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Saadeh W, Chaccour S, Rahme D, Lahoud N, Saleh N. The hidden dangers lurking at home: Unveiling the prevalence of leftover antibiotics and its associated factors among Lebanese households. Public Health Pract (Oxf) 2024; 7:100485. [PMID: 38510659 PMCID: PMC10951703 DOI: 10.1016/j.puhip.2024.100485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/11/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
Background Antimicrobial Resistance (AMR) is a major global concern. Irrational use of antibiotics including self-medication (SM) with leftovers without a medical prescription can be a leading cause. This study aimed to investigate the prevalence and related factors of leftover antibiotics (LA) in Lebanese households. Study design A cross-sectional study of the Lebanese population was conducted between March and October 2022. Methods Through random proportional stratified sampling, a total of 494 families participated in this study. Data collection was carried out through phone calls using a comprehensive and reviewed questionnaire. The data was then analyzed using SPSS version 26. Logistic regression was utilized to identify the factors associated with LA, with the presence of LA in households as the dependent variable and other factors such as age, region of residence, and presence of elderly individuals at home as the independent variables. Results Among selected households, 118 households (23.89%) had LA. The most common type of antibiotic found was penicillin (59.84%). Most of the LA were in the form of tablets and capsules (94%) with valid expiration dates (87%). Antibiotics were mainly prescribed by doctors (61%), and the main reason for prescribing was acute respiratory tract infections (47.46%). SM was reported by 42.37% of the families with LA. A family with elderly patients (p = 0.002; OR = 2.23; 95% CI = 1.33-3.73) and those residing in Mount Lebanon (p = 0.019; OR = 2.28; 95% CI = 1.14-4.56) had significantly higher odds of having LA. Conclusion Leftover antibiotics were found in nearly a quarter of the addressed Lebanese families. Therefore, public educational campaigns should be launched to limit injudicious antibiotic use including SM, and to promote proper disposal of any leftovers. It is also crucial to adopt the One Health approach by developing national programs for the safe disposal of LA and implementing regulations to restrict the distribution of antibiotics in pharmacies without a prescription.
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Affiliation(s)
- Wadih Saadeh
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | | | - Deema Rahme
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Nathalie Lahoud
- Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Nadine Saleh
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
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Alrasheed M, Hamdy Mansy W, Naser Al-Arifi M. Community pharmacist intervention in doxycycline self-medication for acne among pregnant women in Saudi Arabia. Saudi Pharm J 2024; 32:102027. [PMID: 38525265 PMCID: PMC10960118 DOI: 10.1016/j.jsps.2024.102027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Self-medication during pregnancy remains a prevalent global phenomenon, with pregnant women often relying on their own judgment to manage symptoms. Objective: This study aimed to assess community pharmacist practice regarding self-medication requests for acne treatment in pregnant women within Saudi Arabia. Methods A descriptive, observational cross-sectional study was conducted in Riyadh, Saudi Arabia. Community pharmacists completed a questionnaire after interacting with a simulated customer (SC) seeking doxycycline for a pregnant woman. Data were analyzed using SPSS software. Results One hundred community pharmacists participated in the study. The majority were between 25 and 35 years old (56 %) and worked in chain pharmacies (81 %). Notably, 71 % requested a prescription before dispensing any medication. While 66 % advised the SC to consult a physician or dermatologist, only 15 % inquired about the pregnancy and related information of the SC's sister. Conclusion This study suggests a positive trend in community pharmacy practice regarding self-medication requests during pregnancy. However, further improvement is needed, particularly in terms of in-depth inquiry about pregnancy status and potential risks associated with specific medications. Collaborative efforts between the Ministry of Health (MOH), Saudi Food and Drug Administration (SFDA), and pharmacy education programs are crucial to minimize inappropriate dispensing practices and ensure optimal patient safety.
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Affiliation(s)
- Marwan Alrasheed
- Department of Clinical Pharmacy, College of Pharmacy King Saud University, Riyadh 12372, Saudi Arabia
| | - Wael Hamdy Mansy
- Department of Clinical Pharmacy, College of Pharmacy King Saud University, Riyadh 12372, Saudi Arabia
| | - Mohamed Naser Al-Arifi
- Department of Clinical Pharmacy, College of Pharmacy King Saud University, Riyadh 12372, Saudi Arabia
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Pop IA, Gielens E, Kottmann H, Achterberg P. Exploring the discourses around microdosing psychedelics within the r/microdosing online community. Soc Sci Med 2024; 347:116702. [PMID: 38520826 DOI: 10.1016/j.socscimed.2024.116702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 03/25/2024]
Abstract
In the present contribution, we examine the practice of microdosing psychedelics (microdosing) through textual analysis of the content produced by a dedicated online community, the r/microdosing subreddit. We collected a comprehensive dataset of publicly available submissions from this community and used structural topic modelling to identify and analyse the prevalent topics within the discussions. Through our analysis, we identified 16 distinct topics that mapped into clinical, human enhancement, as well as self-medication narratives. Notably, we found that the majority of discussions revolved around "how to" topics, supporting our argument that such online communities serve as essential information hubs, facilitating the dissemination of practical knowledge related to microdosing practices among the general population. The identified impact of the Covid-19 pandemic on the prevalence of discussion topics suggests that individuals within the online community may perceive microdosing primarily as a means of self-medication during times of heightened stress and uncertainty. Our findings contribute to the field of health sociology and psychedelic research by shedding light on the sociocultural factors influencing healthcare practices, including the role of online communities in facilitating processes of self-medicalization and self-medication.
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Affiliation(s)
- Ioana Andreea Pop
- Tilburg University, Sociology Department, PO BOX 90153, 5000 LE, Tilburg, the Netherlands.
| | - Erwin Gielens
- Tilburg University, Sociology Department, PO BOX 90153, 5000 LE, Tilburg, the Netherlands.
| | - Hannah Kottmann
- Tilburg University, Sociology Department, PO BOX 90153, 5000 LE, Tilburg, the Netherlands.
| | - Peter Achterberg
- Tilburg University, Sociology Department, PO BOX 90153, 5000 LE, Tilburg, the Netherlands.
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Bernusky HCR, Tibbo PG, Conrod PJ, Yunus FM, Keough MT, Thompson KD, Krank MD, Hadwin AF, Stewart SH. Do anxiety symptoms and coping motives serially mediate the association between psychotic-like experiences and cannabis-related problems in undergraduate recent cannabis users? Addict Behav 2024; 151:107937. [PMID: 38113687 DOI: 10.1016/j.addbeh.2023.107937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/01/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Many Canadian emerging adults (ages 18-25 years) use cannabis, with 60 % of past-three-month users experiencing one or more cannabis-related problems (i.e., adverse consequences of use). While psychotic-like experiences (PLEs) and cannabis problems overlap, little is known about the mechanisms explaining this link. One hypothesis is that PLEs are distressing and give rise to anxiety, with which emerging adults attempt to cope through increased cannabis use, in turn increasing their risk for cannabis-related problems. We tested a chained-mediational model to determine if anxiety and coping-with-anxiety motives for cannabis use sequentially mediated the link between PLEs and cannabis problems in emerging adult undergraduates; a conditional process model tested for moderation by sex. Emerging adult cannabis users (N = 413; mean [SD] age = 19.1 [1.5] years; 71.9 % female) from five Canadian universities provided cross-sectional, self-report survey data in fall 2021. Validated measures of PLEs, anxiety, cannabis coping-with-anxiety motives, and cannabis-related problems were administered. Path analyses supported the hypothesized chained mediational indirect effect (b = 0.027, 95 % bootstrap CI [0.012, 0.050]). No direct effect was found (p =.698), suggesting that the PLEs-to-cannabis problems association is fully explained by anxiety and cannabis coping-with-anxiety motives. Inconsistent with hypotheses, mediation did not depend on sex (95 % CIs crossed zero); therefore, anxiety and cannabis coping-with-anxiety motives explain the link between PLEs and cannabis problems in emerging adults regardless of their sex. Results highlight anxiety and cannabis coping-with-anxiety motives as potentially important intervention targets in cannabis-using emerging adults with PLEs, possibly preventing the development/worsening of cannabis-related problems.
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Affiliation(s)
- Haley C R Bernusky
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada
| | - Patricia J Conrod
- Département de psychiatrie et d'addictologie, Université de Montréal, 2900, boulevard Édouard-Montpetit, bureau S-750, Pavillon Roger-Gaudry, Montréal, Québec H3T 1J4, Canada
| | - Fakir M Yunus
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Life Sciences Centre (Psychology Wing), Halifax, Nova Scotia B3H 4R2, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele Street, 225 Behavioural Science Building, North York, Ontario M3J 1P3, Canada
| | - Kara D Thompson
- Department of Psychology, St. Francis Xavier University, 2323 Notre Dame Avenue, 125 Annex, Antigonish, Nova Scotia B2G 2W5, Canada
| | - Marvin D Krank
- Department of Psychology, University of British Columbia, 1147 Research Road, ART 334, Kelowna, British Columbia V1V 1V7, Canada
| | - Allyson F Hadwin
- Department of Educational Psychology and Leadership Studies, University of Victoria, 3800 Finnerty Road, Victoria, British Columbia V8P 5C2, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Life Sciences Centre (Psychology Wing), Halifax, Nova Scotia B3H 4R2, Canada.
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5
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Darden ME, Papageorge NW. Rational self-medication. Econ Hum Biol 2024; 53:101350. [PMID: 38335911 DOI: 10.1016/j.ehb.2024.101350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
We develop a model of rational self-medication in which individuals use potentially dangerous or addictive substances (e.g., alcohol) to manage symptoms of illness (e.g., depression) outside of formal medical care. A model implication is that the emergence of better treatments reduces incentives to self-medicate. To investigate, we use forty years of longitudinal data from the Framingham Heart Study and leverage the exogenous introduction of selective serotonin reuptake inhibitors (SSRIs). We demonstrate an economically meaningful reduction in alcohol consumption when SSRIs became available. Our findings illustrate how the effects of medical innovation operate, in part, through changes in behavior.
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Affiliation(s)
- Michael E Darden
- Johns Hopkins University, United States of America; NBER, United States of America.
| | - Nicholas W Papageorge
- Johns Hopkins University, United States of America; NBER, United States of America; IZA, Germany
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Guillaud P, Vest P, Billhot M, Doutrelon C, Hejl C. [A e-Hypercalcemia]. Rev Med Interne 2024; 45:142-146. [PMID: 38228453 DOI: 10.1016/j.revmed.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/14/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024]
Abstract
INTRODUCTION Hypercalcemia is a common biological abnormality. The etiologies are mainly represented by hyperparathyroidism and neoplastic causes. The other causes, including poisoning, are rare, but should not be neglected. OBSERVATION An 82-year-old female patient presented to the emergency room for repeated falls at home, confusion, drowsiness and digestive symptoms. The initial assessment showed hypercalcemia above 3mmol/L. The etiological exploration revealed a very high concentration of 25OH-vitamin D. After repeated interrogations, it appeared that the cause of this intoxication was the intake of a food supplement purchased on the internet, following a prescription from her dentist. CONCLUSION Intoxication due to a food supplement containing vitamin D is possible and potentially serious. Raising the awareness of patients and healthcare professionals is necessary in order to prevent this type of poisoning and/or to diagnose it as soon as possible.
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Affiliation(s)
- P Guillaud
- Laboratoire de biologie-HIA Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - P Vest
- Laboratoire de biologie-HIA Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - M Billhot
- Service de médecine interne-HIA Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - C Doutrelon
- Service de médecine interne-HIA Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - C Hejl
- Laboratoire de biologie-HIA Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France.
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Wangler J, Jansky M. Attitudes, attributions, and usage patterns of primary care patients with regard to over-the-counter drugs-a survey in Germany. Wien Med Wochenschr 2024; 174:61-68. [PMID: 36149587 PMCID: PMC10896805 DOI: 10.1007/s10354-022-00967-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/23/2022] [Indexed: 11/30/2022]
Abstract
Studies show that over-the-counter drugs are widely used by consumers. Moreover, there is a huge selection available and they are prominently featured in advertising. To date, there exist only a few studies that shed light on the attitudes, attributions, and usage patterns of patients with regard to use of over-the-counter drugs. An anonymized explorative waiting room survey was conducted among 900 patients in 60 GP practices in the German states of North Rhine-Westphalia, Hesse, and Rhineland-Palatinate. As well as the descriptive analysis, a t test was applied to independent random samples, in order to identify significant differences between two groups. 65% of respondents reported using over-the-counter drugs frequently or occasionally. With regard to effects, risks, and side effects, 54% state that they usually take advice from their GP and/or pharmacist before purchasing or taking over-the-counter preparations. For 56%, the package information leaflet is a frequent source of information about the over-the-counter drugs used. The respondents consider over-the-counter preparations to be particularly suitable for (preventive) treatment of colds, flu symptoms, and pain management. The widespread perception of over-the-counter drugs as simple to use (62%), low-dose (69%), and low-efficacy (73%) products does not always correspond to the actual capabilities and risks of over-the-counter self-medication. Given the easy availability of over-the-counter drugs and their strong presence in advertising, it is important that patients have a realistic idea of the capabilities and risks of over-the-counter products. In addition to the advice provided by pharmacists, the trusting, long-standing support provided by GPs and their ongoing information and advice services play a central role in this. It would be advisable to give more attention to this public health concern and to promote initiatives to make patients more aware of the risks regarding consumption of drugs without medical consultation.
