used for data entry and analysis, respectively. Binary logistic regression analysis was performed. In multivariable analysis, P-value <0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to identify associated factors.

RESULTS

Self-medication practice was found to be 52.4% (95% CI: (49%, 56%)) among university students. For most students, the major reason for using self-medication was taking the illness as less serious (71.1%). Females (AOR: 1.48; 95% CI: 1.08-2.01), income category (USD 44.01-175.87) (AOR: 0.47; 95% CI: 0.29-0.78), sixth year students (AOR: 8.71; 95% CI: 4.04-18.77) and health officer students (AOR: 2.36; 95% CI: 1.20-4.63) were found to be significantly associated with self-medication practice.

CONCLUSION

More than half of the students practiced self-medication, which is moderately higher than other findings. Gender, income, year of study, and field of study were the major factors that affected self-medication. Therefore, interventions that can halt the high magnitude of self-medication and factors associated with it are crucial. Special attention should be given to students who stay in the university for longer years.

The impact of law enforcement on dispensing antibiotics without prescription: a multi-methods study from Saudi Arabia

Background: Dispensing of antibiotics without a prescription (DAwP) has been widely practised among community pharmacies in Saudi Arabia despite being illegal. However, in May 2018, the law and regulations were enforced alongside fines. Consequently, we wanted to evaluate the impact of these changes.Methods: A study was conducted among 116 community pharmacies in two phases. A pre-law enforcement phase between December 2017 and March 2018 and a post-law enforcement phase one year later. Each phase consisted of a cross-sectional questionnaire-based survey and a simulated client method (SCM) approach. In the SCM, clients presented with either pharyngitis or urinary tract infections (UTI). In SCM, for each phase, all 116 pharmacies were visited with one of the scenarios.Results: Before the law enforcement, 70.7% of community pharmacists reported that DAwP was common with 96.6% and 87.7% of participating pharmacies dispensed antibiotics without a prescription for pharyngitis and UTI respectively. After the law enforcement, only 12.9% reported that DAwP is still a common practice, with only 12.1% and 5.2% dispensing antibiotics without prescriptions for pharyngitis and UTI respectively.Conclusion: law enforcement was effective. However, there is still further scope for improvement. This could include further educational activities with pharmacists, physicians and the public.