Medication storage and self-medication behaviour amongst female students in Malaysia

Understanding non-recreational prescription medication-sharing behaviours: a systematic review

BACKGROUND

Prescription medication sharing refers to the lending or borrowing of prescription medications where the recipient is someone other than the person for whom the prescription is intended. Sharing prescription medication can cause significant harm. Adverse consequences include an increased risk of side effects, delayed health seeking, and severity of disease. Prevalence estimates vary across different populations and people's reasons for, and perceptions of risks from, sharing are poorly understood.

AIM

To better understand prescription medication-sharing behaviours and practices - specifically, the prevalence, types of medications, reasons, perceived benefits and risks, and factors associated with medication sharing.

DESIGN AND SETTING

This systematic review included primary studies in any setting, focusing on people who engage in medication sharing.

METHOD

Electronic databases were searched from inception of databases to February 2023.

RESULTS

In total, 19 studies were included. Prevalence of lifetime sharing ranged from 13% to 78%. All 19 studies reported that analgesics were the most shared, followed by antibiotics (n = 12) and allergy medication (n = 9). Common reasons for sharing were running out of medication (n = 7), cost (n = 7), and emergency (n = 6). Perceived benefits included resolution of the problem and convenience. Perceived risks included adverse drug reactions and misdiagnosis. Characteristics associated with sharing included age, female sex, having asthma, and unused medicines stored at home.

CONCLUSION

Findings suggest that medication-sharing behaviour is common and involves a range of medicines for a variety of reasons. Data on the prevalence and predictors of prescription medication sharing are inconsistent. A better understanding of non-modifiable and potentially modifiable behavioural factors that contribute to sharing is needed to support development of effective interventions aimed at mitigating unsafe sharing practices.

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 MISUSE AND SELF-MEDICATION AMONG PHARMACY STUDENTS IN JORDAN

OBJECTIVE

Aim: To estimate risks and prevalence of self-medication and potential abuse risk among pharmacy students in Jordanian Universities.

PATIENTS AND METHODS

Materials and Methods: A cross-sectional study design was conducted with 450 students, selected using multistage sampling methods, from seven different universities. Data was collected by self-administrated questionnaires covering demographic and academic information, health-related information, use of self-medication, and pattern of self-medication among pharmacy students.

RESULTS

Results: Out of 394 students who answer the questions, 76.9% reported that they had usually treated themselves in case of simple cases without physician or pharmacist consultation. Most commonly used drugs among the surveyed students were Paracetamol 60%, multivitamins supplement 74.25%, and herbal products 37.2%, combination of NSAIDs and Paracetamol 20.6%, and laxatives 19.4%. Cold and flu 25.5%, headache 22.3%, abdominal pain 7.9%, gastric pain 7.9%, cold and flu, headache, abdominal pain, and gastric pain 14.9% were the main conditions which contribute to self-medication practice. It was also found that Pharmacy students were over-confident with the type of cases they could treat without referral to a specialist physician, despite knowing that some of the symptoms may be due to serious health problems. Misuse of analgesics and laxatives was clear, and there was a weakness in knowledge of the indications for the use of the most common drug.

CONCLUSION

Conclusions: The prevalence of self-medication among pharmacy students in Jordan is high, and medical teaching institutions need to educate students about the proper use of medicines. Strict legislation and more education on self-medication are necessary for effective use of medicines.

Pharmacy and Nursing Students' Knowledge and Practices Concerning the Disposal of Unused and Expired Medicines in Kosovo

This descriptive cross-sectional study aimed to assess the knowledge and practices of pharmacy and nursing students at a medical college in Kosovo concerning unused and expired medications. A self-administered questionnaire was distributed to 500 randomly selected students of pharmacy (200 questionnaires) and nursing students (300 questionnaires). Overall, 336 returned the filled forms and the response rate was 67.2. SPSS version 26.0 was utilized for statistical analysis. The results showed that 89.2% of pharmacy students and 82.2% of nursing students check the expiration date of medications before purchasing them and a considerable number of students stated that they possess unused medicines at home (78.4% of pharmacy and 74% of nursing students). Regarding disposal practice, over 50% of both nursing and pharmacy students dispose of unused and expired medications in the trash. A small proportion of students returned unused or expired medicines to the pharmacy (11.4% of pharmacy students and 10.7% of nursing students return unused medications, whereas 14.4% of pharmacy respondents and 10.1% of nursing respondents reported returning expired medicines). There was a statistically significant difference in the ways pharmacy and nursing students purchase pharmaceuticals and in their opinions regarding institutions in charge of disposing of unused and expired medicines (p = 0.000). Students are aware of the detrimental effects improper disposal of unused and expired medicines has on the environment and public health, but lack information regarding the return of unused and expired medicines to the pharmacy. To change the existing practice the most appropriate method would be to add additional lectures on safe disposal practices into existing modules. It is recommended for involved stakeholders in Kosovo to organize training, seminars, and workshops for health professionals especially pharmacists and nurses, since they pass the information to patients/consumers as well as the government to make amendments to current legislation to ameliorate the returning procedures for patients/consumers in pharmacies.