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Affiliation(s)
- Julian Wangler
- Centre for General Medicine and Geriatrics, University Medical Center, Johannes Gutenberg University Mainz, Am Pulverturm 13, 55131, Mainz, Germany.
| | - Michael Jansky
- Centre for General Medicine and Geriatrics, University Medical Center, Johannes Gutenberg University Mainz, Am Pulverturm 13, 55131, Mainz, Germany
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Stein MD, Godersky ME, Kim TW, Walley AY, Heeren TC, Winter MR, Magane KM, Saitz R. Self-medication of pain and discomfort with alcohol and other substances by people with HIV infection and substance use disorder: preliminary findings from a secondary analysis. AIDS Care 2024; 36:414-424. [PMID: 37909062 PMCID: PMC10922286 DOI: 10.1080/09540121.2023.2275047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
There is a limited literature regarding factors associated with self-medication of pain and discomfort using alcohol, non-prescription substances or overuse of prescription medications among people living with Human Immunodeficiency Virus (HIV). This cross-sectional analysis used data from the Boston ARCH Cohort among participants with HIV infection and a history of alcohol or other substance use. Among 248 participants, 37% were female, 50% Black, 25% Latinx; 36% reported fair to poor health and 89% had CD4 cell counts >200/mm3. Half reported self-medication and of those, 8.8% reported doing so only with alcohol, 48.8% only with other substances and 42.4% with both alcohol and other substances. Those reporting self-medication were significantly (p < .05) younger (mean 47 vs 50 years), less employed (11% vs 21%), and less likely to have HIV viral suppression (60% vs. 80%). Depression, anxiety, and HIV symptoms were associated with significantly greater odds of self-medicating, as were substance dependence, recent injection substance use, heavy alcohol use, cocaine use, opioid use, sedative use, and cannabis use. Self-medication, highly prevalent and associated with worse mental health symptoms, greater substance use, and lesser HIV disease control, should be explored by HIV clinicians caring for people who use substances.
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Affiliation(s)
- Michael D. Stein
- Department of Health Law, Policy and Management, Boston University School of Public Health. 715 Albany Street, Boston, MA, USA 02118
| | - Margo E. Godersky
- SORCE, Department of Surgery, University of Washington Medical Center, 1107 NE 45th Street, Suite 502 Seattle, WA, USA 98105
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Ave, 4th Floor, Boston, MA, USA 02118
| | - Theresa W. Kim
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Grayken Center for Addiction, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Ave., Boston, MA, USA 02118
| | - Alexander Y. Walley
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Grayken Center for Addiction, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Ave., Boston, MA, USA 02118
| | - Timothy C. Heeren
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health 85 East Newton Street, 9th Floor, Boston, MA, USA 02118
| | - Michael R. Winter
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health 85 East Newton Street, 9th Floor, Boston, MA, USA 02118
| | - Kara M. Magane
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Ave, 4th Floor, Boston, MA, USA 02118
| | - Richard Saitz
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Grayken Center for Addiction, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Ave., Boston, MA, USA 02118
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Ave, 4th Floor, Boston, MA, USA 02118
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Ali HT, Barakat M, Abdelhalim AR, Al-Kurd IN, Muhammad MKE, Sharkawy MM, Elbahnasawy M, Amer SA. Unravelling the dilemma of self-medication in Egypt: a cross-sectional survey on knowledge, attitude, and practice of the general Egyptian population. BMC Public Health 2024; 24:652. [PMID: 38429721 PMCID: PMC10905903 DOI: 10.1186/s12889-024-17913-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Self-medication (SM) is a rising public health issue, especially in developing countries. It can be associated with various problems such as the delayed seeking of medical advice, drug interactions, and serious events such as antimicrobial drug resistance. We aimed to evaluate the Egyptian general population's knowledge, attitudes, and practices of SM. METHODS We employed a cross-sectional design between February 7th and March 8th, 2023 using a self-administered questionnaire available in Arabic. The questionnaire was developed based on previous studies and included four domains: sociodemographic data, knowledge, attitude, and practice of SM. We utilized both online (Google Forms) and paper surveys, utilizing convenience and snowball sampling methods. Data were analyzed using R Statistical Software (v4.1.3; R Core Team 2022). RESULTS 1630 Egyptian individuals (838 females and 792 males) from the seven provinces were enrolled, with a median age of 25 years (IQR: 22-40). Around 55.97% and 48.28% of the participants had good knowledge and favorable attitudes regarding SM respectively, while 62.8% had practiced SM in the previous three months. The most frequently used medications were painkillers (60.74%) followed by antibiotics (32.13%) and antipyretics (28.61%). The pharmacist's recommendation was the source of SM for 53.61% while 31.53% used old medications at home. Most participants (59.08%) practiced SM because they thought they had simple or minor symptoms. The multivariate regression analysis revealed that females had significantly higher knowledge of SM than males (aOR: 2.10; 95%CI: 1.64-2.71; p-value < 0.001), with no significant differences in practice (aOR: 1.24; 95%CI: 0.99 - 1.56; p-value = 0.065). Individuals working or studying in the medical field were significantly more knowledgeable about SM (aOR: 4.30; 95%CI: 3.27-5.69; p-value < 0.001) and more likely to practice SM (aOR: 1.65; 95%CI: 1.26-2.17; p-value < 0.001). The odds of SM decreased with favorable attitudes (aOR: 0.44; 95%CI: 0.36-0.55; p-value < 0.001) while surprisingly, knowledge level was not significantly contributing to SM practice (aOR: 1.15; 95%CI: 0.90-1.48; p-value = 0.268). CONCLUSIONS SM is prevalent in Egypt, highlighting the importance of raising awareness and encouraging physician consultation as a priority. Governments, healthcare organizations, and educational institutions need to collaborate to provide the necessary support and resources.
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Affiliation(s)
| | - Mostafa Barakat
- Qena Faculty of Medicine, South Valley University, Qena, 83621, Egypt
| | | | | | | | | | - Mohamed Elbahnasawy
- Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Samar Ahmed Amer
- Department of Public Health and Community Medicine, Family Medicine, Membership at Royal College of General Practice [INT], Ministry Of Health (MOH) Saudi Arabia, Zagazig University, EgyptLondon, UK
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Arslan M, Başak H. Modeling individuals' prescription medicine borrowing behavior. Res Social Adm Pharm 2024:S1551-7411(24)00058-5. [PMID: 38448257 DOI: 10.1016/j.sapharm.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Medicine-sharing behavior can be divided into two groups: borrowing medicine from someone else and lending medicine to someone else without consulting a doctor or a pharmacist. There are many reasons for the behavior that leads individuals to share their prescription medicines. However, there is a lack in the literature to investigate individuals' medicine-sharing behavior and related antecedents and outcomes of this behavior. OBJECTIVE(S) The main objective of this study is to model individuals' prescription medicine borrowing (PMB) behavior via the structural equation model based on the Theory of Planned Behavior (TPB). METHODS A measurement tool was developed according to TPB. Exploratory factor analysis was conducted to determine subfactors of PBM behavior. In the second step, confirmatory factor analysis (CFA) was conducted to confirm whether there is a relationship between the observed variables and their underlying latent constructs. Finally, a structural equation model was conducted to specify the relationships between latent variables. IBM Statistical Package for Social Sciences (IBM SPSS Software) version 22 and LISREL 8.80 were used for data analysis. RESULTS Study findings reveal that the participants' attitudes and intentions towards PMB are low, and the rate of exhibiting this behavior is also low. In the proposed prescription medicine borrowing behavior model, the positive effect of attitude towards PMB, perceived behavioral control related PMB, and subjective norm about PMB on intention towards PMB were found statistically significant. Intention towards PMB has been found to have a positive statistically significant effect on PMB behavior. CONCLUSIONS Based on the results of this study, it is possible to say that TPB is an appropriate theory for modeling PMB. Thus, this model will shed light on healthcare providers and policy-makers to avoid individuals from the adverse effects of PMB behavior.
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Affiliation(s)
- Miray Arslan
- Department of Pharmacy Management. Faculty of Pharmacy, Van Yüzüncü Yıl University, 65080, Van, Turkey.
| | - Havva Başak
- Faculty of Pharmacy, Van Yüzüncü Yıl University, Van, Turkey
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11
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Bouqoufi A, Laila L, Boujraf S, Hadj FAE, Razine R, Abouqal R, Khabbal Y. Prevalence and associated factors of self-medication in worldwide pregnant women: systematic review and meta-analysis. BMC Public Health 2024; 24:308. [PMID: 38279083 PMCID: PMC10821266 DOI: 10.1186/s12889-023-17195-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 11/09/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Self-medication during pregnancy is of great interest. The use of drugs during pregnancy requires a careful reflection on the benefits to the mother and the risks to the fetus. Selecting a drug or drugs for treating pregnant women can be difficult for clinicians owing to the various pharmacokinetic and physiological changes encountered during pregnancy. This systematic review and meta-analysis aimed to estimate the pooled prevalence of self-medication and associated factors among women during pregnancy. METHODS Searches were carried out at PubMed, Science Direct, Web of Science, and Google Scholar. The quality of the studies and the risk of bias were analyzed using the Joanna Briggs Critical Appraisal Checklist for Analytical Cross-Sectional Studies instrument. The extracted data were tabulated and analyzed qualitatively and quantitatively through meta-analysis. RESULTS The overall prevalence of self-medication among pregnant women was 44.50% (95% CI: 38.92-50.23). Subgroup analyses showed differences in self-medication prevalence influenced by region, county income, and study design. The Heterogeneity, assessed by the statistical test I2 varied from 96 to 99% and was statistically significant. The result of this funnel plot showed that the funnel plot was symmetry with p-value = 0.36, and there is no publication bias. CONCLUSION The results obtained from this study showed that the prevalence of self-medication among pregnant women is relatively high. This requires effective measures and interventions to reduce self-medication. TRIAL REGISTRATION ID = CRD42022312333 .
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Affiliation(s)
- Afaf Bouqoufi
- Laboratory of Health and Science, Therapeutic Innovation, Translational Research, and Epidemiology. Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Lahlou Laila
- Laboratory of Health and Science, Therapeutic Innovation, Translational Research, and Epidemiology. Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Said Boujraf
- Clinical Neurosciences Laboratory, Faculty of Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Fatima Ait El Hadj
- Laboratory of Health and Science, Therapeutic Innovation, Translational Research, and Epidemiology. Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Rachid Razine
- Laboraoty of Epidemiology and Clinical Research, Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Redouane Abouqal
- Laboraoty of Epidemiology and Clinical Research, Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Youssef Khabbal
- Laboratory of Health and Science, Therapeutic Innovation, Translational Research, and Epidemiology. Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
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Mejia CR, Ruiz-Aquino M, Garcia-Arteta G, Ramos G, Astete-Pérez I, Pineda-Cáceres M, Collahua-Briceño M, Vargas-Patiño K, Arias-Chávez D, Franchi T, Pedersini P, Tovani-Palone MR. Factors associated with the use of medicines and self-medication during the COVID-19 pandemic in 12 Latin American countries. Heliyon 2024; 10:e22299. [PMID: 38173506 PMCID: PMC10761345 DOI: 10.1016/j.heliyon.2023.e22299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic has triggered a rise in the global phenomenon of self-medication. The use of medicines with unsubstantiated claims of benefit for the prevention and/or treatment of infected people has been widely adopted. Objective To determine the factors associated with the use of medicines and self-medication by Latin American populations during the COVID-19 pandemic. Methods This analytical cross-sectional study was conducted via an analysis of secondary data collected from 8777 responses from 12 Latin American countries obtained from a survey on the use of medicines and self-medication during the pandemic. Results Respondents who reported using Paracetamol, Ibuprofen, or antibiotics (ABx) disclosed this as self-medication in 26.9%, 16.6%, and 9.7% of cases respectively. In our multivariate analysis, significant associations were found between: self-medication by individual choice and the use of Hydroxychloroquine, ABx, or non-steroidal anti-inflammatory drugs (NSAIDs) (p = 0.026, = 0.003, and <0.001 respectively); self-medication on the recommendation of a family member, with ABx, Paracetamol, Ibuprofen, or other NSAIDs (p <0.001, <0.001, <0.001, and <0.001 respectively); and self-medication on the recommendation of another person, with Chloroquine, Hydroxychloroquine, Azithromycin, Penicillin, other ABx, Warfarin, Ivermectin, Paracetamol, Ibuprofen, or other NSAIDs (p <0.001, <0.001, <0.001, = 0.001, <0.001, <0.001, = 0.004, <0.001, <0.001, and <0.001 respectively). Conclusion There was a significantly high prevalence of self-medication in our Latin American study population, including the use of medicines not recommended for COVID-19 treatment and/or prevention. The implementation of public health measures aimed at combating the worrying COVID-19 infodemic is essential to prevent this ongoing issue and its associated negative impacts on both current public health and future medication efficacy. This is especially important in the case of ABx due to the threat of a future antimicrobial resistance pandemic.
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Affiliation(s)
| | | | | | - Gin Ramos
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | | | | | - Katherine Vargas-Patiño
- Universidad Continental, Huancayo, Peru
- Asociación Médica de Investigación y Servicios en Salud, Lima, Peru
| | | | - Thomas Franchi
- The Medical School, The University of Sheffield, Sheffield, United Kingdom
| | | | - Marcos Roberto Tovani-Palone
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
- Department of Pharmacy and Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chennai, India
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13
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Nazaryan L, Barseghyan A, Rayisyan M, Beglaryan M, Simonyan M. Evaluating consumer self-medication practices, pharmaceutical care services, and pharmacy selection: a quantitative study. BMC Health Serv Res 2024; 24:10. [PMID: 38172981 PMCID: PMC10765736 DOI: 10.1186/s12913-023-10471-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The primary objectives of this study were the evaluation of consumer self-medication practices, the assessment of pharmaceutical care provided by pharmacy employees, and the analysis of consumer satisfaction with such care. The research was also aimed at examining the main criteria that consumers consider important when selecting a pharmacy in Armenia. METHODS The survey was based on an anonymous questionnaire and carried out between March 2020 and November 2021. It was aimed at providing a comprehensive assessment of pharmaceutical care services and consumer pharmacy choice by investigating two distinct groups: pharmacy consumers and pharmacy employees. RESULTS The research reveals that many residents in Armenia engage in self-medication without consulting professional sources, which can lead to potential risks and result in dangerous consequences. This is partly due to a lack of trust in pharmacy employees, which is primarily due to their inability to provide adequate information and advice. This study highlights a significant need for improvement in the quality of service provided by pharmacy employees. Despite these challenges, the majority of consumers reported having a preferred pharmacy, and that employee knowledge is the most important criterion when choosing a pharmacy. CONCLUSIONS Consumer distrust, in this context, is based on the incomplete knowledge or incompetency of pharmacy employees. Collective actions should be taken to improve the role of pharmacy employees and consequently improve the public trust in them, which can ensure better control of self-medication and reduce the instances of mistreatment.
