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

Self-medication practice among the general public in Jordan: a cross-sectional study

Objectives

The phenomenon of self-medication is a noteworthy public health concern that is increasingly prevalent on a global level, particularly in developing nations. This study aims to explore the prevalence of self-medication of over-the-counter (OTC) medications among the general public in Jordan.

Materials and methods

This cross-sectional online survey study was conducted in Jordan between November and December 2022. An online questionnaire link was distributed to the study participants through social media platforms (Facebook, WhatsApp, and Instagram). The questionnaire tool for this study was adapted from a previously developed questionnaire by Tesfamariam et al. The questionnaire tool comprised four sections that examined participants' demographic characteristics, knowledge of OTC self-medication, attitudes toward OTC self-medication, and associated practices. Binary logistic regression analysis was used to identify predictors of OTC self-medication practice.

Results

A total of 1,218 individuals participated in this study. More than half of the study participants (56.9%) confirmed that they were currently using or had in the past year used medication(s) not prescribed by a healthcare specialist. Participants' agreement level on statements that reflected a positive attitude toward self-medication practice ranged between 13.1 and 33.0%. The statement most commonly agreed with was that 'OTC medications are safe but I would seek a physician's advice before using them' (57.7%). Individuals aged 36-40 years and 51 years and over, those who were married or divorced, those who were employed, and those who had chronic diseases were more likely to practice self-medication compared to others (p < 0.05).

Conclusion

The current study findings suggest a significant lack of awareness among the general population in Jordan regarding the expected efficacy of OTC medications. A restricted level of agreement was observed among the participants concerning the behavior of self-medication.

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.

Supporting health systems and environment in the Democratic Republic of Congo: A call for action

Background

Developing nations have to overcome a number of obstacles to fulfill the Sustainable Development Goals. The Democratic Republic of Congo is one of the five poorest nations in the world and faces several challenges in combating problems related to poverty, health, and sanitation while linking the environment to anthropogenic activities.

Methods

This study analyzes anthropogenic activities and their impact on the environment while providing access to the public health of the Congolese population based on the objectives of sustainable development. Thirty-five articles were selected for further analysis as well as relative data.

Results

In 2022, 21 million cases of malaria were recorded by the national malaria control program, with 13,000 cases of death. The Democratic Republic of Congo has the highest typhoid incidence, with 315 cases per 100,000 people. A number of 31,342 cases of cholera were reported in 2023, according to multiple reports, with 230 deaths, mainly affecting children. In the same year, a triple epidemic of typhoid, shigellosis, and cholera was identified, with 2389 cases and 52 deaths. These observations cause a health emergency, which can be alleviated and resolved by the establishment of an adequate sanitation system. Waste can be recycled and returned to usable raw materials.

Conclusion

Finally, it will be necessary to establish a water safety management plan to combat all diseases linked to the consumption of nonpotable water and improve national coverage on the treatment of recent cases to reduce and at best avoid observed cases of death.

Prevalence, practice, determinants and adverse effects of self-medication among young people living in a suburban community of Ekiti, Nigeria: A community-based cross-sectional study

Objectives

Health hazards such as adverse drug reactions and prolonged morbidity are fallouts of self-medication among young people in sub-Saharan Africa. The aim of this study was to assess the prevalence, practice, determinants, and adverse effects of self-medication among young people living in a suburban community of Ekiti, Nigeria.

Methods

This survey was a descriptive, cross-sectional study of 602 young people aged 16-24 years., who were randomly selected in the community. A predesigned self-administered questionnaire was used for data collection. The study was conducted from 1st March to 31st May 2023. The independent variables measured include the sociodemographic characteristics, while the dependent variables are the practice of self-medication and factors that predisposes to self-medication. The general characteristics of the participants were analyzed using descriptive statistics. The categorical variables were reported as frequency distribution and proportions with 95% confidence intervals and were compared using the Chi-square test or Fisher's exact test. A p-value of <0.05 was considered statistically significant.