Over-the-Counter Medicine Attitudes and Knowledge among University and College Students in Brunei Darussalam: Findings from the First National Survey

Over-the-counter (OTC) medicine is defined as safe and effective for the general public to use, without seeking therapy from a health professional. As primary social media and internet users, university and college students are more likely to be exposed to unverified sources of health information. This study aims to assess the knowledge, attitudes, and behaviour of students at institutions of higher learning in Brunei with regard to the safe use of OTC medicines. A cross-sectional study was performed using a self-administered online questionnaire, adapted from the literature with additional information from the United States Food and Drug Administration (FDA) on the educational resources in understanding OTC medicine for consumers. The questionnaire consisted of 4 sections: demographic information, knowledge of OTC medicines, attitudes, and practice. Descriptive and inferential statistics were used for data analysis. A total of 335 students returned a completed questionnaire. The students had a mean knowledge score of 7.1 out of 9, with more than half (53.4%) having good knowledge (knowledge score > 7), and only a small percentage (5.7%) with poor knowledge. Almost all of the students (99.7%) had a positive attitude toward OTC medicine use. Few of the students practiced improper habits in terms of OTC medicine use, such as not reading the instructions or taking more than the recommended dose. Awareness of proper OTC medicine use among students in institutions of higher learning is necessary to prevent the rise of inappropriate user practices.

Self-Medication Practice with Antibiotics and Its Associated Factors Among Community of Bule-Hora Town, South West Ethiopia

Background

Self-medication with antibiotics is being practiced worldwide with high prevalence, mostly in developing countries. Several factors induce the practice of self-medication, such as irrational and uncontrolled dispensing of medicinal substances, difficulty accessing health-care systems, and cost of diagnosis. Thus, this study assessed the prevalence of self-medication with antibiotics, and its associated factors among the community of Bule-Hora town, South West Ethiopia.

Methods

A community-based cross-sectional study design was used. All households residing in Bule Hora town were used as source population and households in the selected kebeles were included by using a systematic random sampling method. Eight hundred twenty-six study participants were selected for the study. Pre-tested structured questionnaires had been used to collect the required data. Then the collected data were checked for completeness and analyzed by using SPSS version 20. Odds ratios with 95% C.I. were used to measure the association between independent variables and outcome and variables with p-value <0.05 had been considered statistically significant.

Results

Prevalence of self-medication with antibiotics in the past 12 months prior to the data collection was found to be 38.9% [95% CI (1.56, 1.64)]. Being male (AOR = 1.53; 95% CI: 0.489, 0.869) with p value of 0.004, no health insurance scheme (AOR = 2.16; 95% CI: 0.274, 0.779) and availability of some drugs in shop (AOR = 12.98; 95% CI: 0.017, 0.353) with p value of 0.001 were found to be significantly associated with self-medication of antibiotics.

Conclusion

The study revealed that more than one-third of the respondents practiced self-medication. Availability and irrational dispensing of some drugs in the shops were significantly associated with self-medication practice. Therefore, it is important to educate society on the appropriate use of drugs and discourage the use of prescription drugs without medication order.

Evaluation of Prescription Medication Sharing Among Adults in South Korea: A Cross-Sectional Survey

Background: Prescription medication sharing is an inappropriate medication use behavior that can lead to medication errors and adverse drug events, posing a public health threat. The reported prevalence of prescription medication lending and borrowing varies by country, ranging from 6%–23% and 5%–52%, respectively. However, research on medication sharing is scant in Asian countries. Therefore, this study aimed to describe the rate of prescription medication sharing practices and investigate the associated behavioral factors, types of shared medications, and reasons for sharing among adults in South Korea.

Methods: A cross-sectional study was conducted using an online self-administered survey of 1,000 adults (aged 19–69 years; November 2020). A stratified sampling method was used to select survey participants from a nationwide consumer panel, which ensured a representative distribution of the Korean population by age, gender, and region. Descriptive and logistic regression analyses were used to evaluate the information related to sharing behavior.

Results: A total of 1,000 respondents participated in this study. The mean age of the respondents was 44.7 years (standard deviation [SD], 13.4), ranging from 20 to 69 years. The rate of medication sharing was 52.4%. The most prevalently shared medications were analgesic, antipyretic, and antimigraine medications. Prescription medications were shared mostly between family and relatives. Older age was a predictive factor for sharing analgesics. Lower educational level was a predictive factor for sharing ophthalmic medications.

Conclusions: Approximately one in two respondents in our study have experienced medication sharing in their lifetime. Future studies are needed to establish evidence-based strategies for patient education and improve the medication use process. Healthcare professionals should assess patients’ needs for accessing medications and be ready to educate and guide them with specific action plans. Policymakers should consider patient empowerment strategies including public education and campaigns to avoid potential adverse outcomes of medication sharing.

Disposal practice and factors associated with unused medicines in Malaysia: a cross-sectional study

Background

The improper disposal of unused medicines is a worldwide concern because of its impact on the environment, economy, and health. This study aims to describe the disposal practice of unused medicine and identify factors associated with unused medicines in Malaysia.

Methods

This was a cross-sectional, face to face interview-based survey using a structured questionnaire. We used a convenience sampling method to recruit participants from Kuala Lumpur and Selangor in Malaysia.

Results

We interviewed 1184 participants, and the response rate was 96%. Out of the total respondents, 995 (84%) reported having unused medicines. About a quarter of respondents kept unused medicines in the cabinet, and another quarter disposed of them into the trash or toilet. Only half of the respondent who used medicines for chronic illnesses had unused medicines compared to about 90% of respondents who used medicines for acute illnesses. The main reason for having unused medicines among those who used medicines for chronic illness was non-adherence (69%, p <  0.05). Only 27% of these respondents returned unused medicines under the “Medicine Return Programme (MRP)”. The other group who used medicines for acute illnesses had unused medicines because their health conditions improved. Thus, most of the unused medicines will eventually end up in household waste. A multivariate logistic regression analysis identified respondents who used medicines for acute illnesses as the strongest predictor of having unused medicines (Odds Ratio (OR) = 29.8; p <  0.001), followed by those who pay for their medicines (OR = 6.0; p < 0.001) and those who were willing to participate the Medicine Return Programme (OR = 2.5; p = 0.009).