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Affiliation(s)
- Lusine Nazaryan
- Department of Pharmaceutical Management, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia.
| | - Anush Barseghyan
- Department of Pharmaceutical Management, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Maria Rayisyan
- Department of Regulatory Relations of Circulation of Medicines and Medical Devices, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Margarit Beglaryan
- Department of Pharmaceutical Management, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Marta Simonyan
- Department of Pharmaceutical Management, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
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14
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Thomas JE, Pasch KE, Nathan Marti C, Loukas A. Depressive symptoms prospectively increase risk for new onset cigarette and ENDS dependence symptoms. Addict Behav 2024; 148:107870. [PMID: 37776758 DOI: 10.1016/j.addbeh.2023.107870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/30/2023] [Accepted: 09/24/2023] [Indexed: 10/02/2023]
Abstract
Little research has examined the new onset of cigarette and Electronic Nicotine Delivery System (ENDS) dependence symptoms among young adults. This study aims to 1) examine new onset cigarette and ENDS dependence symptoms over a 4.5-year period and 2) examine how depressive symptoms impact new onset dependence symptoms among young adults. Participants were drawn from 24 colleges in Texas who were participating in a multi-wave cohort study (2014-2019). The present study included 4536 participants aged 18-25 who did not report cigarette or ENDS dependence symptoms at wave 1 (64.1% female; 65.2% non-white; m age = 20.62 [SD = 1.80] at wave 1). Cox's regression models were employed to determine the hazard of new onset cigarette and ENDS dependence symptoms overall and the impact of depressive symptoms. Models controlled for sociodemographic factors and other tobacco product use. 14.4% of participants reported new onset cigarette dependence symptoms and 14.6% reported new onset ENDS dependence symptoms over the 4.5 years of the study. Depressive symptoms significantly predicted increased risk for new onset cigarette (HR = 1.30, CI = [1.21, 1.39]) and ENDS (HR = 1.20, CI = [1.12, 1.29]) dependence symptoms. Young adults exhibited dependence symptoms for cigarettes and ENDS products at similar rates across the 4.5 years of the study. Elevated depressive symptoms increased risk of new onset cigarette and ENDS dependence symptoms, advancing evidence for the self-medication hypothesis. Tobacco and nicotine prevention and cessation programs and messaging are needed particularly among young adults who experience depressive symptoms.
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Affiliation(s)
- Jacob E Thomas
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd D3700, Austin, TX 78712, USA.
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd D3700, Austin, TX 78712, USA.
| | - C Nathan Marti
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd D3700, Austin, TX 78712, USA.
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd D3700, Austin, TX 78712, USA.
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15
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Joseph N, Jain J. Perception and Practices of Self-medication Practices among Health Science Students during the ongoing COVID-19 Pandemic in Mangalore, India. Curr Drug Saf 2024; 19:70-81. [PMID: 36655523 DOI: 10.2174/1574886318666230119101656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/04/2022] [Accepted: 11/23/2022] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Health science students are prone to self-medication due to easy accessibility to medicines, background medical knowledge, and their ability to diagnose illnesses. The ongoing COVID-19 pandemic has further encouraged this practice due to the fear of contracting the virus by visiting healthcare establishments. OBJECTIVES This study was conducted to assess the perception and practices of self-medication among health science students during the background of the COVID-19 pandemic. METHODS This cross-sectional study was conducted in July 2021 during the second wave of COVID-19. Data were collected using a Microsoft form circulated among students using WhatsApp or email. RESULTS The mean age of the 350 participants was 20.8 ± 1.5 years. About 165(47.1%) participants had self-medicated over the past one year. The most common mode of self-medication was using previous consultation notes [121(73.3%)]. The most common reason for self-medication stated was the mild nature of the illness [131(79.4%)]. Fifteen (9.1%) participants reported changes in medication from one to another during self-medication. Sixteen (9.7%) participants increased drug dosage during self-medication. Sixteen (26.2%) out of 61 participants who self-medicated with antibiotics did not complete the course. Forty-six (27.9%) out of the 165 participants were not aware of the adverse effects of the drugs being self-medicated on most occasions. One hundred and sixty seven (47.7%) of the total participants did not feel that self-medication practices are harmful. Ninety-five (27.1%) felt that self-medication practices are acceptable during the COVID-19 pandemic. Eighty-six (90.5%) of them thought so to avoid getting COVID-19 infection by visiting healthcare establishments. In multivariable analysis, participants in the final year and those with chronic morbidities were associated with self-medication practices. CONCLUSION Self-medication practices were present among 47.1% of participants. More than onefourth of them were not aware of the side effects of self-medicated drugs on most occasions. About 47.7% participants felt that self-medication practices are not harmful and more than one-fourth of them felt that it was acceptable during the COVID-19 pandemic. Therefore, the students need to be made aware of the harmful consequences of self-medication.
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Affiliation(s)
- Nitin Joseph
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education,
Manipal, Karnataka, India
| | - Jeniya Jain
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Kharaba Z, Al-Azzam S, Altawalbeh SM, Alkwarit A, Salmeh NA, Alfoteih Y, Araydah M, Karasneh R, Aldeyab MA. Health literacy, knowledge, household disposal, and misuse practices of antibiotics among UAE residents: a nationwide cross-sectional study. Expert Rev Anti Infect Ther 2024; 22:103-113. [PMID: 37978885 DOI: 10.1080/14787210.2023.2284878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The study aimed to evaluate health literacy, knowledge, household disposal, and misuse practices of antibiotics among the United Arab Emirates (UAE) residents. RESEARCH DESIGN AND METHODS An observational cross-sectional study was conducted between May 1st and August 31st, 2022. The study encompassed a sample of 1074 participants. RESULTS Participants involved in a medical field (OR: 1.98, 95% CI: 1.45-2.69, p < 0.001) were more likely to have adequate health literacy. Most participants rarely (n = 315; 29.33%) or sometimes (n = 292; 27.19%) sought help from a doctor or pharmacist with reading the instructions and leaflets of antibiotics. A bachelor`s degree was associated with a reduced odds ratio of self-medication with antibiotics (OR: 0.46, 95% CI: 0.29-0.75, p = 0.002). Only 10.61% of unneeded antibiotics were returned to the pharmacy, 79.42% were disposed of at home and 10% were disposed of using other disposal practices. CONCLUSIONS Higher levels of adequate health literacy were observed in those involved in the medical field and those with higher educational levels. The prevalence of self-medication with antibiotics among the UAE population was low. These findings highlight the importance of improving health literacy, promoting responsible antibiotic use, and encouraging proper disposal practices among the population.
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Affiliation(s)
- Zelal Kharaba
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Shoroq M Altawalbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Alin Alkwarit
- Department of Pharmacy, Pharmacy intern, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Noor Abdulkareem Salmeh
- Department of Pharmacy, Pharmacy intern, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Yassen Alfoteih
- College of Dentistry, City University Ajman, Ajman, UAE
- College of Humanities, City University Ajman, Ajman, UAE
| | - Mohammad Araydah
- Department of Internal Medicine, Princes Basma Teaching Hospital, Irbid, Jordan
| | - Reema Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Mamoon A Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
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Tassew WC, Ferede YA, Sisay Woldie S, Yirdaw BW, Fenta Hussien H, Bayuh Yimer B, Gismie Hailemariam D, Adane Mengistu B, Mengistie Zeleke A. Self-medication practice and associated factors among pregnant women in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2023; 11:20503121231194429. [PMID: 38146496 PMCID: PMC10749516 DOI: 10.1177/20503121231194429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/26/2023] [Indexed: 12/27/2023] Open
Abstract
Background In spite of, the need for evidence-based intervention on the potential harmful effects of self-medication practices during pregnancy, there is no systematic review and meta-analysis study regarding self-medication practices in Ethiopia. Therefore, the aim of this study is to determine prevalence of self-medication practice and associated factors among pregnant women in Ethiopia. Method We used PubMed, the Cochrane Library, Google Scholar, the Wiley Online Library, and African Journals Online to choose important studies. The I-squared statistic method was used to check for heterogeneity between studies. Random effect model was used to estimate the pool prevalence of self-medication among pregnant women. Publication bias was determined by the funnel plot and Egger's test. Result A total of 11 studies with 4643 study participants were included in this review. The finding from the current meta-analysis showed that the overall prevalence of self-medication practice among pregnant women is 33.92% (95% CI: 23.15-44.70, I² value = 80.9%). First trimester of pregnancy (OR: 2.24, 95% CI: 1.44-3.47), women who faced health problems during pregnancies at the moment (OR: 5.7, 95% CI: 3.92-8.29), previous self-medication practice (OR: 13.07, 95% CI: 5.14-33.25) and previous pregnancy-related problems (OR: 2.065, 95% CI: 1.44-2.96) were positively associated with self-medication practice among pregnant women. Conclusion The prevalence of self-medication practices among pregnant women is found to be high. Self-medication practices of the pregnant women were significantly higher among women who were in first-trimester pregnancy, encountered illness during pregnancy, previous self-medication history, and previous pregnancy-related problems.Prospero registration number: CRD42023394907.
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Affiliation(s)
- Worku Chekol Tassew
- Department of Medical Nursing, Teda Health Science College, Gondar, Ethiopia
| | - Yeshiwas Ayal Ferede
- Department of Reproductive health, Teda Health Science College, Gondar, Ethiopia
| | - Samson Sisay Woldie
- Department of Reproductive health, Teda Health Science College, Gondar, Ethiopia
| | - Berhanu Wale Yirdaw
- Department of Pediatric Nursing, Teda Health Science College, Gondar, Ethiopia
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Chiniard T, Dib É, Guénot F, du Baret de Limé M, Manen O, Monin J. Flight safety risk assessment of self-medication among fighter pilots: a cross-sectional study. Int J Clin Pharm 2023; 45:1415-1423. [PMID: 37430120 DOI: 10.1007/s11096-023-01611-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/27/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Fighter pilots are a specific population in which any adverse drug reaction can unpredictably interact with aeronautical constraints and thus compromise flight safety. This issue has not been evaluated in risk assessments. AIM To provide a semi-quantitative assessment of the risk to flight safety of self-medication in fighter pilots. METHOD A cross-sectional survey that aimed at identifying the determinants of self-medication in fighter pilots was conducted. All medications consumed within 8 h preceding a flight were listed. A modified Failure Mode and Effects Analysis was performed, and any adverse drug reaction reported in the French marketing authorization document of a drug was considered a failure mode. The frequency of occurrence and severity were evaluated using specific scales to assign each to three risk criticality categories: acceptable, tolerable, and unacceptable. RESULTS Between March and November 2020, the responses of 170 fighter pilots were analyzed, for an overall return rate of approximately 34%. Among them, 78 reported 140 self-medication events within 8 h preceding a flight. Thirty-nine drug trade names (48 different international nonproprietary names) were listed, from which 694 potential adverse drug reactions were identified. The risk criticality was considered unacceptable, tolerable and acceptable for 37, 325 and 332 adverse drug reactions, respectively. Thus, the risk criticality was considered unacceptable, tolerable and acceptable for 17, 17, and 5 drugs, respectively. CONCLUSION This analysis suggests that the overall risk to flight safety of the current practice of self-medication in fighter pilots may be considered at least tolerable, or even unacceptable.
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Affiliation(s)
- Thomas Chiniard
- Department of Anesthesiology and Intensive Care, Bégin Military Hospital, Saint-Mandé, France.
- French Military Medical Service Academy, École du Val-de-Grâce, Paris, France.
| | - Élise Dib
- 6th Medical Unit, 1st Medical Center, Vincennes, France
| | - François Guénot
- Medical Service, Nuclear Missile Submarines Squadron, Brest Naval Base, Brest, France
| | | | - Olivier Manen
- Medicine Department, Aeromedical Center, Percy Military Hospital, Clamart, France
- French Military Medical Service Academy, École du Val-de-Grâce, Paris, France
| | - Jonathan Monin
- Medicine Department, Aeromedical Center, Percy Military Hospital, Clamart, France
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Abstract
BACKGROUND Cancer survivors are at increased risk of pain due to their either cancer and/or treatments. Substances like alcohol may be used to self-medicate cancer pain; however, these substances pose their own health risks that may be more pronounced for cancer survivors. METHODS We used cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS) 2012-2019 to quantify the association between cancer pain and alcohol use. We used negative binomial regression, with interaction terms added to examine variations across age, sex, and race. We also examined whether alcohol use relates to cancer pain control status. RESULTS Cancer survivors with cancer pain were more likely to be younger, female, Black, and to have been diagnosed with breast cancer. Cancer pain was associated with lower alcohol consumption (incidence rate ratio (IRR): 0.88, confidence interval (CI): 0.77, 0.99). This association was primarily among people 65 and older, women, and white and Hispanic people. Cancer pain control status was not related to alcohol use. CONCLUSIONS Lower alcohol use among cancer survivors with pain has many possible explanations, including several alternative pain management strategies or a decrease in social engagement. Our findings of racial and gender disparities in cancer pain are consistent with the broader evidence on disparities in pain. IMPLICATIONS FOR CANCER SURVIVORS Cancer pain management for marginalized groups should be improved. Healthcare providers should screen cancer survivors for both pain and substance use, to prevent unhealthy self-medication behaviors.