Results

Over 30% (31.7%) of the participants engage in self-medication. A larger proportion of the people who practiced self-medication lived a trekking distance of less than 1 km from the nearest health facility with a doctor (p = 0.044). The practice of self-medication was statistically related with being a student when compared with gainfully employed and unemployed people (p = 0.006). Fever (39.8%), abdominal pain (17.3%) and headaches (16.2%) were the topmost three ailments that necessitated self-medication. Antimalarials (44.0%), antibiotics (25.1%), and antipyretics (16.8%) were high on the list of drugs used for self-medication. Headache (34.0%) was the most common adverse reaction from self-medication among the participants studied.

Conclusion

Adverse reactions and drug addiction were negative fallouts of self-medication, which can affect the health of young people as they grow into adulthood. Therefore, monitoring of drug outlets must be taken seriously by government agencies to prevent the worsening of the negative effects of self-medication.

Subchronic doses of artemether-lumefantrine, ciprofloxacin and diclofenac precipitated inflammatory and immunological dysfunctions in female Wistar rats

Recents reports have shown increases in the abuse of anti-malaria, antibiotic and analgesic drugs. This study evaluated the effects of co-administration of artemether-lumefantrine (AL), ciprofloxacin (CPX) and diclofenac (DFC) on inflammatory and immunological status of female Wistar rats. Ninety-six female Wistar rats were assigned into eight groups of twelve animals each. Group A was control, groups B, C, D, E, F, G and H were administered AL, CPX, DFC, AL + CPX, AL + DFC, CPX + DFC and AL + CPX + DFC respectively. Dosages of administered drugs were 178 mg/kg b/w of AL, 185 mg/kg b/w of CPX and 9 mg/kg b/w of DFC. Animals were sacrificed after 6 and 12 weeks of oral administration. Blood was obtained through cardiac puncture. The liver was harvested and processed for immunohistochemical analysis. Differential leukocyte count and neutrophil adhesion test was conducted on whole blood. Immunological response was assessed by the serum levels of C-reactive protein (CRP), interleukin-1β (Il-1β), interleukin-6 (Il-6), monocyte chemoattractant protein-1 (MCP-1), vascular cell adhesion molecule-1 (VCAM-1), myeloperoxidase, and total immunoglobulin G. Data were analyzed with Graph pad prism 5, using one way analysis of variance at 5 % level of significance. Total leukocyte, lymphocyte and basophils count increased (p<0.05) in B, C, E, F, G and H, while neutrophil count decreased (p<0.05) in D, E, G and H at 6 weeks. Neutrophil adhesion decreased (p<0.05) in B, E, F, G and H at 6 weeks. There was no significant difference (p>0.05) in the expression of Il-6, MCP-1 and VCAM-1 across the groups. Il-1β decreased in H, while CRP increased in H at 6 weeks and 12 weeks. MPO activity decreased (p<0.05) in B, C, D, E, G and H at 6 weeks, but increased (p<0.05) in D and G at 12 weeks. Immunohistochemical analysis indicated increase (p<0.05) in tumour necrosis factor-α in liver tissues of B, C, D, E, F and G, while nuclear factor erythroid 2-related factor 2 increased (p<0.05) in C, D, E, F and G, but decreased (p<0.05) in H at 12 weeks. The co-administration of AL, CPX and DFC induced inflammatory responses with attendant immunological dysfunctions and liver damage.

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.

Drug take-back program: assessment of knowledge, practices, and barriers to safe disposal of unused medication among healthcare students in a Nigerian university

BACKGROUND

The safe disposal of unused medication is a critical public health issue, with risks including environmental pollution, accidental ingestion, and misuse. Inadequate adherence to proper disposal methods among healthcare students could affect the practice of safe disposal of unused medicines as future healthcare professionals. This study, conducted at a Nigerian university, aimed to assess the knowledge, adherence to safe disposal practices, and barriers faced by healthcare professional students regarding unused medication disposal.