Conclusion

The prevalence of unused medicines and their improper disposal were high in Malaysia. Unused medicines are associated with people who use medicines for acute illnesses, pay for their medication, and are willing to participate in an MRP. Rationale prescription and optimal dispensing practice, together with a broader MRP facilities coverage, could reduce unused medicine possession.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11676-x.

Poor and Unsatisfactory Disposal of Expired and Unused Pharmaceuticals: A Global Issue

Pharmaceuticals are beneficial to humankind and emerged as crucial arms to treat/manage multiple disease pathogenesis in the present era. In analogous, these medicines/ medical devices should be used cautiously as they possess a potential threat to induce multiple undesired effects that may be related to human health or the environment. Daunting effects may arise due to the improper disposal of unused/expired medicines. Hence, to minimize such harm, there should be adequate knowledge and practice among the population regarding the safe disposal of unused/expired medicines or related pharmaceutical devices. The lack of approved information regarding safe disposal of such substances may invite serious concerns like environmental pollution, which may induce immediate health hazards to the present population and upcoming future generations. There are numerous ways to dispose of, or manage the unused and expired pharmaceutical substances. Sharing the medicines among siblings, friends, and family members are never free from serious health risks. Storing the unused and expired medicines in the home increases the risk of intentional or accidental ingestion of such substances and may create a health emergency. Disposing medicines like household and municipal waste may lead to environmental pollution and harm to humans and animals. The present review finds the multiple unsafe ways of disposal of unutilized medications/tools. Furthermore, it also summarizes the disposal pattern of unutilized medications among the few developed and undeveloped nations.

Prevalence of Home Storage of Medicines and Associated Factors in Iraq

BACKGROUND: In most families around the world, medicines can be used to treat chronic or acute diseases. Simple access to medicines at home has led to high drug consumption rates for self-limiting diseases. Incorrect use of these home-stocked medications may also contribute to severe health risks, increase pathogens’ tolerance, prolonged distress, increased adversity, medication reactions, and delays in seeking adequate care if misdiagnosis occurs. Nothing is known about how Iraqi people store their medicines at home. AIM: The purpose of this study is to obtain data on the prevalence and related factors of drug storage in Diyala Governorate, Iraq. METHODS: A community-based cross-sectional descriptive study was conducted in Diyala Province, Iraq in July 2019. A total of 200 students participated in this study. A pre-tested standardized questionnaire was used to collect data and the analysis was performed using descriptive statistical methods. All the participants (100%) enrolled reported to keep medicines at their homes. RESULTS: The average number of drug users per household is 12.32%. Refrigerators are the main storage location (65%), followed by kitchen counters (33%). The majority of stored drugs were prescribed by physicians (78.5%) and the leading source of those drugs is a private pharmacy (55.71%). The most popular medicinal products stored were analgesics (23.1%), followed by antimicrobials (antibiotics, antibacterial, and antifungal) (19.44%). Among all medicines, currently used drugs accounted for 43.34%, remaining drugs accounted for 29.78%, and reserved drugs accounted for 26.87% for future use. The most common dosage forms of these drugs are tablets (21.16%) and capsules (20.95%). Most participants (82.5%) revealed that they always check the expiration date before use, and (37%) admitted to sharing drugs with others. CONCLUSION: The prevalence of drug storage in households in the Diyala Governorate of Iraq is high because all participants keep drugs at home. Regardless of the method used, these drugs should be retained, and proper storage procedures and conditions are rarely observed.

Differences in the Pattern of Non-Recreational Sharing of Prescription Analgesics among Patients in Rural and Urban Areas

Introduction: This study aimed to analyze differences in sharing of prescription analgesics between rural and urban populations. Methods: We surveyed 1000 participants in outpatient family medicine settings in Croatia. We used a 35-item questionnaire to analyze patients’ characteristics, pain intensity, prescription analgesic sharing behavior, and perception of risks regarding sharing prescription medications. Results: Prescription analgesic sharing was significantly more frequent in the rural (64%) than in the urban population 55% (p = 0.01). Participants from rural areas more commonly asked for verbal or written information than those from urban areas when taking others’ prescription analgesics (p < 0.001) or giving such analgesics (p < 0.001). Participants from rural areas more commonly informed their physician about such behavior compared to those from urban areas (p < 0.01), and they were significantly more often asked about such behavior by their physician (p < 0.01). Perceptions about risks associated with sharing prescription medication were similar between rural and urban populations. Conclusions: There are systematic differences in the frequency of prescription analgesics and associated behaviors between patients in family medicine who live in rural and urban areas. Patients from rural areas were more prone to share prescription analgesics. Future studies should examine reasons for differences in sharing prescription analgesics between rural and urban areas.

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.

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The prevalence and perception of self-medication among adults in the Klang Valley, Malaysia

OBJECTIVES

Self-medication, while potentially beneficial, also brings certain risks such as inappropriate treatment and adverse effects. In this study, we determine the prevalence and perception towards self-medication among adults living in the Klang Valley, Malaysia.

METHODS

This study was a cross-sectional study which sampled 562 respondents across the Klang Valley, Malaysia using a stratified quota sampling method and a self-administered questionnaire. The questionnaire consisted of three sections: demographic data, self-medication practices and perception towards self-medication. Perception towards self-medication was measured using 20 statements with a 5-point Likert scale. Descriptive and inferential tests as well as factor analysis were used to analyse the data.

KEY FINDINGS

The overall prevalence of self-medication for minor ailments was 63.5%. Self-medication was practised to a similar degree regardless of respondent demographics. Respondents most frequently obtained their medicines for self-medication of minor ailments from pharmacies without consulting the pharmacist (68.6%), followed by using leftover medications at home (44.8%) and obtaining medicines from friends and family (16.0%). Factor analysis revealed that self-medication behaviour is driven by good perception towards self-medication in terms of efficacy, safety and convenience, as well as by previous personal or shared experiences.