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Affiliation(s)
- Collin M Calvert
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55454-1015, USA.
| | - Diana Burgess
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, Mail code: 152, Bldg. 9, One Veterans Drive, Minneapolis, MN, 55417, USA
| | - Darin Erickson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55454-1015, USA
| | - Rachel Widome
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55454-1015, USA
| | - Rhonda Jones-Webb
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55454-1015, USA
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Ortiz-Prado E, Izquierdo-Condoy JS, Mora C, Vasconez-Gonzalez J, Fernandez-Naranjo R. Poor regulation, desperation, and misinformation, a countrywide analysis of self-medication and prescription patterns in Ecuador during the COVID-19 pandemic. Res Social Adm Pharm 2023; 19:1579-1589. [PMID: 37659922 DOI: 10.1016/j.sapharm.2023.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND The rapid spread of the SARS-CoV-2 virus during the early phase of the pandemic led to an unprecedented global health crisis. Various factors have influenced self-medication practices among the general population and unsubstantiated prescribing practices among healthcare professionals. OBJECTIVE This study aimed to describe trends in the purchase and sale of medicines during the COVID-19 pandemic period (2020-2022) in Ecuador, by comparing them with pre-pandemic periods. METHODS In this study, a cross-sectional design was employed to conduct a comprehensive analysis of 28 pharmacological groups, categorized according to the Anatomical Therapeutic Chemical Classification (ATC). Utilizing an integrated drug consumption database, the study examined physician prescribing data, medicine usage, and spending levels in Ecuador during the COVID-19 pandemic. The analysis involved computing absolute differences in monthly resolution, calculating excessive expenditure in comparison to previous yearly averages, and using Defined Daily Dose (DDD) methodology for internationally comparable results. Furthermore, a correlation analysis was performed to investigate potential associations between prescribed and consumed medicines and the number of new cases and deaths. RESULTS In Ecuador, the average yearly expenditure among these groups prior to the pandemic (2017-2019) amounted to $150,646,206 USD, whereas during 2020 and 2021, the same groups represented a total expenditure of $228,327,210, reflecting a significant increase. The excess expenditure during this period reached 51.4%, equivalent to $77,681,004 USD. Notably, 13% of this expenditure consisted of Over the Counter (OTC) Medicines. The study also identified a remarkable surge in sales of ivermectin, which increased by 2,057%, and hydroxychloroquine, which increased by 171%, as measured by DDD. CONCLUSIONS This study highlights the substantial consumption of medicines by the population in Ecuador during the pandemic. It is concerning that many medications were sold without proven therapeutic indications, indicating that misinformation and desperation may have led to improper prescribing by physicians and patients resorting to ineffective drugs. Moreover, since the sale of these therapeutic drugs requires a prescription, poor regulation, and a lack of control within pharmacies likely contributed to such practices.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de Las Américas, Quito, 170125, Ecuador.
| | - Juan S Izquierdo-Condoy
- One Health Research Group, Faculty of Medicine, Universidad de Las Américas, Quito, 170125, Ecuador
| | - Carla Mora
- Medical Department, Quifatex, Quito, 170138, Ecuador
| | - Jorge Vasconez-Gonzalez
- One Health Research Group, Faculty of Medicine, Universidad de Las Américas, Quito, 170125, Ecuador
| | - Raúl Fernandez-Naranjo
- One Health Research Group, Faculty of Medicine, Universidad de Las Américas, Quito, 170125, Ecuador
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Malli IA, Hubayni RA, Marie AM, Alzahrani DY, Khshwry EI, Aldahhas RA, Khan RF, Zaidi SF. The prevalence of self-medication and its associated factors among college students: Cross-sectional study from Saudi Arabia. Prev Med Rep 2023; 36:102457. [PMID: 37869536 PMCID: PMC10589874 DOI: 10.1016/j.pmedr.2023.102457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023] Open
Abstract
Background Self-medication with OTC or prescription drugs is widespread, may impair health, and leads to microbial resistance. Self-medication treats symptoms without a prescription. Self-medication is common among students across disciplines. Thus, this study evaluates medical and non-medical students' self-medication prevalence, knowledge, and variables. Methods 352 people completed a verified 25-item online questionnaire from September 5 to November 17, 2021. Self-medication and demographic characteristics such as gender, professional college, and family income were examined using a chi-square test of independence. Results 210 (59.6 %) participants were from the College of Medicine, and 142 (40.34 %) were from other professional health colleges. Health professional students self-medicated 55.9 %. This research found substantial connections between self-medication knowledge, gender, and family income. With a p-value of 0.0001, 32 % of women agreed that self-medication is safe, compared to 15.8 % of men. Female students were more likely than boys (61.9 % vs 38.1 %, p-value = 0.0291) to self-medicate as their initial therapy. Family income was also related to self-medication; 69.6 % of low-income pupils self-medicated to reduce doctor visits, p-value = 0.0477. Conclusion Students of all majors self-medicate. Medical students were more informed about generic drug safety and administration. There were substantial unfavorable sentiments regarding self-medication, highlighting the need for educational health activities to raise student understanding of its risks.
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Affiliation(s)
- Israa Abdullah Malli
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Rahaf Ahmed Hubayni
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Amirah Mohammed Marie
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Dhaii Yahya Alzahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Elaf Ismeal Khshwry
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Raghad Abdulmohsen Aldahhas
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Rahaf Fayez Khan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Syed Faisal Zaidi
- Faculty of Eastern Medicine, Hamdard University, Islamabad Capital Territory, Pakistan
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Bedhomme S, Vaillant-Roussel H, Vorilhon P, Lafarge E, Pereton B, Prunet-Spano C, Pereira B, Vennat B, Savanovitch C. Pediatric pharmaceutical interventions in self-medication: a descriptive study in community pharmacies. BMC Prim Care 2023; 24:232. [PMID: 37932731 PMCID: PMC10626637 DOI: 10.1186/s12875-023-02180-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/12/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND The practice of self-medication is common but not without risk, especially for vulnerable populations such as the pediatric population. Community pharmacists have an important role of vigilance in dispensing drugs available without a medical prescription, with the possibility of carrying out a Pharmaceutical Intervention (PI) if necessary. The aim of our study was to characterize the Pediatric Pharmaceutical Interventions (PPIs) in self-medication carried out during a spontaneous request for a drug at the community pharmacy. METHODS We conducted a descriptive study in 139 pharmacies in the Auvergne-Rhône-Alpes region (France). Data were collected from students under the supervision of internship masters in the pharmacy, using the validated GIPAMED (GrId for PhArmaceutical Self-MEDication interventions) notification grid, the first week of each month, from February to May for five years (2017 to 2021). Collected data were entered on a secure university platform. RESULTS Of the 3,552 PIs collected, 8,3% (n = 286) were PPIs. Of these PPIs, 35% (n = 100) was generated by requests for optional prescription drugs contraindicated by the pathophysiological condition, 28.3% for drugs requiring a prescription and 20.6% for over the counter drugs not indicated by the symptomatology. Finally, 10% of requests required a referral for a medical consultation. Four Anatomical Therapeutic Chemical (ATC) classes accounted for more than 90% of the requests: respiratory system (39.5%), alimentary tract and metabolism (19.2%), nervous system (11.5%), and musculoskeletal system (10.8%). The most common drugs generating PPIs were: ibuprofen, oxomemazine and combination camphor/essential oils, mainly due to age-related or weight-related contraindication. Paracetamol also generated PPIs frequently, mainly due to problems with drug compliance and more precise infra-therapeutic doses. When these PPIs were dispensed, the pharmacist's proposed solutions were accepted in 94.8% (n = 271) of the cases. CONCLUSIONS The community pharmacist has an important role in providing information about medicines and their correct use to patients. Our research shows that this attention benefits vulnerable populations, such as children, even for drugs that are widely used (e.g. paracetamol and non-steroidal anti-inflammatory drugs) or active substances for which there are age-related or weight-related contraindications (e.g. antitussives, camphor combinations).
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Affiliation(s)
- Sabrina Bedhomme
- Faculty of Pharmacy, University of Clermont Auvergne, Clermont-Ferrand, France.
- Research Unit ACCePPT, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Hélène Vaillant-Roussel
- Research Unit ACCePPT, University of Clermont Auvergne, Clermont-Ferrand, France
- Department of General Practice, University of Clermont Auvergne, Clermont-Ferrand, France
- DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Research Unit ACCePPT, University of Clermont Auvergne, Clermont-Ferrand, France
- Department of General Practice, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Elodie Lafarge
- Faculty of Pharmacy, University of Clermont Auvergne, Clermont-Ferrand, France
- Research Unit ACCePPT, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Bénédicte Pereton
- Faculty of Pharmacy, University of Clermont Auvergne, Clermont-Ferrand, France
- Research Unit ACCePPT, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Céline Prunet-Spano
- Research Unit ACCePPT, University of Clermont Auvergne, Clermont-Ferrand, France
- ISPB (Institut des Sciences Pharmaceutiques et Biologiques), Claude Bernard Lyon 1 University, Lyon, France
| | - Bruno Pereira
- DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Brigitte Vennat
- Faculty of Pharmacy, University of Clermont Auvergne, Clermont-Ferrand, France
- Research Unit ACCePPT, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Chantal Savanovitch
- Faculty of Pharmacy, University of Clermont Auvergne, Clermont-Ferrand, France
- Research Unit ACCePPT, University of Clermont Auvergne, Clermont-Ferrand, France
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Wolf M, Emberger-Klein A, Menrad K. Usage of Natural Health Products (NHPs) for respiratory diseases: user characteristics and NHP-Consumption behavior during the Covid-19 pandemic in Germany. BMC Complement Med Ther 2023; 23:372. [PMID: 37865731 PMCID: PMC10589963 DOI: 10.1186/s12906-023-04180-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/22/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND Respiratory diseases (RD) can challenge healthcare systems around the globe. Natural health products (NHPs) are popular complementary and alternative medicine options for health issues concerning non-fatal RD. Little is known about the characteristics of the users of RD-NHPs and about their NHP consumption behavior during the Covid-19 pandemic in Germany. METHODS A representative online survey was conducted in Germany in 2022. 1707 participants were classified based on having used NHPs for RD within the previous 12 months, having used NHPs but not for RD within the previous 12 months and not having used NHPs. Data were analyzed using descriptive and inferential statistical methods as well as a multinomial logistic regression model. RESULTS Users of RD-NHPs within the previous 12 months were more likely to be employed and to consult pharmacists more often for non-fatal health issues than individuals who did not take RD-NHPs. RD-NHP users were more likely to suffer from a Covid-19 infection and to have children living in the same household than other NHP users. Compared to non-NHP users, RD-NHP users were more likely to be female, highly educated and have stronger openness-to-change value orientations. Vaccination-related behavior was no indicator of RD-NHP usage. Most RD-NHP users took NHPs in self-medication. Few reported informing their practitioner about their self-medication. Drugstores were the most visited supply source for NHPs during the pandemic, followed by pharmacies. Common information sources regarding NHPs were the products themselves and pharmacists. CONCLUSION This study emphasized the important role of NHPs as a popular prevention and treatment option for RD. RD-NHPs were more likely used by individuals who were employed, who suffered from a RD and who consult pharmacists for non-fatal health issues. The importance of product information and pharmacies as information sources should be considered to make communication strategies about safe self-medication options with RD-NHPs more effective, which could help to reduce the burden of health facilities regarding non-fatal RD. To improve and develop future pandemic-control strategies, health professionals and policy makers should consider NHP usage behavior and provide critical information about chances and risks of self-medicated NHP consumption.
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Affiliation(s)
- Miriam Wolf
- Department of Marketing and Management of Biogenic Resources, Campus Straubing for Biotechnology and Sustainability, Hochschule Weihenstephan-Triesdorf (University of Applied Sciences), Technical University of Munich, Am Essigberg 3, D-94315, Straubing, Bavaria, Germany
| | - Agnes Emberger-Klein
- Department of Marketing and Management of Biogenic Resources, Campus Straubing for Biotechnology and Sustainability, Hochschule Weihenstephan-Triesdorf (University of Applied Sciences), Technical University of Munich, Am Essigberg 3, D-94315, Straubing, Bavaria, Germany
| | - Klaus Menrad
- Department of Marketing and Management of Biogenic Resources, Campus Straubing for Biotechnology and Sustainability, Hochschule Weihenstephan-Triesdorf (University of Applied Sciences), Technical University of Munich, Am Essigberg 3, D-94315, Straubing, Bavaria, Germany.
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Anabire NG, Billak GD, Helegbe GK. Alcohol intake, smoking, self-medication practices and burden of anaemia among traders in Tamale metropolis of Ghana. BMC Res Notes 2023; 16:214. [PMID: 37700371 PMCID: PMC10498630 DOI: 10.1186/s13104-023-06480-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
OBJECTIVE Lifestyle choices including physical inactivity, smoking, abuse of alcohol and drugs, unhealthy diet are common among traders and market women and these behavioural activities predispose individuals to ill-health conditions including cardiovascular diseases and chronic anaemia. We evaluated lifestyle choices such as alcohol intake, smoking and resorting to self-medication among traders in the Tamale Central market in Ghana. We then associated these lifestyle choices with anaemia. RESULTS A total of 400 participants were recruited for this study. Haemoglobin (Hb) levels of participants were measured using Mission® Plus Hb meter and anaemia was diagnosed by Hb < 12 g/dl for non-pregnant females and Hb < 13 g/dl for males. Of the participants, a majority (69.3%) were males, and most of them (56.0%) were within 18-35 years age bracket. While alcohol intake and smoking were uncommon, self-medication was a common practice among the participants. Anaemia was a common condition; diagnosed in 44.5% of participants, but was independent of age, alcohol intake and smoking. However, anaemia was more common in females (χ2 = 15.9, p < 0.001) and was associated with self-medication (χ2 = 5.7, p = 0.017). We recommend that traders in the Tamale metropolis should seek routine health check-ups to help avert adverse health consequences associated with anaemia.
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Affiliation(s)
- Nsoh Godwin Anabire
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry Cell and Molecular Biology, University of Ghana, Ghana, Accra, Ghana
| | - George Doopaar Billak
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Gideon Kofi Helegbe
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana.
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Paulsamy P, Venkatesan K, Hamoud Alshahrani S, Hamed Mohamed Ali M, Prabahar K, Prabhu Veeramani V, Khalil Elfaki N, Elsayed Ahmed R, Ahmed Elsayes H, Hussein Ahmed Abdalla Y, Babiker Osmsn Mohammed O, Ahmed Qureshi A, Alqahtani F, Shaik Alavudeen S. Parental health-seeking behavior on self-medication, antibiotic use, and antimicrobial resistance in children. Saudi Pharm J 2023; 31:101712. [PMID: 37601142 PMCID: PMC10432793 DOI: 10.1016/j.jsps.2023.101712] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/22/2023] [Indexed: 08/22/2023] Open
Abstract
Aim and Objectives The study sought to identify parental trends in children's self-medication, health-seeking behavior, knowledge of self-medication, antibiotic use, and antimicrobial resistance in Asir, Saudi Arabia. Methods A web-based cross-sectional study was carried out by a survey questionnaire. Snow Ball sampling technique was used to select the Eight hundred and sixteen parents with children in the Asir region by WhatsApp and email, and 650 participants who met the inclusion criteria consented to participate in the study. Results There were 1809 episodes of childhood illnesses reported during the study period. The mean scores are on knowledge at 8.11 ± 2.43, favorable attitude at 17.60 ± 1.17, and practice was 7.72 ± 1.72, and a significant correlation was found between knowledge, attitude, and practice (KAP) at p = 0.01. Out of 624, the majority of parents showed strong knowledge and proficiency in antibiotics. However, the attitude scores of over 50% towards the usage of antibiotics were subpar. Around 54% of parents were self-medicating their children and 43% were unaware that skipping doses contributes to anti-microbial resistance (AMR). The facilitators for self-medication were male gender (aOR: 2.13; 95% CI: 1.26-3.98, p < 0.05), having more children (aOR: 2.78; 95% CI: 1.27-4.12 p < 0.01), professional qualification (aOR:3.07; 95% CI 1.57- 4.68; p < 0.01), residing in urban area (aOR: 3.17; 95% CI: 2.13-5.61, p < 0.05), working in health care (aOR: 5.99; 95% CI: 1.78-18.2, p < 0.01) and high income (aOR: 3.57; 95% CI: 2.08-6.34, p < 0.05). Conclusions The findings indicated that the majority of parents had unfavorable views and improper practices of antibiotic usage. Strategic education programs to the targeted population, especially to the parents about side effects of antibiotics, dangerous consequences of self-medication, and crucial AMR concerns must be addressed immediately.