METHODS

A cross-sectional study was carried out among 930 healthcare students in a Nigerian University, comprising medical and surgery, nursing, pharmacy, physiotherapy, and medical laboratory science students. Information was gathered from respondents using a self-administered questionnaire. Multivariate analyses were used to evaluate the relationship between specific variables and participants' knowledge and practice scores, while chi-square and logistic regression tests were used for categorical variables at p < 0.05.

RESULTS

A total of 930 students participated in this study. The results revealed a significant gap in knowledge, with (67.7%; 630) of the participants unaware of proper disposal methods and most scoring either 0 (31.9%; 297) or 1 (46.0%; 428) out of 4 on a knowledge-based questionnaire. Pharmacy students were the most knowledgeable, with 44.4% falling into the high knowledge category. However, their knowledge did not always correspond to correct practices, with only (10.1%; 94) of participants reporting use of recommended disposal methods such as returning unused medicine to a pharmacy or a drug take-back program. Significant associations were found with course of study (χ²=12.14, p = 0.033) and awareness of correct disposal methods (χ²=4.035, p = 0.045). Those aware of the correct disposal method had a higher odds ratio of high knowledge score (OR = 1.62, 95% CI: 1.1-2.41, p = 0.018) compared to those who were not aware. In terms of disposal practices, those who had received training on safe disposal had significantly higher odds of good practice score (OR = 2.25, 95% CI: 1.36-3.74, p = 0.002). Major barriers identified included lack of access to drug take-back programs (50.4%; 469), lack of knowledge (36.8%; 342), and inconvenience (10.3%; 14).

CONCLUSION

A knowledge gap was revealed among the respondents regarding the safe disposal of unused medications. Despite the presence of knowledge and awareness, these do not necessarily translate into good disposal practices. This call for strategies to overcome identified barriers, with the aim to bridge the knowledge-practice gap and promote safe disposal of unused medication. The study underscores the urgent need for improved public health policies and educational programs on safe medication disposal.

Current rates of purchasing of antibiotics without a prescription across sub-Saharan Africa; rationale and potential programmes to reduce inappropriate dispensing and resistance

INTRODUCTION

Antimicrobial resistance (AMR) is a global concern. Currently, the greatest mortality due to AMR is in Africa. A key driver continues to be high levels of dispensing of antibiotics without a prescription.

AREAS COVERED

A need to document current rates of dispensing, their rationale and potential ways forward including antimicrobial stewardship programmes (ASPs). A narrative review was undertaken. The highest rates of antibiotic purchasing were in Eritrea (up to 89.2% of antibiotics dispensed), Ethiopia (up to 87.9%), Nigeria (up to 86.5%), Tanzania (up to 92.3%) and Zambia (up to 100% of pharmacies dispensing antibiotics without a prescription). However, considerable variation was seen with no dispensing in a minority of countries and situations. Key drivers of self-purchasing included high co-payment levels for physician consultations and antibiotic costs, travel costs, convenience of pharmacies, patient requests, limited knowledge of antibiotics and AMR and weak enforcement. ASPs have been introduced in some African countries along with quality targets to reduce inappropriate dispensing, centering on educating pharmacists and patients.

EXPERT OPINION

ASP activities need accelerating among community pharmacies alongside quality targets, with greater monitoring of pharmacists' activities to reduce inappropriate dispensing. Such activities, alongside educating patients and healthcare professionals, should enhance appropriate dispensing of antibiotics and reduce AMR.

[Evaluation of self-medication practices and their characteristics among Uvira in Democratic Republic of Congo students]

Introduction

self-medication poses a threat to public health. The purpose of this study was to evaluate self-medication practices among Uvira students in the Democratic Republic of the Congo (DRC).

Methods

we conducted a cross-sectional descriptive study based on an indirect interview of 700 students, using a self-administered survey questionnaire. Data were processed using XLSTAT.

