Self-Medication Practices, Prevalence, and Associated Factors among Syrian Adult Patients: A Cross-Sectional Study

Impact assessment of self-medication on COVID-19 prevalence in Gauteng, South Africa, using an age-structured disease transmission modelling framework

OBJECTIVE

To assess the impact of self-medication on the transmission dynamics of COVID-19 across different age groups, examine the interplay of vaccination and self-medication in disease spread, and identify the age group most prone to self-medication.

METHODS

We developed an age-structured compartmentalized epidemiological model to track the early dynamics of COVID-19. Age-structured data from the Government of Gauteng, encompassing the reported cumulative number of cases and daily confirmed cases, were used to calibrate the model through a Markov Chain Monte Carlo (MCMC) framework. Subsequently, uncertainty and sensitivity analyses were conducted on the model parameters.

RESULTS

We found that self-medication is predominant among the age group 15-64 (74.52%), followed by the age group 0-14 (34.02%), and then the age group 65+ (11.41%). The mean values of the basic reproduction number, the size of the first epidemic peak (the highest magnitude of the disease), and the time of the first epidemic peak (when the first highest magnitude occurs) are 4.16499, 241,715 cases, and 190.376 days, respectively. Moreover, we observed that self-medication among individuals aged 15-64 results in the highest spreading rate of COVID-19 at the onset of the outbreak and has the greatest impact on the first epidemic peak and its timing.

CONCLUSION

Studies aiming to understand the dynamics of diseases in areas prone to self-medication should account for this practice. There is a need for a campaign against COVID-19-related self-medication, specifically targeting the active population (ages 15-64).

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.

Efficacy of a 2-week therapy with levofloxacin concomitant versus a levofloxacin sequential regimen for Helicobacter pylori infection in the Syrian population: a study protocol for randomized controlled trial

BACKGROUND

Treating Helicobacter pylori is becoming increasingly difficult with the development of bacterial resistance to many established treatment regimens. As a result, researchers are constantly looking for novel and effective treatments. This trial aims to establish the efficacy of levofloxacin-based sequential treatment regimen and concomitant levofloxacin-based regimen as empirical first-line therapy in the Syrian population.

METHOD

This is an open-label, prospective, single-center, parallel, active-controlled, superiority, randomized clinical trial. The recruitment will target Helicobacter pylori-positive males and females between the ages of 18 and 65 to evaluate the efficacy of empirical first-line therapy in the Syrian population. We are planning to recruit up to 300 patients which is twice the required sample size. One hundred fifty individuals will be randomly assigned to undergo either a sequential levofloxacin-based treatment regimen or a concomitant levofloxacin-based regimen. High-dose dual therapy (proton-pump inhibitor and amoxicillin) will be the rescue therapy in the event of first-line failure. The first-line eradication rate in both groups is the primary outcome, and one of the secondary outcomes is the overall eradication rate of high-dose dual therapy in the event of first-line treatment protocol failure. Intention-to-treat analysis and per-protocol analysis will be used to evaluate the eradication rates of Helicobacter pylori for first-line treatment protocols.

DISCUSSION

For the first time in the Syrian population, this randomized controlled trial will provide objective and accurate evidence about the efficacy of a sequential levofloxacin-based treatment regimen.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06065267 . Registered on October 3, 2023. Prospective registered. Enrollment of the first participant has not started yet.

Relationship between the Health Literacy and Self-Medication Behavior of Primary Health Care Clientele in the Hail Region, Saudi Arabia: Implications for Public Health

BACKGROUND AND AIM

Because they are unaware of the potential adverse effects of medications, people frequently self-medicate as a form of self-care. This study aimed to investigate the factors associated with health literacy and the propensity to self-medicate among the primary healthcare clientele of the city of Hail, Saudi Arabia.

METHODS

This research employed a cross-sectional approach with the participation of 383 primary health center clientele of the Hail Region of Saudi Arabia. Participation was enacted via convenience sampling from December 2022 to February 2023. The data were collected using a self-administered questionnaire. The investigation utilized descriptive statistics as well as multiple linear regression and correlation for the data analysis.

RESULTS

Participants who were aged 30 years and above, single, had a college degree, were non-Saudi, had a white-collar occupation and received information from the internet/Google/YouTube had a significant relationship (p < 0.05) with health literacy. On the self-medication scale (SMS), there were significant relationships with age, marital status, educational level and occupation (p < 0.05). The nationality and source of information factors related to health had a positively significant effect on health literacy (p < 0.01), while middle age (24-29 years) had a positive effect on the self-medication scores (p < 0.01). There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS) scores (r = 421, p < 0.001).