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Affiliation(s)
- Premalatha Paulsamy
- College of Nursing, Mahala Branch for Girls, King Khalid University, Asir, Saudi Arabia
| | - Krishnaraju Venkatesan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha, Asir, Saudi Arabia
| | | | - Maha Hamed Mohamed Ali
- Faculty of Medical and Applied Science, Public Health Department, King Khalid University, Asir, Saudi Arabia
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
- Department of Pharmacy Practice, Faculty of Pharmacy, Dr. M.G.R. Educational and Research Institute, Velappanchavadi, Chennai, Tamil Nadu, India
| | - Vinoth Prabhu Veeramani
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | | | - Rasha Elsayed Ahmed
- Medical-Surgical Nursing, College of Nursing, Tanta University, Egypt
- College of Nursing, Mahala Branch for Girls King Khalid University, Asir, Saudi Arabia
| | - Hala Ahmed Elsayes
- Psychiatric and Mental Health Nursing, Faculty of Nursing, Tanta University, Egypt
- Psychiatric and Mental Health Nursing, Faculty of Nursing, King Abdul Aziz University, Saudi Arabia
| | | | | | - Absar Ahmed Qureshi
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha, Asir Province, Saudi Arabia
| | - Friyal Alqahtani
- Department of Community Nursing, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Holborn T, Schifano F, Deluca P. No prescription? No problem: A qualitative study investigating self-medication with novel psychoactive substances (NPS). Int J Drug Policy 2023; 118:104109. [PMID: 37422986 DOI: 10.1016/j.drugpo.2023.104109] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND The proliferation of Novel Psychoactive Substances (NPS) presents a challenge for global drug policy. The ease of online drug purchase and the emergence of the dark web have created new avenues for the growth of NPS. Despite the global nature of this issue, limited research has examined motivations of use. These include perceived safety or convenience, an interest in novel pharmacology and self-exploration. Recent evidence has suggested individuals may be self-medicating with NPS, however this phenomenon has yet to be thoroughly explored. This study aims to investigate the occurrence of NPS self-medication, identify the specific NPS involved, and understand the motivations behind their use. METHODS Discussions surrounding self-medication using NPS were collected between October 2022 and February 2023 via a content analysis of a Reddit community. Ninety-three threads, comprising 182,490 words and 5023 comments, were collected and cleaned. A frequency analysis was conducted to identify the NPS discussed, and data was analysed systematically through the process of iterative categorization (IC). RESULTS Our study revealed frequent discussions about the self-medication with several NPS, notably etizolam, clonazolam, diclazepam, flualprazolam, 2-FMA, 4F-MPH, 3-FPM and 3-MeO-PCP. Individuals were mainly self-treating ADHD, anxiety and depression. Motivations for choosing NPS included access, cost, legality and a dissatisfaction with conventional healthcare. Substances were often chosen based on a profile of "Functionality" and outcomes varied. The use of clonazolam was highlighted as particularly problematic. CONCLUSION The current study provides insight into the phenomenon of self-medication with NPS within an internet demographic, exploring the motivations behind why individuals choose NPS for a variety of disorders. The easy access to NPS and lack of scientific data pose a significant challenge for drug policy. Future policies should focus on improving healthcare providers knowledge of NPS use, removing barriers to adult ADHD diagnosis and rebuilding trust between individuals and addiction services.
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Affiliation(s)
- Tayler Holborn
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
| | - Paolo Deluca
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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Lydiard JB, Patel H, Strugatsky Y, Thompson WK, Pelham WE, Brown SA. Prospective associations between cannabis use and depressive symptoms across adolescence and early adulthood. Psychiatry Res 2023; 325:115190. [PMID: 37146464 PMCID: PMC10807261 DOI: 10.1016/j.psychres.2023.115190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/20/2023] [Accepted: 04/02/2023] [Indexed: 05/07/2023]
Abstract
Cannabis use and occurrences of depression during adolescence are common. However, the temporal relationship between the two is less understood. Does depression lead to cannabis use, or does cannabis use lead to depression, or is it a combination of both? Furthermore, this directionality is confounded by other substance use, specifically binge drinking, which is common during adolescence. This study aimed to examine the temporal directionality of cannabis use and depression among a prospective, longitudinal, sequential cohort of 15 to 24-year-olds. Data were drawn from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. The final sample included 767 participants. Multilevel regression models were run to assess concurrent (at the same time point) and prospective (1 year later) associations between cannabis use and depression. When measured concurrently, depressive symptoms did not significantly predict past-month cannabis use but did significantly predict more days of use among cannabis users. Prospective associations indicated that depressive symptoms significantly predicted cannabis use 1 year later and cannabis use significantly predicted depressive symptoms 1 year later. We found no evidence that these associations varied by age or binge drinking. Overall, the relationship between cannabis use and depression appears to be complex and not unidirectional.
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Affiliation(s)
- Jessie B Lydiard
- Department of Psychiatry, University of California San Diego, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States
| | - Herry Patel
- Department of Psychiatry, University of California San Diego, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States
| | - Yoni Strugatsky
- Department of Psychiatry, University of California San Diego, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States
| | - Wesley K Thompson
- Center for Population Neuroscience and Genetics, Laureate Institute for Brain Research, Tulsa, OK, United States
| | - William E Pelham
- Department of Psychiatry, University of California San Diego, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States
| | - Sandra A Brown
- Department of Psychiatry, University of California San Diego, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States; Department of Psychology, University of California San Diego, La Jolla, CA, United States.
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Girmaw F, Sendekie AK, Mesfin B, Kassaw AT. Self-medication practices among pregnant women in Ethiopia. J Pharm Policy Pract 2023; 16:74. [PMID: 37337251 PMCID: PMC10278325 DOI: 10.1186/s40545-023-00584-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/09/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Self-medication is a worldwide issue that requires special attention due to the potentially harmful effects it can have not only on pregnant women but also on the fetus. OBJECTIVES This study assessed the magnitude of self-medication practice and associated factors among pregnant women following antenatal care (ANC) in primary healthcare settings in the North Wollo Zone of Ethiopia. METHODS An institutional-based cross-sectional study was conducted on 395 pregnant mothers who attended ANC follow-up in selected health centers in the North Wollo Zone of Ethiopia from April 20 to May 20, 2021. A multi-stage sampling method was employed to enroll participants. A face-to-face structured interview was conducted to collect the data. A logistic regression analysis was used to determine the factors associated with self-medication practice. A p value < 0.05 at the 95% confidence level was considered statistically significant. RESULTS Out of a total of 444 participants approached, 395 (89%) participated in the study. Of these, 44.6% reported practicing self-medication during the current pregnancy. Age < 35 (AOR = 2.18, 95% CI 1.02-9.15; p = 0.032), rural residence (AOR = 3.01, 95% CI 1.43-10.19; p = 0.017), and previous medication use (AOR = 5.02, 95% CI 1.24-12.93; p = 0.015) were found to have a significant association with self-medication practice. CONCLUSION Self-medication was highly prevalent among pregnant women in the study setting and result indicates need for critical action. Younger rural women with a history of self-medication use should be provided counselling to find a prescription medication, and measures are needed to minimize self-medication related harm in pregnant women.
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Affiliation(s)
- Fentaw Girmaw
- Department of Pharmacy, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, College of Medicines and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Betelhem Mesfin
- Department of Adult Health Nursing, School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Abebe Tarekegn Kassaw
- Department of Pharmacy, College of Health Science, Woldia University, Woldia, Ethiopia
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Mboni HM, Tshikongo AK, Chirubagula VB, Shakalenga CM, Kanyegere AM, Rugema BB, Mushobekwa SS, Akiba DB, Rusati NM. [Evaluation of self-medication practices and their characteristics among Uvira in Democratic Republic of Congo students]. Pan Afr Med J 2023; 45:53. [PMID: 37637404 PMCID: PMC10460111 DOI: 10.11604/pamj.2023.45.53.39690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/07/2023] [Indexed: 08/29/2023] Open
Abstract
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.
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Affiliation(s)
- Henry Manya Mboni
- Département de Pharmacologie, Faculté des Sciences Pharmaceutiques, Université de Lubumbashi, Lubumbashi, République Démocratique du Congo
- Filière des Techniques Pharmaceutiques, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
| | - Arsène Kabamba Tshikongo
- Département de Biologie Clinique, Faculté des Sciences Pharmaceutiques, Université de Lubumbashi, Lubumbashi, République Démocratique Congo
| | - Valentin Bashige Chirubagula
- Département de Pharmacologie, Faculté des Sciences Pharmaceutiques, Université de Lubumbashi, Lubumbashi, République Démocratique du Congo
| | - Cedrick Mutombo Shakalenga
- Département de Pharmacologie, Faculté des Sciences Pharmaceutiques, Université de Lubumbashi, Lubumbashi, République Démocratique du Congo
| | - Arsène Mutula Kanyegere
- Filière des Techniques Pharmaceutiques, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
| | - Bontemps Byakujoga Rugema
- Filière des Sciences Infirmières, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
| | - Saili Stay Mushobekwa
- Filière des Sciences Infirmières, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
| | - Derrick Bushobole Akiba
- Filière de Santé Publique, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
| | - Nicolas Mihuhi Rusati
- Filière de Santé Publique, Institut Supérieur des Techniques Médicales d´Uvira, Uvira, République Démocratique du Congo
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Narang P, Garg V, Sharma A. Regulatory, safety and economic considerations of over-the-counter medicines in the Indian population. Discov Health Syst 2023; 2:17. [PMID: 37251102 PMCID: PMC10201516 DOI: 10.1007/s44250-023-00032-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/04/2023] [Indexed: 05/31/2023]
Abstract
Background and purpose of review Over-the-counter (OTC) medication has been an integral component of an established health care system but their easy accessibility might pose significant risks. This review has attempted to highlight the present scenario of OTC utilization in India, regarding standard practices followed globally. An attempt has also been made to highlight the lifecycle of a prescription and OTC medicine and the benefits and regulatory process involved in the prescription-to-OTC switch. Findings A paradigm shift has been observed in self-medication practice with OTC medicines in recent times and has become a widespread practice worldwide. Numerous key drivers, such as increasing consumer awareness, broader consumer access to essential medication, and socio-economic benefits to the public health care system, have advocated this practice. On the other hand, self-medication using OTC is also inextricably linked with inevitable risks such as excessive drug dosage, polypharmacy, drug abuse, and drug interactions. Nevertheless, these issues could be further regulated by employing a defined OTC framework. The government of India has recognized the utmost need to develop a robust policy framework for the effective utilization of OTC drugs. Also, various initiatives toward modifying existing laws or developing new OTC drug policies has been taken. Conclusion Prioritizing the utmost safety of the consumers and evident need of strong regulatory framework with respect to OTC drugs, the term "OTC" has been recommended as a distinct category of drugs by Government of India. This review has highlighted various factors that can play an essential role in OTC utilization and can be considered during policy reformation.
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Affiliation(s)
- Prashant Narang
- Medical Affairs, Haleon (Formerly GSK Consumer Healthcare Pte Ltd.), 10th Floor, One Horizon Center, Golf Course Road, DLF Phase 5, Gurugram, Haryana 122002 India
| | - Vandana Garg
- Medical Affairs, Haleon (Formerly GSK Consumer Healthcare Pte Ltd.), Singapore, Singapore
| | - Atul Sharma
- Medical Affairs, Haleon (Formerly GSK Consumer Healthcare Pte Ltd.), 10th Floor, One Horizon Center, Golf Course Road, DLF Phase 5, Gurugram, Haryana 122002 India
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31
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Meneo D, Bacaro V, Curati S, Russo PM, Martoni M, Gelfo F, Baglioni C. A systematic review and meta-analysis of the association between young adults' sleep habits and substance use, with a focus on self-medication behaviours. Sleep Med Rev 2023; 70:101792. [PMID: 37269785 DOI: 10.1016/j.smrv.2023.101792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 06/05/2023]
Abstract
Young adults (18-30 years) are vulnerable to sleep-wake disturbances and substance use, which are bi-directionally associated. The present work aims to organise the literature that deals with the association between sleep and substance use in young adults, also considering self-medication behaviours. We adopted a framework that accounts for the multidimensionality of sleep and the effect of different substances. We considered sleep disturbances (insomnia symptoms, sleep quality), sleep health dimensions (duration, satisfaction, efficiency, timing, daytime alertness), circadian characteristics (chronotype). Substances were alcohol, caffeine, nicotine, cannabis, others. We included 46 studies. The use of caffeine and nicotine was associated with higher odds of sleep disturbances. No significant effect was detected for sleep duration. In narrative findings, daytime dysfunction was associated with alcohol and caffeine use, and poor sleep satisfaction with nicotine use. Few evidence were available for the other sleep health dimensions. Evening chronotype was associated with alcohol, caffeine, and nicotine use. Few studies focused on cannabis or self-medication. Longitudinal results were inconclusive. We found a distinct pattern of associations between different substances and different sleep outcomes. Further investigation considering the multidimensionality of sleep would create a better understanding of the complex relationship between substance use and sleep health in young adults.