CONCLUSION

The prevalence of self-medication is high among adults in the Klang Valley, Malaysia. Adults who self-medicate view the consequences of self-medication in a positive light and may be influenced by previous personal or shared experiences. As certain risks with self-medication may be underestimated, efforts to educate the public while promoting a more proactive approach among healthcare professionals should be encouraged.

Knowledge, attitudes and practices related to self-medication with antimicrobials in Lilongwe, Malawi

Background

The use of antimicrobials is associated with the emergence of antimicrobial resistance (AMR), and self-medication increases the risk of the inappropriate use of antimicrobials. This study aims to describe the knowledge, attitudes, and practices (KAP) regarding self-medication with antimicrobials among residents in Lilongwe, Malawi.

Methodology

This study has a cross-sectional, mixed-methods design. We conducted two focus group discussions (n=15) to describe community attitudes towards self-medication with antimicrobials and used a structured questionnaire to collect data on individual KAP regarding self-medication from 105 respondents.

Results

Self-medication was common, and the sources of these medicines were market vendors, pharmacies, drugs shared with friends and family and those leftover from previous treatments. The lack of medical supplies, long distances to health facilities, poor attitudes of medical professionals towards patients, and past experience with the disease and treatment are the main factors that influence self-medication. KAP respondents had little knowledge of antimicrobials, their use, or any awareness of AMR. Seventy-four per cent (n=78) were unable to differentiate antimicrobials from other categories of medicines, and 92.4% wrongly responded that antimicrobials could be used to stop a fever. Concerning attitudes towards self-medication, over 54% wrongly believe that antimicrobials are effective in treating common colds. In regard to practice, 53% reported that they would use antimicrobials to treat upper respiratory infections, and 41% agreed that they must complete antibiotic therapy even if they are improving. Logistic regression analysis found that stocking antimicrobials at home for future use significantly promotes self-medication whereas an awareness of AMR would reduce self-medication.

Conclusion

Self-medication is a public health risk that needs to be addressed urgently. Findings from this study point to the need for multifaceted interventions.

Demographic, socio-economic and other associated risk factors for self-medication behaviour among university students of Sri Lanka: a cross sectional study

Background

Self-prescribing practices are considered as a significant issue in the health sector due to mal-practices. This has become a more worsen issue in developing countries with easy access to medication. Current study was undertaken to estimate the prevalence of self-medication and to evaluate the driving factors behind this behavior, among university students of Sri Lanka.

Method

A total of 700 randomly selected undergraduates of three state universities in Sri Lanka, were recruited as the study population for the cross-sectional study. Information on socio-demographic, Knowledge, Attitudes and Practices relevant to Self-Medication (SM) were gathered using an interviewer administered questionnaire. Binary logistic regression was used to calculate the Odds Ratios (OR) and the 95% confidence intervals of the OR for socio-demographic risk factors on SM.

Results

Around 78% of the studied population denoted a SM behaviour. Only, 37.7% of respondents were familiar with the classification of “Over the Counter” (OTC) drugs, while majority were well aware of the risks of SM (> 50%). Fever (61.3%) and cough (56.7%) were the major health issues for SM, while antipyretics and drugs for cough and runny nose (73.6%) were the mostly used medication. Previous experience (76%) and trivial nature of health issues (73%) were recognized as the major reasons for SM. Majority of respondents declared that community pharmacies (86.9%) and left over medication from previous prescriptions (51%) were the sources for SM. Based on the binary logistic regression, age, residence locality, field of study and academic year were recognized as significant risk factors (P < 0.05) for SM within the studied undergraduate population.

Conclusion

Based on the high prevalence rate of SM, the health authorities of Sri Lanka should pay more attention towards the wellbeing and responsible medication usage of undergraduates. Designing of effective tools and regulations to monitor the selling of medication and improving the health education are recommended to ensure responsible SM within the country.

Exploring the perceived factors that affect self-medication among nursing students: a qualitative study

Background

Self-medication is the use of one or more medications without physician’s diagnosis, opinion, or prescription and supervision, which includes the use of herbal or chemical drugs. Todays, self-medication is one of the biggest socio-health and economic problems among nursing students of various societies, including Iran, and because this issue can affected by contextual factors, this study aimed to explore the perceived factors that affect self-medication among nursing students.

Methods

In this qualitative study, a semi-structured interview was conducted with 11 nursing students. The transcript of each interview was reviewed several times and classified into main categories and sub-categories by content analysis. To evaluate this study, Guba and Lincoln’s four criteria, including credibility, transferability, dependability, and confirmability were considered for trustworthiness.

Results

After analyzing the qualitative content of the interviews, four main categories, including educational backgrounds, nature of the disease, access to the media, and beliefs and personal experiences, and ten subcategories, including contact with clinical environment, relative knowledge about medications, simplicity of the disease, recurrence of the disease, influence of the media, use of the internet, believing in own knowledge, positive experiences of traditional medicine, and using own and others’ experiences, were extracted.

Conclusions

It seems that, having a relative awareness about various diseases and medications, which is sometimes associated with taking a few educational courses with an internship, creates a false confidence in student for self-medication and prescribing drugs to others. It would be beneficial if the education system and associated tutors could inform the students about the possible consequences of this issue. By knowing the internal and subjective factors that influence the self-medication, this arbitrary practice can be largely prevented.

Older Patients' Compliance with Drug Storage Recommendations

Background

Whereas storage conditions are regulated and closely monitored in every stage of the drug supply chain before drug dispensing, it is unknown if patients store drugs at home according to storage recommendations.

Objective

The objective of this study was to investigate how older patients store their prescription drugs at home and to what extent they comply with drug storage recommendations.