CONCLUSION

Age of 30 years old or above, single status, a college degree, non-Saudi status, white-collar occupation and receiving information from the internet/Google/YouTube were all significant for health literacy. There were also significant relationships with the SMS scores for age, marital status, educational level and occupation. The factors affecting health literacy were older participant age, nationality and the source of information regarding health. Conversely, among the participants, being in the middle-aged group (24-29 years) was a factor that affected their self-medication scores. There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS).

Mortality and risk factors associated with peptic ulcer bleeding among adult inpatients of Damascus Hospital, Syria: A cross-sectional study

Peptic ulcer bleeding is associated with significant morbidity and mortality, while monitoring mortality is extremely beneficial to public health, and the latest estimates date back to 2010 for the Syrian population. This study aims to estimate the in-hospital mortality rate and risk factors associated with peptic ulcer bleeding among adult inpatients at Damascus Hospital, Syria. A cross-sectional study with systematic random sampling. Sample size (n) was calculated using the proportional equation: [n = Z2P (1 - P)/d2], with the following hypothesis: Z = 1.96 for the 95% confidence level, P = .253 for mortality in patients hospitalized with complicated peptic ulcers, a margin of error (d) = 0.05, 290 charts were reviewed, and the Chi-square test (χ2 test) was used for categorical variables, and the t test for continuous data. We reported the odds ratio in addition to mean and standard deviation with a 95% confidence. A P value less than .05 was considered statistically significant. Data were analyzed using a statistical package for the social sciences (SPSS). The mortality rate was 3.4%, and the mean age was 61.76 ± 16.02 years. The most frequent comorbidities were hypertension, diabetes mellitus, and ischemic heart disease. The most commonly used medications were NSAIDs, aspirin, and clopidogrel. 74 patients (25.52%) were using aspirin with no documented indication P < .01, odds ratio = 6.541, 95% CI [2.612-11.844]. There were 162 (56%) Smokers. Six patients (2.1%) suffered from recurrent bleeding, and 13 (4.5%) needed surgery. Raising awareness about the risks of using non-steroidal anti-inflammatory drugs may reduce the occurrence of peptic ulcers and, as a result, peptic ulcer complications. Larger, nationwide studies are needed to estimate the real mortality rate in complicated peptic ulcer patients in Syria. There is a lack of some critical data in the patients' charts, which necessitates action to correct.

The self-medication behaviors of residents and the factors related to the consideration of drug efficacy and safety-A cross-sectional study in China

Background: Over-the-counter (OTC) drugs facilitates residents self-medication. However, inappropriate self-medications have become a serious problem in China and even all over the world. Objectives: To make an investigation on the current status of Chinese residents' self-medication behaviors and important considerations, and to explore the factors related to the considerations of drug efficacy and safety. Design: A quantitative, cross-sectional study. Methods: Multi-stage sampling was used to conduct a cross-sectional investigation in China 22 provinces, 5 autonomous regions and 4 municipalities directly under the Central Government. State that an interviewer-administrated questionnaire, was used for data collection. The questionnaire that was used in the investigation included demographic sociological characteristics, health literacy scale-short form (HLS-SF), the 10-item Big Five Inventory (BFI-10), the EuroQol-5D visual analogue scale (EQ-5D VAS), self-medication status and important considerations when self-medicating. Descriptive statistics were performed, and the Chi-square test was used for univariate analysis. Log-binomial regression was used for multivariate analysis on whether residents regard drug efficacy or safety as an important consideration. Results: 9256 respondents were included in the data analysis. The self-medication rate of Chinese adults was as high as 99.1%. Paracetamol and other analgesics were the most common types of OTC medication that respondents purchased, followed by vitamins/minerals. Medical staff recommendations, drug safety and efficacy were the top three important considerations. The residents in the east, central and western regions who consider safety is 63.5%, 61.5%, and 66.8% respectively. The proportion of curative effect was 60.2%, 55.7%, and 61.4% respectively. Log-binomial regression showed that western respondents, retired people, those who mainly used ways including basic medical insurance for employees, commercial medical insurance, free medical treatment to cover their medical cost, respondents with high neuroticism, high health literacy were more likely to consider drug safety as an important factor (p < 0.05). Eastern respondents, employed, main way of medical expenses borne was Out-of-pocket Payment, those with chronic disease were more likely to consider drug efficacy as an important factor (p < 0.05). Female, respondents with high levels of agreeableness, conscientiousness, openness, and self-rated health status were more likely to regard both drug safety and efficacy as important considerations (p < 0.05). Conclusion: Self-medication is practiced by most Chinese adults. Whether Chinese adults take drug efficacy or safety as an important consideration is related to their demographic and sociological characteristics, Big Five personality characteristics, health literacy and self-assessed health status. There is a need to strengthen the management of OTC drugs and public education about self-medication.