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Affiliation(s)
- Debora Meneo
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy.
| | - Valeria Bacaro
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Sara Curati
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Paolo Maria Russo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Monica Martoni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Francesca Gelfo
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Chiara Baglioni
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy; Department of Clinical Psychology and Psychophysiology/Sleep, Medicine, Centre for Mental Disorders, University Medical Centre, Freiburg, Germany
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Diarra T, Okeibunor J, Diallo B, Onyeneho N, Rodrigue B, N’da Konan Yao M, Yoti Z, Fall S. Therapeutic Itineraries during the Ebola Epidemic in the Democratic Republic of Congo. J Immunol Sci 2023; Suppl 3:88-101. [PMID: 38333360 PMCID: PMC7615621 DOI: 10.29245/2578-3009/2023/s3.1101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
While treating a disease, patients or their relatives make decisions to pursue different therapeutic options, and various stages are involved in searching for a cure. This paper explored the pattern of health-seeking in the Democratic Republic of Congo (DRC) during the 10th Ebola virus disease (EVD) outbreak. Eight hundred randomly selected adults were surveyed using a questionnaire. Qualitative data were also collected through in-depth interviews with 17 community leaders and 20 focus group discussions with community members. The results showed that modern healthcare facilities are not usually considered the first option for treatment. The therapeutic journey generally begins with the patients, who treat themselves based on the what they know about the disease and the resources they have at their disposal. However, if the disease is not cured through self-medication, then patients or their relatives will visit a pharmacy. Patients request medication they know to be effective in treating the disease, and relatives can also assist in obtaining medication in the case of immobile patients. Pharmacies commonly sell the medication to patients or their relatives without a medical prescription.
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Affiliation(s)
| | | | | | | | | | | | | | - Soce Fall
- World Health Organization, Switzerland
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Masumoto S, Nakayama G, Haruta J, Maeno T. Association between experience of interprofessional care and self-medication among family caregivers: A cross-sectional study. Res Social Adm Pharm 2023; 19:773-777. [PMID: 36658019 DOI: 10.1016/j.sapharm.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although healthcare professionals pay attention to the drugs prescribed by physicians, few studies have assessed self-medication by family caregivers. Family caregivers' experience of interprofessional care in the care of patients can influence caregivers' health behaviors. OBJECTIVES This study aimed to describe self-medication among family caregivers of community-dwelling adult patients, and to assess association between family caregivers' experience of interprofessional care and their self-medication, adjusting for possible confounding factors. METHODS We conducted a cross-sectional survey from November to December 2020 in Ibaraki Prefecture, Japan. Family caregivers between 40 and 74 years old and caring for community-dwelling adult patients with chronic conditions were recruited. The use of any self-medication in the last 2 weeks by family caregivers was the outcome variable. The explanatory variable was family caregivers' experience of interprofessional care in the care of patients, using the Japanese version of the Caregivers' Experience Instrument (J-IEXPAC CAREGIVERS). Adjusted covariates were age, gender, educational attainment, annual household income, self-rated health, and caregiving time of family caregivers. RESULTS Of 1091 recruited family caregivers, 750 were included in the analysis. A total of 258 (34.4%) family caregivers reported having used self-medication in the past 2 weeks. Logistic regression analysis showed that having a higher score on the J-IEXPAC CAREGIVERS (odds ratio 0.80 per 1 standard deviation increase) was associated with less use of self-medication by caregivers. CONCLUSIONS This study revealed that about one-third of family caregivers self-medicate, and this practice is associated with a less positive experience of interprofessional care. These results suggest that it is important for healthcare professionals to be aware of the health condition of family caregivers and to provide appropriate advice regarding self-medication.
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Affiliation(s)
- Shoichi Masumoto
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan; Department of General Medicine, Tsukuba Central Hospital, 1589-3 Kashiwadacho, Ushiku, Ibaraki, 300-1211, Japan.
| | - Gen Nakayama
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Junji Haruta
- Medical Education Center, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku ku, Tokyo, 160-8582, Japan.
| | - Tetsuhiro Maeno
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
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Dienye NP, Imarhiagbe C, Dan-Jumbo AI, Dienye PO, Uriah S, Nnadi NO, Akinla CO. Assessment of Healthcare-Seeking Behaviour and Self-Medication among Adult Patients with Gastrointestinal Symptoms at a Rural Clinic in the Niger Delta of Nigeria. West Afr J Med 2023; 40:367-374. [PMID: 37119128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND Patients' behaviour in making decisions regarding their health is currently changing from a passive role to an active one in which they participate fully in the control of their health as well as take initiatives in self-care. OBJECTIVES This study evaluated health-seeking behaviour and practice of self-medication among patients with abdominal pain in a rural Primary Health Centre in the Niger Delta. METHODS This was a cross-sectional study among 400 patients that attended the Primary Health Centre in Oyorokoto, Rivers State, Nigeria. Interviewer-administered questionnaires were used to collect data on participants' demographics, medicines-taking behaviour, and practice of self-medication, Data analysis was done using Statistical Package for Social Science for windows version 20. The p-value of <0.05 at a confidence level of 95% was considered significant. RESULTS Most of the participants chose to consult formal health care when they experienced health problems (57.3%), and self-medication prevalence was 29.5%. The majority of the respondents (65.8%) took medication based on a health worker's advice while 32.5% depended on past experience with a similar illness. The practice of self-medication was significantly associated with gender, age, and religion. The female gender and older age groups significantly practice self-medication compared to the males and younger age groups(p<0.001). Christians significantly practice self-medication (p = 0.038). CONCLUSION Increasing public awareness of the rational choice of getting medical assistance is very important. A health education program to increase awareness about the use of medicines among the general public and to enable them make the right decisions relating to their health problems is advocated.
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Affiliation(s)
- N P Dienye
- Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - C Imarhiagbe
- Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - A I Dan-Jumbo
- Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - P O Dienye
- Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - S Uriah
- Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - N O Nnadi
- Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - C O Akinla
- Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
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35
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Rau D, Eichau S, Borriello G, Cerqueira J, Wagner C. Assessment of the treating physicians' first-hand experience with handling and satisfaction of ofatumumab therapy: findings from the PERITIA survey conducted in Europe. BMC Neurol 2023; 23:147. [PMID: 37038104 PMCID: PMC10084644 DOI: 10.1186/s12883-023-03190-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/28/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Real-world evidence on experience and satisfaction of ofatumumab as a treatment option for relapsing multiple sclerosis (RMS) is limited. OBJECTIVE To present cumulative responses from a questionnaire related to first-hand experience of treating physicians on handling and convenience of ofatumumab therapy along with concerns related to COVID-19. METHODS PERITIA was a multicentre survey conducted to collect responses from the ASCLEPIOS I/II trial investigators from Europe via an online questionnaire. RESULTS Forty-six physicians (Germany, n = 14; Spain, n = 12; Portugal, n = 10; Italy, n = 10) completed the survey. Overall, 43% of the physicians considered the benefit-risk ratio of ofatumumab as very good. Over 93% were in favour of ofatumumab self-administration at home and the majority (83%) believed it to be completely true that self-administration of ofatumumab eases the burden for patients in terms of time. All investigators would like to potentially use anti-CD20 therapy as a long-term strategy. Even during the COVID-19 pandemic, physicians were in favour of a self-administration of MS therapy at home over other anti-CD20 therapy infusions. CONCLUSION European neurologists who were part of this survey considered the benefit-risk-ratio of ofatumumab as favourable and the monthly self-administered subcutaneous injections offering convenience for patients in the clinical practice.
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Affiliation(s)
| | - Sara Eichau
- Hospital Universitario Virgen de La Macareona of Sevilla, Seville, Spain
| | - Giovanna Borriello
- MS Center, Neurology Unit, Fatebenefratelli San Pietro Hospital, Rome, Italy
| | | | - Carola Wagner
- Novartis Pharma GmbH, Nuremberg, Germany and working on behalf of Novartis Pharma Vertriebs GmbH, Nuremberg, Germany
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Muflih SM, Al-Azzam S, Karasneh RA, Bleidt BA, Conway BR, Bond SE, Aldeyab MA. Public knowledge of antibiotics, self-medication, and household disposal practices in Jordan. Expert Rev Anti Infect Ther 2023; 21:477-487. [PMID: 36843495 DOI: 10.1080/14787210.2023.2182770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND This study aimed to assess public understanding of antibiotics, self-medication, and drug disposal practices. METHODS A cross-sectional self-administered online survey was undertaken in Jordan. RESULTS The study was completed by 1,105 participants. When asked about their knowledge of antibiotics, rational antibiotic use, and disposal practices, 16% percent believed they should discontinue antibiotics once they felt better, and 12% agreed to take the same antibiotics prescribed to others for the same illness. Self-medication with antibiotics was practiced by 44% of the participants. Prior experience, healthcare costs, and pharmacy location were all major determinants of self-medication. Only 6.4% of unneeded antibiotics were returned to the pharmacy, 60% were kept at home, and 26.6% were disposed of at home. Almost half of those who kept the antibiotics said they would use them again, and one-third said they would give them to friends and family. Respondents who had used antibiotics within the previous 6 months (p = 0.052) and relied on medication leaflets (p = 0.031) and physician recommendations (p = 0.001) were less likely to self-medicate with antibiotics. CONCLUSIONS The study highlighted areas of inappropriate use of antibiotics, self-medication and the improper antibiotic disposal that can inform antimicrobial stewardship.
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Affiliation(s)
- Suhaib M Muflih
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Reema A Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Barry A Bleidt
- Department of Socio behavioral and Administrative Pharmacy, College of Pharmacy, Nova Southeastern University, Davie-Fl, USA
| | - Barbara R Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK.,Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, UK
| | - Stuart E Bond
- Pharmacy Department, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - Mamoon A Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
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37
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Nyeko R, Otim F, Obiya EM, Abala C. Anti-malarial drug use, appropriateness and associated factors among children under-five with febrile illnesses presenting to a tertiary health facility: a cross sectional study. Malar J 2023; 22:103. [PMID: 36941616 PMCID: PMC10029306 DOI: 10.1186/s12936-023-04534-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/15/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Malaria is endemic in 95% of Uganda and constitutes the country's most significant public health problem-being the leading cause of morbidity and mortality, especially among children under five years of age. The current national malaria treatment policy is to use artemisinin-based combination therapy (ACT) as first-line treatment, and recommends parasitological confirmation of malaria before therapy. Adherence to this policy, however, remains suboptimal, with the self-initiated home-based therapy being common-posing undue exposures to, and pressure on the current artemisinin-based combinations, with the danger of emergence of drug resistance. The study evaluated the anti-malarial use and its appropriateness among febrile children under five presenting to a tertiary health facility in northern Uganda in light of the current malaria treatment policy. METHODS This was a cross-sectional study in a tertiary health facility in northern Uganda between March and September 2021. Children aged 6-59 months with fever were selected using systematic random sampling. A pretested interviewer-administered questionnaire was used to collect clinical data from the caregivers. Data were analysed using SPSS version 23. Descriptive statistics and multiple logistic regression models were applied. P-value < 0.05 was considered for statistical significance. RESULTS Seventy-two (34.3%) of the 210 children with fever in this study used anti-malarials prior to the hospital visit, 29.2% (21/72) of which were on a self-medication basis, 22.2% (16/72) were empiric prescriptions-all of which inappropriate, and only 48.6% (35/72) were prescribed based on a parasitological diagnosis of malaria. The most commonly used anti-malarials were artemether-lumefantrine 60/72 (88.3%), while a lesser proportion of quinine 7/72 (9.7%), artesunate 3/72 (4.2%) and dihydroartemisinin-piperaquine 2/72 (2.8%) were used. The factors independently associated with anti-malarial use among the children with febrile illnesses were duration of fever (p = 0.001); level of the nearest facility (p = 0.027), distance from the nearest health facility (p = 0.025), and caregivers' age (p = 0.038). CONCLUSIONS Inappropriate use of anti-malarials for childhood febrile illnesses is prevalent in the study setting, facilitated by the ease of over-the-counter access, empiric prescription and use of leftover anti-malarials. This calls for a need to address communities' health-seeking behaviour and the health providers' practice alike.
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Affiliation(s)
- Richard Nyeko
- Department of Paediatrics and Child Health, Faculty of Medicine, Lira University, Lira, Uganda.
| | - Felix Otim
- Department of Laboratory, St. Mary's Hospital Lacor, Gulu, Uganda
| | - Evelyn Miriam Obiya
- Department of Paediatrics and Child Health, St. Mary's Hospital Lacor, Gulu, Uganda
| | - Catherine Abala
- Department of Paediatrics and Child Health, St. Mary's Hospital Lacor, Gulu, Uganda
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Braun TD, Green Z, Meshesha LZ, Sillice MA, Read J, Abrantes AM. Self-compassion buffers the internalized alcohol stigma and depression link in women sexual assault survivors who drink to cope. Addict Behav 2023; 138:107562. [PMID: 36463606 PMCID: PMC10184311 DOI: 10.1016/j.addbeh.2022.107562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/01/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Depression is strongly implicated in drinking to cope and the development of alcohol use disorders (AUD) in women, particularly among women with a history of sexual assault victimization (SAV). Alcohol use in women is heavily stigmatized, and substance use stigma is associated with depression. This study examined the link between internalized alcohol stigma (AS) and depression and tested whether self-compassion buffered (i.e., moderated) this association in a sample of women with a history of SAV and unhealthy drinking to cope. METHOD Women sexual assault survivors (N = 288; 82 % White, 91.2 % Non-Hispanic, 20.2 % sexual minority) reporting unhealthy drinking (Alcohol Use Disorders Inventory Test-C ≥ 4) and drinking to cope (Drinking Coping Motives Questionnaire-Revised ≥ 2) completed online self-report surveys. Hierarchical regression analyses tested associations between internalized-AS and self-compassion with depression after controlling for covariates (age, income, education, AUD symptoms, and posttraumatic stress disorder) and then, whether self-compassion moderated the Internalized-AS and depression link. RESULTS Internalized-AS accounted for 1.4 % of variance in depression (p < .01); self-compassion accounted for added variance when subsequently modeled (8.2 %, p < .001). Moderation analyses revealed self-compassion to buffer the internalized-AS and depression link. Among participants reporting high levels of self-compassion, there was no association between internalized-AS and depression (p = .894). DISCUSSION While findings are modest, they align with the previously observed link between internalized-AS and depression and extend these findings to women with a history of SAV endorsing elevated coping motives and unhealthy drinking. Self-compassion may protect against this link, pending further research sampling greater diversity of participants and longitudinal and controlled designs.