Methods

We conducted a cross-sectional study between October 2015 and March 2016. Forty-four participating Dutch community pharmacies selected four home-dwelling patients (aged ≥ 65 years) using at least one prescription drug. A complete drug inventory at patients’ homes was performed. Drugs were considered to fulfill the storage recommendation when these met all drug quality (Q) and information (I) criteria: adequately stored according to drug product label storage recommendations for temperature, light, humidity (Q1); expiry date not passed (Q2); integer primary package (Q3); drug identifiability (I1); drug package insert or information leaflet availability (I2).

Results

One hundred and seventy patients [53.5% female, mean age 74.9 (standard deviation 7.3) years] were included and 1133 prescription drugs stored at home were registered. More than half of the patients (51.2%) complied with all storage quality and information criteria. Assessment of the individual criteria showed that 76.4% of patients were compliant with criterion Q1 while 90.6, 95.3, 97.1 and 71.2% of patients complied with criteria Q2, Q3, I1 and I2, respectively. 53.2% of drugs that should be kept refrigerated according to storage criterion Q1 were not stored between 2 and 8 °C.

Conclusion

This study illustrates that more than half of the older patients comply with general drug storage recommendations.

Electronic supplementary material

The online version of this article (10.1007/s40266-018-0524-8) contains supplementary material, which is available to authorized users.

Self-medication with Antibiotics in WHO Southeast Asian Region: A Systematic Review

Antibiotics are essential treatments, especially in the developing world like World Health Organization (WHO) Southeast Asian region where infectious diseases are still the most common cause of death. In this part of the world, antibiotics are purchased and used without the prescription of a physician. Self-medication of antibiotics is associated with the risk of inappropriate drug use, which predisposes patients to drug interactions, masking symptoms of an underlying disease, and development of microbial resistance. Antibiotic resistance is shrinking the range of effective antibiotics and is a global health problem. The appearance of multidrug-resistant bacterial strains, which are highly resistant to many antibiotic classes, has raised a major concern regarding antibiotic resistance worldwide. Even after decades of economic growth and development in countries that belong to the WHO Southeast Asian region, most of the countries in this region still have a high burden of infectious diseases. The magnitude and consequence of self-medication with antibiotics is unknown in this region. There is a need for evidence from well-designed studies on community use of antibiotics in these settings to help in planning and implementing specific strategies and interventions to prevent their irrational use and consequently to reduce the spread of antibiotic resistance. To quantify the frequency and effect of self-medication with antibiotics, we did a systematic review of published work from the Southeast Asian region.

Assessing the Perceptions and Practice of Self-Medication among Bangladeshi Undergraduate Pharmacy Students

Objectives: To evaluate the perceptions and extent of practicing self-medication among undergraduate pharmacy students. Methods: This cross-sectional, questionnaire-based study was conducted over a six month period (January to June 2016) among undergraduate pharmacy students in five reputable public universities of Bangladesh. It involved face-to-face interviews regarding self-medication of 250 respondents selected by simple random sampling. Results: Self-medication was reported by 88.0% of students. Antipyretics (58.40%) were mostly preferred for the treatment of fever and headaches. The major cause for self-medication was minor illness (59.60%, p = 0.73) while previous prescriptions were the main source of knowledge as well as the major factor (52.80%, p = 0.94) dominating the self-medication practice. The results also demonstrated 88.80% of students had previous knowledge on self-medication and 83.60% of students always checked the information on the label; mainly the expiry date before use (85.60%). A significant (p < 0.05) portion of the students (51% male and 43% female) perceived it was an acceptable practice as they considered self-medication to be a segment of self-care. Furthermore, students demonstrated differences in their response level towards the adverse effect of drugs, the health hazard by a higher dose of drug, a physician’s help in case of side effects, taking medicine without proper knowledge, and stopping selling medicine without prescription. Conclusions: Self-medication was commonly used among pharmacy students primarily for minor illnesses using over-the-counter medications. Although it is an inevitable practice for them it should be considered an important public health problem as this practice may increase the misuse or irrational use of medicines.

Assessment of Nature, Reasons, and Consequences of Self-medication Practice among General Population of Ras Al-Khaimah, UAE

Aim

The aim of this study is to assess the nature, reasons, and consequences of self-medication practice among the general population of Ras Al-Khaimah, UAE.

Materials and Methods

This was a prospective, cross-sectional, survey-based study. Data with respect to knowledge, awareness, and practices regarding self-medication were collected through an interviewer-assisted questionnaire answered by the study participants. Thus, collected data from 413 survey respondents were analyzed using SPSS version 24.0.

Results

The prevalence of self-medication practices among our study respondents was 52.1%. A headache (155 [37.5%]) was the most common clinical condition treated through self-medication practice. Familiarity with the treatment/medication (198 [48%]) was the most common cited reasons, whereas the advertisement and friend's advice were the most (182 [44%]) cited sources of information for self-medication usage. The majority (265 [64.1%]) of the respondents were considered self-medication practice as safe. However, 19 respondents reported side-effects or complications during the due course of self-medication. It was observed that there is a statistically significant association (P < 0.05) between age and employment status of this study participants with self-medication practices.

Conclusion

The data from this study show that the self-medication practice is very common among the study population. Variables such as younger age group and occupation status were significantly associated with self-medication practice. We emphasize the role of pharmacist in educating the community regarding safe medication practices such as harmful effects of self-medicating and inappropriate practices such as sharing the medications among family members and friends.

Assessment of the association between drug disposal practices and drug use and storage behaviors

Objective

Keeping unnecessary drugs at home is a situation showing both causes and consequences of irrational use of medicine. This study aimed to evaluate the approaches of a company's employees regarding drug storage, use, and disposal.