Results

according to the survey conducted on these 700 students, the prevalence of self-medication was 99.3% (n=695), of which 42.3% (n=294) started during adolescence. Of the total respondents, 57.4% (n=399) said they resorted to self-medication every time they fell ill and were short of money (n=471, 67.7%) for a consultation. The most commonly cited pathology encountered during this practice was malaria (n=212, 30.5%). Of all drugs used, paracetamol was in the first place (n=106, 15.3%) while the tablet was the form most used by these students (n=598, 86%). In terms of the drug combination, Fansidar-Coartem (n=106, 17.2%) was the most common; the dosage was age-dependent in 65.6% (n=456) of cases. This study also showed that 37.4% (n=695) of the students interviewed used phytotherapy, mainly to treat malaria (n=124, 47.3%).

Conclusion

among Uvira students, self-medication is extremely used, especially against malaria. Efforts must be made by healthcare personnel in collaboration with policymakers to raise awareness about the rational use of medications, in order to better control and potentially eradicate this practice that is harmful to health.

Self-medication with over-the-counter drugs among consumers: a cross-sectional survey in a Southwestern State in Nigeria

OBJECTIVES

This study set out to assess the knowledge, perception and practices of consumers regarding self-medication with over-the-counter (OTC) drugs, the prevalence of risky practices and their associated factors in pharmacy outlets in Ibadan, Southwestern Nigeria.

SETTING

A cross-sectional study was conducted using an interviewer administered questionnaire. Descriptive statistics and multivariate analysis were performed by using SPSS V.23 with statistical significance set at p<0.05.

PARTICIPANTS

658 adult consumers aged 18 years and above.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was self-medication, measured using the following question: A positive answer indicates a self-medicated participant. Do you practise self-medication?

RESULTS

Respondents who had practised self-medication with OTC drugs were 562 (85.4%), of which over 95% were involved in risky practice. Consumers agreed (73.4%) that OTC drugs can be recommended by pharmacists and perceived (60.4%) that OTC drugs are harmless regardless of how they are used. Reasons for practising self-medication with OTC drugs include: if it is a minor condition, I can take the initiative (90.9%), visiting a hospital wastes my time (75.5%) and ease accessibility of the pharmacy (88.9%). Overall, (83.7%) respondents had good practices of handling and use of OTC drugs, while (56.1%) had good knowledge of OTC drugs and identification of OTC drugs. Factors associated with consumer handling and use of OTC drugs in self-medication were older participants (p=0.01), those with postsecondary education (p=0.02), and who possessed good knowledge (0.02), were more likely to practise self-medication with OTC drugs.

CONCLUSION

The study revealed a high prevalence of self-medication, good practices towards handling and use of OTC drugs, and moderate knowledge of OTC drugs by the consumers. This underscores the need for policy-makers to introduce measures to enforce consumer education by community pharmacists to minimise the risks of inappropriate self-medication with OTC drugs.

Safe Disposal of Unused Medicine among Health Professions Students at Makerere University: Knowledge, Practices and Barrier

Background

Environmental contamination with antimicrobial agents is one of the leading drivers of antimicrobial resistance (AMR) worldwide. However, scarce data exists concerning the factors fueling unsafe disposal of medicines globally. This study aimed to assess for the knowledge, practices, and barriers concerning safe disposal of unwanted medicines among health professions students (HPS) at Makerere University, Uganda.

Methods

We conducted a cross-sectional study using an online assessment tool sent through WhatsApp groups and E-mail addresses of undergraduate HPS at the College of Health Sciences Makerere University, Uganda between 1stFebruary and 16thMarch 2022.Good knowledge was defined as a score of 80% of the knowledge domain questions on a standardized questionnaire.

Results

We enrolled 205 participants, 135 (65.9%) were male, with a median age of 23 (range: 19 -43) years. Overall, 157 (76%) participants had good Knowledge. The mean knowledge score was 63%. About half (n=102, 49.8%) of the participants had unused medicines kept at their respective residential places, mainly antibiotics (27%, ×/102) and analgesics (21 %, ×/102). The most common method of medicine disposal was dumping into household garbage (n=103, 50.2%). Only 37 (18%) of participants had ever used the take-back method of medicine disposal. The most reported barriers for safe disposal were inadequate knowledge and insufficient advice from the dispensers concerning safe disposal practices. Year of study was the only factor significantly associated with knowledge about safe disposal of medicines, (adjusted Odds Ratio: 9.7, 95%CI 2.3 - 40.5, p= 0.002), with participants in higher academic years having more knowledge than those in lower years.