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Affiliation(s)
- Tosca D Braun
- Alpert Medical School of Brown University, Providence, RI, United States; Butler Hospital, Providence, RI, United States; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States.
| | - Zoë Green
- University of Connecticut Health Center, Farmington, CT, United States
| | - Lidia Z Meshesha
- Department of Psychology, University of Central Florida, Orlando, FL, United States
| | - Marie A Sillice
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Jennifer Read
- Department of Psychology, University at Buffalo, Buffalo, NY, United States
| | - Ana M Abrantes
- Alpert Medical School of Brown University, Providence, RI, United States; Butler Hospital, Providence, RI, United States
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Lerango TL, Alagaw A, Tunje A, Andarge E, Duko B, Tilahune AB, Lerango SL. Self-medication practice among pregnant women in Wolaita Zone, Southern Ethiopia: An institutionally based cross-sectional study. Heliyon 2023; 9:e13833. [PMID: 36915492 PMCID: PMC10006518 DOI: 10.1016/j.heliyon.2023.e13833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
Background Self-medication is a treatment based on symptoms without prescription and medical consultation. Despite being one of the critical practices that impose a harmful effect on the fetus and the woman herself, evidence on its practice and associated factors are not well-documented. This study, therefore, assessed the self-medication practice and associated factors among pregnant women in Wolaita Zone, Southern Ethiopia. Methods An institutionally based cross-sectional study was conducted at public health institutions in Wolaita Zone, Southern Ethiopia by recruiting a total of 408 pregnant women using a systematic random sampling technique between March 2019 and April 2019. We used the Antenatal care (ANC) registry as a sampling frame. A pre-tested, structured, interviewer-administered questionnaire used to depict Self-medication practice and associated factors. Data entered using Epi-data and analyzed by SPSS 23.0. Results The overall prevalence of self-medication was 14.9% (95% CI:11-18). The odds of using self-medication may decreased by 75% for women who were in their third trimester (AOR = 0.25, 95% CI: 0.10, 0.64). However, the odds of practicing increased by 13-folds among pregnant women reported earlier (previous) self-medication experience (AOR = 13.62, 95% CI: 6.66-27.84). Conclusion The prevalence of self-medication was high in the current study setting. Women's gestational period (third trimester) and earlier self-medication experience were associated with their current self-medication practice.
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Key Words
- ANC, Antenatal Care
- AOR, Adjusted Odds Ratio
- CHI, Community-Based Health Insurance
- CI, Confidence Interval
- COR, Crude Odds Ratio
- Cross-sectional
- EFDA, Ethiopian Food and Drug Authority
- ETB, Ethiopian Birr
- HC, Health Center
- HDA, Health (Women) Development Army
- HMIS, Health ManagementInformation System
- OTC, Over-The-Counter Medicines
- PH, Primary Hospital
- POM, Prescription-Only-Medicines
- Pregnant women
- SNNPR, Southern Nations Nationalities and Peoples Region
- Self-medication
- Southern Ethiopia
- WHO, World Health Organization
- Wolaita
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Affiliation(s)
- Temesgen Leka Lerango
- School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Amsalu Alagaw
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Abayneh Tunje
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Eshetu Andarge
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.,Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Bereket Duko
- Research Fellow, Australian Centre for Precision Health, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia.,Adjunct Research Fellow, Curtin School of Population Health, Curtin University, Perth, Australia
| | | | - Semalgn Leka Lerango
- School of Medicine, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Misau YA, Mogere D, Mbaruk S, Usman US, Bello S, Oduwole O, Moriam C. Educational Interventions for Antibiotics Misuse and Self-Medication in Africa: A Systematic Review and Meta-Analysis [Protocol]. West Afr J Med 2023; 40:114-120. [PMID: 36718718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Antibiotics misuse and self-medication remains one of the most serious public health challenges globally. Persistent rise in resistant bacterial infections has been attributed to high prevalence of antibiotics misuse and self-medication. Large volume of literature has emerged describing studies that evaluate the effectiveness of various types and combinations of educational and behavior-modification techniques to reduce antibiotics misuse and self-medication. No previous systemic review has attempted to assess the quality of evidence in public domains on educational strategies aiming to reduce prevalence and improve knowledge, attitude and practice on antibiotics misuse and self-medication in Africa. This study, therefore, intends to assess the quality of evidence presented and determine the effectiveness of health education as an intervention tool for reducing prevalence and improving knowledge and attitude on antibiotics misuse and self-medication among adults in Africa. METHODS This study will include published papers on effectiveness of health education in reducing antibiotics misuse and self-medication from 2011-2021. Systematic search for literature will be conducted according to the Preferred Reporting Item for Systematic Reviews and Meat-analysis (PRISMA) guidelines to identify published studies based on our predetermined inclusion and exclusion criteria in PubMed, EMBASE, PsychINFO, CINAHL and Web of Sciences. Two independent reviewers will assess all identified studies and another set of reviewers will extract data for analysis and evidence synthesis.
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Affiliation(s)
- Y A Misau
- Department of Community Medicine College of Medical Sciences, Abubakar Tafawa Balewa University, Bauchi State, Nigeria.,Department of Epidemiology and Biostatistics, School of Public Health, Mount Kenya University, Thika Kenya
| | - D Mogere
- Department of Epidemiology and Biostatistics, School of Public Health, Mount Kenya University, Thika Kenya
| | - S Mbaruk
- Department of Epidemiology and Biostatistics, School of Public Health, Mount Kenya University, Thika Kenya
| | - U S Usman
- Department of Community Medicine College of Medical Sciences, Abubakar Tafawa Balewa University, Bauchi State, Nigeria
| | - S Bello
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Oyo State, Nigeria
| | - O Oduwole
- Department of Medical Laboratory Science, College of Basic Health Sciences, Achievers University, Owo, Ondo State, Nigeria
| | - C Moriam
- Cochrane Nigeria, Calabar Institute of Tropical Research and Prevention, University of Calabar, Cross Rivers State, Nigeria
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Abdelwahed AE, Abd-Elkader MM, Mahfouz A, Abdelmawla MO, Kabeel M, Elkot AG, Hamad MR, Ibrahim RAE, Ghallab MMI, Hamza N; Collaborators group. Prevalence and influencing factors of self-medication during the COVID-19 pandemic in the Arab region: a multinational cross-sectional study. BMC Public Health 2023; 23:180. [PMID: 36707840 DOI: 10.1186/s12889-023-15025-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The novel coronavirus pandemic (COVID-19) has begun with a wave of misinformation and fear of infection. This may have led people to self-medicate inappropriately. The World Health Organization describes self-medication (SM) as utilizing medicines to relieve symptoms or health conditions without consulting a physician. Inappropriate drug use is a burden on both health resources and patient health in the Arab region. This study aimed to detect the prevalence and influencing factors of self-medication among the general Arab population during the COVID-19 pandemic. METHODS A multinational cross-sectional study was conducted among the general population of ten Arab countries from early August to late October 2021. Participants aged 18 years or older could join the study via social media platforms. A convenience sampling technique was used. A developed and validated web-based questionnaire was used to collect data on self-medication practice, associated influencing factors, information sources, commonly used medications, and commonly treated conditions. Descriptive, univariate, and multivariate regression analyses were applied using IBM SPSS v 26 and R v 4.0.0 software. RESULTS A total of 8163 participants completed the questionnaire, and 518 participants were excluded from the analysis due to inconsistencies in their data. Almost two-thirds (62.7%) of participants reported practicing self-medication during the COVID-19 pandemic. At the country level, Egypt had the highest prevalence of self-medication practice (72.1%), while Palestine had the lowest prevalence (40.4%). The most commonly used drugs were analgesics, antipyretics, and vitamins (86, 65.1, and 57.1%, respectively), while antitussives and antibiotics scored 47.6 and 43.3%, respectively. Experience with similar health conditions (74.6%) and urgency of the problem (47.2%) were the most frequent factors that led to self-medication. Additionally, 38.2% of the self-medicated participants (SMPs) used drugs as prophylaxis against COVID-19. Pharmacist consultation was the most common source of information about self-medication (66.7%). Multivariate analysis showed that predictors of self-medication were older age (p = 0.008), presence of chronic illness (p = 0.015), and having monthly income or medical insurance that does not cover the treatment cost (p = 0.001, p < 0.001, respectively). CONCLUSION Self-medication is considered a common practice across the Arab population. It is necessary to regulate policies and raise awareness among the public about self-medication.
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Saha A, Zam D, Khan AA, Dutta P, Mannan A, Alam N. Prevalence and determinants of self-medication practices among general population: A cross-sectional study in Thimphu, Bhutan and Chattogram, Bangladesh. J Public Health Res 2023; 12:22799036231152327. [PMID: 36726455 PMCID: PMC9885035 DOI: 10.1177/22799036231152327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
Background Self-medication is a global phenomenon and a potential contributor to negative health consequences on human health including emergence of antibiotic drug resistance globally. Objective The primary objective of this study was to estimate the prevalence and determinants of self-medication in Thimphu, Bhutan and Chattogram, Bangladesh, two neighbouring South Asian country. Methodology A community-based cross-sectional study was conducted in the city of Thimphu, Bhutan and Chattogram, Bangladesh. A pre-tested and semi-structured questionnaire was used to collect information on socio-demographic characteristics, health status and self-medication practices in the previous year. Results Out of the 998 recruited participants, 61.8% (170/275) from Thimphu and 41.5% (300/723) from Chattogram reported self-medication practices in last year of interview. In Thimphu, eye/ear infection (90.9%), fever (84.9%), headache (80.5%) and cough and cold (78.2%) were the major illnesses reported for self-medication, whereas in Chattogram people mostly self-medicated for skin disorder (74.4%), diarrhoeal illness (59.1%) and eye/ear infection (48.1%). Knowledge on side-effects of the drugs taken for self-medication was comparatively higher in Thimphu than in Chattogram. Both in Thimphu and Chattogram, higher odds of self-medication were found for common illnesses with adjusted OR 7.8; 95% CI 3.3-18.4 and adjusted OR 2.0; 95% CI 1.4-2.8, respectively in Thimphu and Chattogram. Conclusion Self-medication was found to be substantially high in both the cities, however, rate of self-medication was higher in Thimphu compared to Chattogram. Knowledge and awareness raising about harmful effect of self-medication and effective regulation over selling of prescription medication in pharmacies should be strengthened in both countries.
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Affiliation(s)
- Ayan Saha
- Department of Bioinformatics and
Biotechnology, Asian University for Women, Chattogram, Bangladesh
- Disease Biology and Molecular
Epidemiology Research Group, Chattogram, Bangladesh
| | - Dawa Zam
- Department of Public Health, Asian
University for Women, Chattogram, Bangladesh
| | - Ayesha Ahmed Khan
- Department of Microbiology, Chittagong
Medical College, Chattogram, Bangladesh
| | - Preya Dutta
- Disease Biology and Molecular
Epidemiology Research Group, Chattogram, Bangladesh
- Department of Pharmacy, BGC Trust
University Bangladesh, Chattogram, Bangladesh
| | - Adnan Mannan
- Disease Biology and Molecular
Epidemiology Research Group, Chattogram, Bangladesh
- Department of Genetic Engineering &
Biotechnology, University of Chittagong, Chattogram, Bangladesh
| | - Nazmul Alam
- Department of Public Health, Asian
University for Women, Chattogram, Bangladesh
- Nazmul Alam, Department of Public Health,
Asian University for Women, Badsha Miah Road, Chattogram-4000, Bangladesh.
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Yan B, He Z, Dong S, Akezhuoli H, Xu X, Wang X, Zhou X. The moderating effect of parental skills for antibiotic identification on the link between parental skills for antibiotic use and inappropriate antibiotic use for children in China. BMC Public Health 2023; 23:156. [PMID: 36690967 PMCID: PMC9872431 DOI: 10.1186/s12889-023-15099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Inappropriate antibiotic consumption promotes antibiotic resistance. However, findings on the association between antibiotic-related knowledge and behaviors are inconsistent and contradictory, resulting in unjustified guidance of interventions. The mechanisms between the different kinds of antibiotic-related skills contained in knowledge modules in some previous studies are indistinct and rarely studied. METHODS A cross-sectional survey was conducted between June 2017 and April 2018 in three Chinese provinces, investigating 9526 parents with children aged 0-13 years old. Data from 1944 parents who self-medicated their children and 2478 respondents whose children sought care were analyzed. RESULTS Skills for antibiotic identification were found to be a moderator for the association between skills for antibiotic use and two inappropriate behaviors. Compared with parents with low levels of both skills for antibiotic identification and use, those mastering both skills at either medium (OR = 0.48, 95% CI [0.26-0.88]) or high (OR = 0.15, 95% CI [0.07-0.34]) level were less likely to self-medicate their children with antibiotics. Parents with a medium level of skills for antibiotic identification and high level of skills for antibiotic use (OR = 0.18, 95% CI [0.08-0.44]) and those with a high level of both skills (OR = 0.15, 95% CI [0.05-0.47]) were less likely to ask doctors for antibiotics when seeking care. CONCLUSION Parents' high level of skills for antibiotic identification is revealed to promote inappropriate antibiotic use when parents master a low level of skills for antibiotic use. Conversely, based on excellent skills for antibiotic use, better skill for antibiotic identification is associated with a greater reduction in inappropriate behaviors. We recommend future health education to strengthen skills for antibiotic identification along with guidance on antibiotic use.
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Affiliation(s)
- Bo Yan
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhenke He
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shixin Dong
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hailati Akezhuoli
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xin Xu
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaomin Wang
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Xudong Zhou
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China.
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Mhadi AA, Ong SC, Abed Y, Abu Ali KA. Irrational use of medicine in Arab countries: findings from a systematic review of literature (2000-2019). Int J Pharm Pract 2023; 31:165-175. [PMID: 36595471 DOI: 10.1093/ijpp/riac082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 10/14/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This study aimed to analyse the patterns of the irrational use of medicines in Arab countries and to determine the factors contributing to these patterns. METHODS A systematic literature review was conducted using two major databases: PubMed and Scopus. The systematic search targeted original studies conducted in Arab countries from 2000 to 2019. A conceptual framework was adopted from a previous study and was utilized to assess the irrational use of medicines and its influencing factors. RESULTS A total of 136 studies from 16 Arab countries were included. Almost all were cross-sectional studies. Most focused on evaluating the irrational use of medicines rather than investigating the cause. The number of medications per encounter was 2.3 which is within the limits of developed countries (2.7). The percentage of antibiotics per 100 encounter was 50.1% and the percentage of injections prescribed per 100 encounter was 15.2%. The consumption of antibiotic and injections was much higher than that recommended by WHO. At the same time, the review identified that one fourth of all medications were unnecessarily prescribed. SUMMARY The literature review revealed that the irrational use of medicine is prevalent in most Arab countries. Excessive use of antibiotics was the most commonly observed pattern. Therefore, there is a need to conduct further research to identify the factors that drive the irrational use of medicines in Arab countries and then to make recommendations to mitigate this issue.