Method

This online-based descriptive study was held in a multi-centered private-sector company in a voluntary basis. The survey assessing participants' drug handling and storage behaviors was answered by 1121 employees from across eight provinces of Turkey in 2016. Main outcome measures were storage and disposal of unused/unwanted drugs at home in a rational way.

Results

The percentage of participants who declared that they keep unused/unwanted drugs at home was 28.0%. About one-third of participants disposed their unused/unwanted drugs via the "garbage, sink, toilet, etc.". Participants ≥30 years old and living with <4 household members significantly tended to bring their unused/unwanted drugs to the company's drug-box. Nearly half of all participants (46.5%) stated a recent change in their disposal behavior. The vast majority of participants (94.6%) who previously took drugs back to the company's drug-box stated that they either had, or would, help their contacts adopt such behaviors. These participants were also significantly less likely to dispose of drugs inappropriately, practice self-medication, be unaware of expired drugs at home, or fail to store drugs according to the labelling.

Conclusion

While our findings showed that a substantial number of participants still had unused drugs at home and disposed of them inappropriately, it is understood that they started to exhibit more favorable behaviors in recent years.

Assessment of health seeking behaviour and self-medication among general public in the state of Penang, Malaysia

Background:

Patients’ behaviour in making decisions regarding health is currently changing from passive recipients to recipients who play an active role in taking action to control their health and taking self-care initiatives.

Objectives:

This study was conducted to evaluate the health seeking behaviour among general public and its associated factors; and to evaluate the medicine taking behaviour in public and the practice of self-medication.

Methods:

A cross-sectional study was undertaken among general public in Penang Island, Malaysia. A convenience sampling of 888 participants successfully completed the survey. Self-administered questionnaires were distributed among the residents in the north east of Penang Island.

Results:

This study showed that most of the participants chose to consult the physician when they experience any health problems (66.7%), followed by self-medication (20.9%). The first action for consulting the physician was significantly predicted by Malay respondents and retired people (OR 3.05, 95% CI 1.04-8.89). The prevalence of self-medication was 54%. The practice of self-medication was significantly associated with Chinese participants, educated people, people with alone living status and people with more self-care orientation.

Conclusion:

Increasing the awareness of the public about the rational choice of getting medical assistance is a very important issue to control their health. A health education program is needed to increase the awareness about the use of medicines among the general public and to enable them to make the right decisions relating to health problems.

Pattern and predictors of medicine use among households in Gondar Town, northwestern Ethiopia: a community-based medicine utilization study

Background

Medicine use can be influenced by several factors. Health managers need specific information about irrational use of medicines, in order to identify opportunities to enhance rational use of medicines in their communities. This study aimed to assess the pattern and factors associated with household medicine use in Gondar town, northwestern Ethiopia.

Methods

An interviewer-administered cross-sectional survey was conducted on 771 households, carried out between 5 April and 6 May 2015. The questionnaire contained items focusing on different aspects of medicine use in the households. The analysis involved descriptive summary and binary logistic regression test, which assessed association of independent variables with medicine use.

Results

Of the households interviewed, 22.4% (173/771) disclosed the presence of at least one chronic disease in the family; while 49.2% reported the use of medicine in the one month prior to the study. Almost all of the households (92.6%) reported a habit of discontinuing medicines, and 17.8% disclosed a practice of sharing medicines with household members and others. Level of education, presence of health professionals, and individuals with chronic illness in the households were linked to increased likelihood of reporting medicine use. Discarding leftover medicines with garbage (56.7%) was the principal means of disposal reported by the households.

Conclusions

A high proportion of reported medicine use, together with problems such as sharing with other people and leaving medicines unfinished were found among the households in the study.

Risk perception about medication sharing among patients: a focus group qualitative study on borrowing and lending of prescription analgesics

Background

One form of self-medication is sharing of medications, defined as borrowing or lending medications in situations where the receiver of these drugs is not the individual to whom the medications were allocated.

Objective

To explore experiences and opinions of patients about sharing prescription analgesics, reasons for sharing prescription analgesics, the way in which patients choose to share those medications, their awareness of risk regarding sharing prescription analgesics, and how they estimated the potential risk.

Methods

This qualitative study was conducted by focus group discussions with 40 participants led by a moderator trained in focus group methodology using a semi-structured moderator guide. Adults aged ≥18 years who had received a prescription for an analgesic at least once in a lifetime were included. Six separate focus groups were conducted to discuss participants’ perception of risks associated with sharing of prescription analgesics among patients. Additionally, participants filled out two questionnaires on demographic data, their own behavior regarding sharing analgesics, and their attitudes about risks associated with sharing prescription analgesics.

Results

In a questionnaire, 55% of the participants indicated that they personally shared prescription analgesics, while subsequently in the focus group discussions, 76% confessed to such behavior. Participants recognized certain risks related to sharing of prescription analgesics, mentioned a number of reasons for engaging in such behavior, and indicated certain positive aspects of such behavior. Forty-five percent of the participants indicated that sharing prescription analgesics is riskier than sharing nonprescription analgesics.

Conclusion

There is a prevalent attitude among participants that sharing prescription analgesics is a positive behavior, where potential benefits outweigh risks.

Self-medication practice in Ethiopia: a systematic review

BACKGROUND

Self-medication patterns vary among different populations, and are influenced by many factors. No review has been done that comprehensively expresses self-medication practice in Ethiopia. The aim of this study was to provide an overview of the literature on self-medication practice in Ethiopia.

MATERIALS AND METHODS

Databases (PubMed, Google Scholar, ResearchGate, and Hinari) were searched for published studies on the practice of self-medication in Ethiopia without restriction in the year of publication or methodology. Some studies were also identified through manual Google search. Primary search terms were "self medication", "Ethiopia", "self care", "non-prescription", "OTC drug use", "drug utilization", and "drug hoarding". Studies that measured knowledge only or attitude only or beliefs only and did not determine the practice of self-medication were excluded.