Conclusion

Despite a good knowledge level among the participants, the practice of safe disposal of unused medicines remains suboptimal in this population. Strategies aimed at enhancing safe disposal practices such as giving proper instructions to medicine buyers by dispensers regarding disposal practices are recommended to abate the growing burden of AMR.

Knowledge and Behavior in Rational Drug Use Among College Students in Zunyi City

Objective

To investigate the current status of knowledge and behavior about rational drug use in college students in different colleges and universities in a city in southwest China, providing reference for students’ education of rational drug use in colleges and universities.

Methods

A questionnaire survey on knowledge and behavior in rational drug use was carried out on the students recruited by occasional sampling method in 6 colleges and universities in Zunyi, China. Statistical analyses on demographic information and answers to questionnaire questions were carried out with SPSS 18.0.

Results

A total of 865 valid questionnaires were recovered from 923 questionnaires sent out. Some knowledge and behaviors of the students on drug use were irrational. There was statistically significant difference in some specific questions of the knowledge in rational drug use between medical and non-medical students (P<0.05); the average score of rational drug use behavior of medical students was lower than that of non-medical students (P<0.05); the average score of the rational drug use behavior of female students was lower than that of male (P<0.05); the students’ major types had significantly different influence on their behavior in rational drug use (P<0.05). The school-carried pharmacy education can effectively improve students’ rational medication; the majority of college students believed that it is necessary to popularize the knowledge of rational drug use on campus; and students’ favorite way to acquire knowledge about rational drug use was to attend related lectures or elective courses.

Conclusion

The knowledge and behavior of rational drug use among college students need to be improved. Professional medical education may exert a positive impact on rational drug use among college students. Thus, it is necessary to popularize the knowledge of rational drug use among college students, especially in non-medical colleges and universities.

Antimicrobial stewardship: Assessment of knowledge, awareness of antimicrobial resistance and appropriate antibiotic use among healthcare students in a Nigerian University

BACKGROUND

Inappropriate use of antibiotics is a major cause of antimicrobial resistance (AMR). Inadequate knowledge about AMR among healthcare students could affect their practice of antimicrobial stewardship as future healthcare professionals. This study aims to assess the use of antibiotics and knowledge of AMR among future healthcare professionals of a Nigerian University.

METHODS

Respondents' knowledge of antimicrobial resistance, use of antibiotics, and source of antibiotics in the past 12 months was explored using a self-administered questionnaire. Multivariate analyses were used to evaluate the relationship between specific variables and respondents' knowledge.

RESULTS

Of the 939 questionnaires administered to the students, 866 were filled given a response rate of 92.2 %. A total of (765; 88.3 %) of the respondents were aware that antimicrobial resistance makes it harder to eliminate the infection from the body as existing drugs become less effective. In all 824, (95.2 %) of the respondents had use antibiotics in the past 12 months. The use of antibiotics to treat malaria was self-reported by (175; 21.2 %). About half (432; 52.4 %) purchased the antibiotics from community pharmacies, while others obtained their antibiotics from the hospitals (192; 23.3 %), patent medicine stores (150; 18.2 %), and friends and family (50; 6.1 %) in the last 12 months. In all 506, (58.4 %) had good knowledge of antimicrobial resistance. Logistic regression shows that students in 3rd to 6th year 9.29 [AOR = 9.29, 95 % CI: (3.7-22.96)], had greater knowledge of antimicrobial resistance.

CONCLUSIONS

The healthcare students demonstrated a moderate knowledge of AMR. This underscores the need to adopt several educational tactics to introduce the concepts of AMR to the students and ensure there are strict policies to regulate the flow of antibiotics.