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Affiliation(s)
- Ashraf Abdulrahim Mhadi
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.,Directorate of Pharmacy, Ministry of Health, Gaza, Palestine
| | - Siew Chin Ong
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Yehia Abed
- Faculty of Public Health Al-Quds University, Gaza, Palestine
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Bi B, Qin J, Zhang L, Lin C, Li S, Zhang Y. Systematic Review and Meta-Analysis of Factors Influencing Self-Medication in Children. Inquiry 2023; 60:469580231159744. [PMID: 36998210 PMCID: PMC10069002 DOI: 10.1177/00469580231159744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
To evaluate the prevalence, influencing factors, and behavior rules of self-medication in children. Articles on self-medication in children from various electronic databases (PubMed, Cochrane Library, Web of Science, the WHO website (https://www.who.int/), ABI, CNKI, and Wanfang), were searched to August 2022. The single-group meta-analyses of the prevalence, influencing factors, and behavior rules of self-medication in children were performed using Revman 5.3 and Stata 16.0. The overall pooled prevalence of self-medication in children was 57% (95% CI: 0.39-0.75, I² = 100%, P < .00001 Z = 6.22). The pooled prevalence for main influencing factors, in terms of caregivers, was: 73% (95% CI: 0.72-0.75, I² = 100%, P < .00001, Z = 111.18) for those in rural areas; 55% (95% CI: 0.51-0.59, P = .04, Z = 26.92, I² = 68%, P < .00001) for females; 75% (95% CI: 0.74-0.76, I² = 68%, P < .00001, Z = 106.66) for those whose income was less than 716 dollars; 77% (95% CI: 0.75-0.79, I² = 99%, P < .000001, Z = 92.59) for the middle-aged and elderly; and 72% (95% CI: 0.58-87, I² = 99%, P < .00001, Z = 9.82) for those with a degree below bachelor. In the process of self-medication for children, 19% (95% CI: 0.06-0.32, I² = 99%, P < .00001, Z = 2.82) of the caregivers did not read the instructions, 28% (95% CI: -0.03-0.60, I² = 100%, P < .000001, Z = 1.77) neglected adverse effects, 49% (95% CI: 0.11-0.87, I² = 100%, P = .01, Z = 2.51) spontaneously increased or decreased the dosages, 49% (95% CI: 0.48-0.55, I² = 65%, P < .00001, Z = 16.51) had an awareness of over-the-counter (OTC) drugs, and 41% (95% CI: 0.18-0.64, I² = 99%, P < .00001, Z = 3.49) misrecognized the antibiotics. Self-medication for children was common, although the overall prevalence was not very high. The prevalence of self-medication in children was relatively higher among those caregivers who were female, rural, had low-income, were elder, or had a degree below bachelor. Common behaviors during self-medication in children included spontaneous dose increase or decrease, a lack of awareness of OTC drugs, and misconception of antibiotics. Government departments should formulate corresponding policies to provide quality health education resources for the caregivers of children.
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Affiliation(s)
- Bingqing Bi
- School of Public Health, Capital Medical University, Beijing, China
| | - Jiangmei Qin
- China National Health Development Research Center, Beijing, China
- China Health Economics Association, Beijing, China
| | - Lifang Zhang
- China National Health Development Research Center, Beijing, China
- China Health Economics Association, Beijing, China
| | - Chunmei Lin
- China National Health Development Research Center, Beijing, China
- China Health Economics Association, Beijing, China
| | - Shugang Li
- School of Public Health, Capital Medical University, Beijing, China
| | - Yanchun Zhang
- China National Health Development Research Center, Beijing, China
- China Health Economics Association, Beijing, China
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Joseph N, Colaco SM, Fernandes RV, Krishna SG, Veetil SI. Perception and Self-Medication Practices Among the General Population During the Ongoing COVID-19 Pandemic in Mangalore, India. Curr Drug Saf 2023; 18:233-245. [PMID: 35570530 DOI: 10.2174/1574886317666220513101349] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/03/2022] [Accepted: 03/07/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The practice of self-medication appears to be much more rampant during the- COVID-19 pandemic. Hence, awareness about its consequences is essential among the general population during the current circumstances. OBJECTIVES To study the prevalence of and perception towards self-medication, as well as its determinants among the general population of Mangalore. METHODS This cross-sectional study was done during the second wave of the COVID-19 pandemic in August 2021. Data were collected using a Microsoft form disseminated among residents of Mangalore through WhatsApp and email. RESULTS The mean age of the 225 participants in this study was 34.5±15.2 years. Self-medication practice was indulged by 77(34.2%) out of the total participants. The most common symptom for which self-medication was practiced was for common cold [54(70.1%)], and the most commonly used drug was paracetamol [67(87%)]. 167(74.2%) participants felt that self-medication practices were harmful, but the rest 58(25.8%) felt that it was not a harmful practice. 116 (51.6%) participants felt that the advertisements in mass media and social media promoted self-medication practices among people. Out of the 69(30.7%) participants who felt that self-medication practice was acceptable during the current circumstances, the majority [66(95.6%)] felt that it was better to avoid visiting any doctor or health care facility presently to avoid acquiring COVID-19. In the multivariable analysis, participants with a history of self-medication among their family members, relatives, or friends were more likely to indulge in self-medication (p<0.001). Perceptions that self-medication practices were harmful were more among females (p=0.0397). CONCLUSION More than one-third of the participants indulged in self-medication practice. More than one-fourth of the participants felt that self-medication practices were not harmful. About one-third felt it was acceptable, and most of them felt so to avoid the risk of contracting the Coronavirus infection. Awareness of its hazards, particularly among males and those with a family history of selfmedications, is required at Mangalore.
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Affiliation(s)
- Nitin Joseph
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Lin Y, Cai CZ, Alias H, Wong LP, Hu Z. A cross-sectional survey of self-medication with Traditional Chinese Medicine for treatment and prevention of COVID-19. Complement Ther Med 2022; 71:102898. [PMID: 36372316 DOI: 10.1016/j.ctim.2022.102898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate user behavioural profiles and the prevalence of self-medication with traditional Chinese medicine (TCM) for COVID-19 among the general public in China. DESIGN Cross-sectional study. SETTING Self-administered online survey was carried out between January and June 2021 in China. RESULTS A total of 1132 complete responses were received from a nationwide sample. A considerable proportion viewed TCM to be more effective than Western medicine for treating COVID-19 (67.1 %) and stated that it is safer to use TCM (63.5 %) and easier to access TCM for treating COVID-19 (63.5 %). A total of 16.4 % (95 %CI 14.3-18.7) reported ever self-medicating with TCM to resolve COVID-19 symptoms and 12.2 % (95 % CI 10.3-14.2) ever using TCM to prevent SARS-CoV-2 infection. Lianhua Qingwen capsule/granule (53.2 %), Ganmao granule (50.5 %) and Banlangen granule (44.6 %) were most commonly used to resolve COVID-19 symptoms whereas Banlangen granule (60.1 %) was commonly used for the prevention of SARS-CoV-2 infection. Older age participants, from rural areas, with chronic diseases, higher socioeconomic status, and a positive attitude towards TCM were more likely to self-medicate using TCM to resolve COVID-19 symptoms. CONCLUSION Self-medication with TCM during the COVID-19 pandemic for symptom control or prevention is prevalent. The findings of the user behavioural profile and types of TMCs commonly used in this study provide beneficial information for the development of strategies to improve public health-seeking behaviour and the performance of the country's healthcare system in the era of the COVID-19 pandemic.
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Rodriguez L, Read JP. Trauma cue-elicited emotional response profiles influence acute experiences of alcohol urge. J Behav Ther Exp Psychiatry 2022; 77:101772. [PMID: 36113909 DOI: 10.1016/j.jbtep.2022.101772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 05/24/2022] [Accepted: 07/29/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Affective responses to trauma cues in individuals with posttraumatic stress (PTS) can evoke a desire to drink and may shed light on novel mechanisms of PTS-drinking. The present study aimed to (1) identify and characterize patterns of acute emotional responses (ER) to trauma cues and (2) examine how these patterns influence drinking urge. METHODS University students (N = 304; Mage = 19; 52.3% female) completed a structured clinical interview to confirm trauma history and PTS. At an experimental session one week later, participants completed a series of three trauma cue exposures. Affect and drinking urge were measured at baseline, after each cue exposure, and at experiment's end. RESULTS Latent profile analysis of ER yielded a five-profile solution: (1) Nonresponders (2) Low Responders (3) Moderate Responders (4) Resilient Responders and (5) High Responders. Profiles differed by trait neuroticism, PTS, and emotion dysregulation, with High Responders as the most severe group. In latent growth curve models, profiles significantly predicted alcohol urge trajectories in a graded pattern. High Responders, with the greatest affective intensity, showed the strongest urge. Duration of affect was also implicated with Resilient Responders, who had similar intensity but faster overall affective recovery time compared to High Responders, demonstrating lower mean levels of urge. LIMITATIONS External validity is limited. CONCLUSIONS Individual differences in ER to trauma cues are important for understanding alcohol urge. Findings can inform integrative treatments for PTS-drinking by targeting ER to shorten affective recovery to trauma reminders and reduce the need for alcohol use as a regulation strategy.
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Affiliation(s)
- Lauren Rodriguez
- Department of Psychology, State University of New York, University at Buffalo, USA; 386 Park Hall, Buffalo, NY, 14260-4110, USA.
| | - Jennifer P Read
- Department of Psychology, State University of New York, University at Buffalo, USA; 231 Park Hall, Buffalo, NY, 14260-4110, USA.
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Eltom EH, Alanazi AL, Alenezi JF, Alruwaili GM, Alanazi AM, Hamayun R. Self-medication with antibiotics and awareness of antibiotic resistance among population in Arar city, Saudi Arabia. J Infect Dev Ctries 2022; 16:1762-1767. [PMID: 36449649 DOI: 10.3855/jidc.16853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/07/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Self-medication with pharmaceutical products can be defined as the use of these products without a medical prescription, and the production, distribution, and sale of these products are the client's responsibility, while they think it is within rational usage. Among these products, antibiotics remain the most serious problem leading to the spread of antibiotic resistance, with consequences of increased morbidity, mortality, and extended hospital stays. METHODOLOGY This is a cross-sectional study aimed to estimate the prevalence of self-medication with antibiotics among Arar city population and assessing their awareness of antibiotic resistance. Data had been collected through a self-administered validated online questionnaire. Data entry and analysis were performed using a statistical package for the social science program (SPSS) version 20. RESULTS The overall number of respondents to our survey was 462, with 56.7% female and 43.3% male participants. The prevalence of self-medication with antibiotics was (77.5%). The main reasons for self-medication with antibiotics were ease of use (54.6%) and cost-saving (24.8%). When asked about what they think about self-medication with antibiotics for self-care, 20.1% of our participants thought that it is a good practice and 41.6% thought that it is an acceptable practice. 81.4 % of respondents thought that antibiotic resistance occurs when your body becomes resistant to antibiotics and no longer works well. CONCLUSIONS In the Northern region, despite the open and rapid access to medical care services, it appears that a high proportion of young adult population prefers custom antibiotics without a medical prescription.
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Affiliation(s)
- Elhassan Hussein Eltom
- Department of Pharmacology, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia.
| | | | | | | | | | - Rahma Hamayun
- Department of Pharmacology, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
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Saleh EA, Haddadin RN, Saleh B, Elayeh E. Changes in drug demand when a pandemic coincides with other outbreaks in a war zone country: a cross-sectional pilot study. J Pharm Policy Pract 2022; 15:89. [PMID: 36419090 PMCID: PMC9682693 DOI: 10.1186/s40545-022-00487-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Yemen's health system has severely deteriorated due to the ongoing civil war accompanied by the COVID-19 pandemic which coincided with other outbreaks of endemic infections. Many health institutions closed due to insufficient equipment and supplies. Consequently, pharmacists became the available healthcare provider on the frontlines. This study aimed to evaluate the pattern of demand for prescription and nonprescription drugs during the pandemic based on the pharmacist's perspective in Yemen, a conflict zone country. METHODS An online survey was developed, validated, and distributed among pharmacists. The questionnaire was composed of two sections: (1) demographic characteristics of the participants and (2) changes in the demand for different drug categories. Chi-square test and Fisher's exact test were used to find statistical associations. RESULTS Responses (330) were received from pharmacists working in 12 out of 22 governorates in Yemen. During the pandemic, there was an increase in the demand for prescription drugs such as antibiotics, antimalarials, and sedatives (95%, 90%, and 71%, respectively) and an increase in the demand for nonprescription drugs such as vitamins (93%) and paracetamol (> 90%). Some of these drugs could have serious side effects if taken without medical advice, and others could result in severe effects if taken concomitantly. In addition, there was an increase in the demand for prescription drugs without a prescription, which was reported by 50% of the participants. No statistical difference was seen between the frontline districts and major cities in terms of requesting these drugs without a prescription. On the other hand, most participants (75.2%) did not attend any training or workshop during the last 6 months of conducting this survey. CONCLUSION COVID-19 has increased the demand for many prescription and nonprescription drugs, where the irrational use of these drugs may lead to devastating health effects. In war zone areas hit by a pandemic, policymakers and public health organizations should focus on training and educating pharmacists as important health care and medicine providers for the public.
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Affiliation(s)
- Ebtesam A. Saleh
- grid.411125.20000 0001 2181 7851Department of Pharmacology & Toxicology, School of Pharmacy, University of Aden, Aden, Yemen
| | - Randa N. Haddadin
- grid.9670.80000 0001 2174 4509Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Bassam Saleh
- Medical and Health Unit, International Organization of Migration (IOM), Aden, Yemen
| | - Eman Elayeh
- grid.9670.80000 0001 2174 4509Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
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