RESULTS

The database search produced a total of 450 papers. After adjustment for duplicates and inclusion and exclusion criteria, 21 articles were found suitable for the review. All studies were cross-sectional in nature. The prevalence of self-medication varied from 12.8% to 77.1%, with an average of 36.8%. Fever/headache, gastrointestinal tract diseases, and respiratory diseases were the commonest illnesses/symptoms for which self-medication was taken. The major reasons for practicing self-medication were previous experience of treating a similar illness and feeling that the illness was mild. Analgesics/antipyretics, antimicrobials, gastrointestinal drugs, and respiratory drugs were the common drug classes used in self-medication. Mainly, these drugs were obtained from drug-retail outlets. The use of self-medication was commonly suggested by pharmacy professionals and friends/relatives.

CONCLUSION

Self-medication practice is prevalent in Ethiopia and varies in different populations and regions of the country. Some of the self-medication practices are harmful and need prompt action. Special attention should be given to educating the public and health care providers on the types of illnesses that can be self-diagnosed and self-treated and the types of drugs to be used for self-medication.

Risks associated with borrowing and sharing of prescription analgesics among patients observed by pain management physicians in Croatia: a qualitative study

Background

Understanding and improving patient safety is a key issue in medicine. One of the potential threats to patient safety is the sharing of medication among patients, which is a form of self-medication. This study analyzed experiences and attitudes of pain management physicians (PMPs) about sharing prescription analgesics among patients.

Methods

This qualitative study was conducted by semi-structured interviews among PMPs employed in Croatian pain clinics. The study involved two researchers and 15 PMPs.

Results

Among PMPs, 80% have seen patients who share their prescription analgesics with other patients for whom prescription is not intended. Most PMPs consider prescription analgesics sharing a risky and negative behavior. Some of them, however, found certain positive aspects associated to it, such as being a benevolent behavior, helping patients to get medications when they need them, and helping them cope with pain.

Conclusion

The majority of physicians specialized in pain management encountered patients sharing prescription analgesics. Most of them considered this as risky behavior with a number of potential consequences. It has been noted that this problem is neglected and that physicians should inquire about medication sharing. Direct-to-consumers advertising was perceived as a factor contributing to such behavior. Patient education and more involvement of physicians in identifying this behavior were cited as potential remedies for preventing sharing of prescription analgesics.

Self-medication practices among female students of higher educational institutions in Selangor, Malaysia: A quantitative insight

Background:

World Health Organization has defined self-medication as the selection and use of medications (including herbal and traditional product) by individuals to treat self-recognized illnesses or symptoms. The prevalence of self-medication is reported to be higher among female students.

Objective:

To investigate the awareness and self-medication practices among female students of higher education institutions in Malaysia.

Method:

A descriptive, cross-sectional study was conducted in four higher education institutes of Selangor, Malaysia. Convenience sampling approach was used to collect data from a sample 475 students. A “pretested” questionnaire was used as a study instrument.

Results:

A total of 461 questionnaires were returned (response rate 97.05%). The prevalence of self-medication among female students in higher educational institutions was 57.2% (n = 262). The most common source of self-prescribed medicine was a pharmacy or clinics (n = 206; 45%). It was found that antipyretics were the most common medications used without doctor's consultation (n = 212; 89.1%). Analgesics and antipyretics (n = 79; 62.7%) were highly recommended by students to their family and friends. The common reason for self-medication was prior successful experience (n = 102, 81.0%). The majority of respondents (n = 280; 61.1%) reported that they believed over-the-counter medications were as effective as medications prescribed by a doctor.

Conclusion:

The prevalence of self-medication practice among female students in the sample of the four higher education institutions was moderate. More studies are required to generalize these findings across Malaysia.

The self medication use among adolescents aged between 13-18 years old; Prevalence and behavior, Riyadh - Kingdom of Saudi Arabia, from 2014-2015

Background and objectives

In Saudi Arabia, people have easy access to medication and can purchase prescribed medications, such as anti-acne medications and antibiotics, over the counter without the need for a prescription from a physician.Our research is focused on estimating the prevalence of self-medication and understanding the reason for self-medication because previous studies have shown an increase in the practice of self-medication globally and locally.The aim of this study is to estimate the prevalence of self-medication among adolescents aged 13-18 years of both genders in Riyadh, Saudi Arabia. In addition, we aim to identify the indications and external and internal factors behind self-medication, including the effects of gender, peer influence and parental supervision on the decision of adolescents to self-medicate.

Patients and Methods

An observational and cross-sectional adolescent-based study was performed to estimate the degree of self-medication among 400 intermediate and high school students in private and governmental schools living in Riyadh between 2014 and 2015 using a multistage random sampling technique. A validated self-administered questionnaire was used for data collection, and data were tabulated and analyzed with the SPSS version 21 computer program.

Results

We found that the rate of self-medication among adolescents was high (94.5%). Analgesics were the most common medication used (87.3%), and the least common medication used was hormones (5%). A majority of the students reported that headache was the reason for using analgesics. The sources of the medications included the pharmacy (51.64%), followed by parents (34.33%). The results showed that self-medication was significantly associated with the type of school that the adolescents attended (P < 0.011) and the health status of the adolescents (P -value <0.035).

Conclusion

Self-medication is highly prevalent in Riyadh, particularly among adolescents. Easy access to pharmacies was found to be the leading cause for self-medication. The use of these drugs was associated with inappropriate drug use and the deterioration of health status. Self-medication should be closely monitored and awareness should be increased with educational programs among students.

Prescription Drug Diversion: Predictors of Illicit Acquisition and Redistribution in Three U.S. Metropolitan Areas

OBJECTIVE

Prescription drug diversion, the transfer of prescription drugs from lawful to unlawful channels for distribution or use, is a problem in the United States. Despite the pervasiveness of diversion, there are gaps in the literature regarding characteristics of individuals who participate in the illicit trade of prescription drugs. This study examines a range of predictors (e.g., demographics, prescription insurance coverage, perceived risk associated with prescription drug diversion) of membership in three distinct diverter groups: individuals who illicitly acquire prescription drugs, those who redistribute them, and those who engage in both behaviors.

METHODS

Data were drawn from a cross-sectional Internet study (N = 846) of prescription drug use and diversion patterns in New York City, South Florida, and Washington, D.C.. Participants were classified into diversion categories based on their self-reported involvement in the trade of prescription drugs. Group differences in background characteristics of diverter groups were assessed by Chi-Square tests and followed up with multivariate logistic regressions.

RESULTS

While individuals in all diversion groups were more likely to be younger and have a licit prescription for any of the assessed drugs in the past year than those who did not divert, individuals who both acquire and redistribute are more likely to live in New York City, not have prescription insurance coverage, and perceive fewer legal risks of prescription drug diversion.

CONCLUSION

Findings suggest that predictive characteristics vary according to diverter group.

Prescription medication sharing: a systematic review of the literature

We reviewed the literature on nonrecreational prescription medication sharing. We searched PubMed, EMBASE, PsycINFO, and a customized multidatabase for all relevant articles published through 2013; our final sample comprised 19 studies from 9 countries with 36 182 participants, ranging in age from children to older adults, and published between 1990 and 2011. The prevalence rate for borrowing someone's prescription medication was 5% to 51.9% and for lending prescription medication to someone else was 6% to 22.9%. A wide range of medicines were shared between family members, friends, and acquaintances. Sharing of many classes of prescription medication was common. Further research should explore why people share, how they decide to lend or borrow, whether they are aware of the risks, and how they assess the relevance of those risks.

Predictors of Self-Medication Behavior: A Systematic Review

BACKGROUND

Self-medication with over the counter (OTC) and non OTC drugs may provoke serious consequences for users and societies. Recognition of its predictors therefore, is pivotal in plans to hinder the aggregating behavior. This study aimed to identify possibly all predictors of self-medication and the range of its prevalence among different populations.

METHODS

Medline, Amed, Scopus, Medlib, SID, Pub Med, Science Direct, and super searcher of Google Scholar were scrutinized using "self-medication", "self-prescription" and "self-treatment" key words without a time limit with special focus on Iranian studies. Authors independently assessed the title, abstract and full text of identified articles for inclusion and any disagreement was resolved with consensus.

RESULTS

The range of reported self-medication in the 70 included publications was 8.5-98.0%. Having a minor illness (15 studies), health care costs (9 studies), lack of adequate time to visit a physician (11 studies), prior experience (7 studies) in using a drug and long waiting time to visit a qualified practitioner (5 studies) were most frequently reported reasons of self-medication.

CONCLUSION

The observed diversity in the reported prevalence and reasons of self-medication among different sub-groups of populations (e.g. males vs. females) and between developed and developing countries highlights the importance of explanatory behavioral chain analysis of self-medication in different population groups and countries. Even within a single country, predictors of this harmful practice could be inconsistent. Lack of sufficient quality re-search to identify precipitating factors of self-medication in developing countries is paramount.

Perceptions and practices of self-medication among medical students in coastal South India

Self-medication is a common practice worldwide and the irrational use of drugs is a cause of concern. This study assessed the prevalence of self-medication among the medical students in South India. The data was analysed using SPSS version 11.5. A total of 440 students were included in the study. The prevalence of self-medication was 78.6%. A larger number of females were self-medicating (81.2%) than males (75.3%). The majority of the students self-medicated because of the illness being too trivial for consultation (70.5%). Antipyretics were most commonly self-medicated by the participants (74.8%). Only 47% of the participants opined that self-medication was a part of self-care and it needs to be encouraged. 39.3% of the participants perceived that the supply of medicine without prescription by the pharmacist can prevent the growing trend of self-medication. Easy availability and accessibility to health care facilities remains the cornerstone for reducing the practice of self-medication.

Medicines in Pharmacy Students' Residence and Self-medication Practices

This study was aimed at identifying the types of medicines in pharmacy students’ residence and to determine if a relationship exists between keeping medicines in students’ accommodation and self-medication practices. A cross-sectional survey of a random sample of 240 undergraduate pharmacy students of the University of Jos, Jos, Nigeria, was carried out. Participating students were given a self-administered questionnaire, and only 188 students returned their filled questionnaire. The data collected were entered and analyzed using SPSS 16, and the χ²-test was used to determine associations between the variables. The results revealed that 66.0% of respondents had medicines in their room. A total of 318 medicines items (2.56 items per student's room) of which 37.1% were leftover medicines were present in respondents’ rooms. Analgesics (34.3%) and antibiotics (25.2%) were the common classes of medicines present in respondents’ rooms. Respondents reported getting these medicines on prescription (25.8%) and self-medication (56.5%) or both (17.7%). Self-medication practice was common among respondents (53.2%); however, no significant relationship (P>0.05) existed between having medicine in students’ room and self-medication practices. Common reasons given by respondents for having medicines in their rooms were that they were leftover medicines and that they were keeping them for emergency use or for use in an event of a similar illness. Most respondents (72.2%) reported disposing of their unused medicines in a trash can/dust bin. This study demonstrated that the prevalence of medicine storage in students’ room and self-medication practice is high. Analgesics and antibiotics were the most common types of medicines present in students’ residence.