Self Medication Practices in a Rural Filipino Community

Objectives:

The purpose of the study was to assess the factors affecting prevalence of self- medication practices using commercial drugs of the Rural Filipino Family including its correlation and who among them experienced non therapeutic effect. Methods: This study was a descriptive cross- sectional question based study. The study was conducted in 3 rural, agricultural lands, municipality in three different provinces wherein 2 municipalities were accomplished around the Region 2 while the remaining one was conducted in Cordillera Administrative Region.

Descriptive data were expressed as percentage, frequency and mean.

Pearson- r was utilized in assessing correlation the factors. Results: Almost all of the respondents practices self-medication 90.3% within the family, the respondent’s profile, wherein majority of them who accomplished the semi- constructed and assisted questionnaire were females, predominantly were mothers, with a mean age of 39 years, and primarily of them were nuclear type of family composing an average family members of 5 people, most of them finished a college degree, and most of the family earned a range of ₱1001- ₱P5000 with a mean of ₱4,476,and majority was enrolled in a health insurance.

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the most commonly used medication were paracetamol which rank first followed by Ibuprofen, both commercial drugs falls under the classification of analgesics and or antipyretic while the third one was amoxicillin an antibiotics. On the aspect of the accuracy of medication usage, paracetamol, Ibuprofen and loperamide were the topmost correctly used. On the other hand, most of the commercial medications incorrectly used were antibiotics wherein amoxicillin was the leading medication that was wrongly used then cotrimoxazole and cephalexin.

Fever is the most common illnesses prompted the family to self- medicate, followed by headache and then cough and colds. The families’ understanding and compliance to the commercial drugs utilized in self-medication was good, and majority were aware to its indication but not with the non- therapeutic effects. Almost perceived their health as most important and their current health status were in good term. Most of the family intervened thru self- medication in times of illness occurrence rather than attending health facilities or using herbal preparations. Majority did not experience such non- therapeutic effects. While the minority who experienced non- therapeutic reactions, predominantly both dizziness and epigastric pain leading manifestation felt by the family then followed by the occurrence of rash or itchiness and ringing of ears. The study revealed that there was a negative correlation between the prevalence of self-medication with prevalence of adverse effect.

Conclusion:

In this study, the researchers concluded that self-medication is safe practice of self- care as the occurrence of adverse effect is low and negatively correlated to the prevalence of self- medication. However, the revealed number of family experienced adverse effect as they practiced self- medication must not be ignored for the public health safety will be at risk and in jeopardy.

Recommendation:

There must be further study utilizing a standardized gathering tool to facilitate more efficient result. Then, there must be further study to be conduct to further assess the community, to increase their knowledge about the different adverse effect of such medication that they take without the guidance of the medical team. Moreover, Deductive community intervention addressing the erroneous usage of medications to decrease the inappropriate usage of medication drugs in self- medication practices such as appropriate health awareness. Furthermore, a law or ordinance must be established to guide the drug retailers protect the vulnerable people.

INTRODUCTION

Background of the Study

In 1960’s, Self-care and self- medication was regarded as an unnecessary and bad practice while the traditional or paternalistic will be the solely ruling treatment of the patient illness and it was regarded as safe and responsible practice. Moreover, the paternalistic approach makes the patient invisible towards his own wellness for he will be dependent on his doctors. But, as medical advancement of the medical discoveries, including technologies, and development including the enhancement of health professions, the paternalistic approach changes into a patient centered and disease prevention health model which self-care and self-medication of nonprescription also known as over- the – counter drugs was included, approved and advocated (The Story of Self-medication and Self Medication, 2006). In addition, self-medication was regarded as an important pillar of primary health care (Pushpa, R., et. al. 2012) and a common health-seeking behavior ( Yi Wen, F., et. al., 2011), which World Self Medication Industry (WSMI) a non-government organization with World Health Organization (WHO)
affirms saying that self- medication as a key component of self- care. William Osler once said “a desire to take medicine is perhaps the great feature which distinguishes man from animals”. The quoted word may justify a person to take medication without any advice by appropriate health allied such as Doctor, Pharmacist and Nurses this practice is called Self Medication (Phalke V.D., et. al., 2003).

This occurrence of self- medication practices was due to various factors. These contributing factors were perceived of signs and symptoms as minor or mild or it was the same with the previous illnesses and treated by the same medications, expensive health facility, availability of Health Care Personnel, fear of the crowd in the clinic, readily availability and s of medication without prescription (Adualem, T., et. al., 2004; Verma, R. K., et. al., 2010; Worku, S., et. al, 2006). A study showed that self- medication practices were rampantly increasing especially to economically deprived countries wherein most episodes of illness are treated through the said practice (Geissier, P. W., et. al. 2000). Based from the literatures the most common used medication were ranging from analgesics, anti-microbiasl, and anti-pyretics (Shankar, P.R., et. al., 2002; Verma, R. K., et. al., 2010; Worku, S., et. al, 2006; Sweileh,W. M.,et. al, 2004). While, the most common illnesses that prompted to practice self- medication were fever, pain, respiratory infections, gastrointestinal illnesses and skin diseases (Worku, S., et. al, 2006). Moreover, a significant evidence of approval to WSMI advocacy in the Philippines is the establishment and development of Botika ng Barangay (BnB) in the different communities as a program of the Department of Health (DOH) that sells Bureau of Foods and Drugs (BFAD) approved over-the-counter medicines. Two well-known antibiotics namely Amoxicillin and Cotrimoxazole, essential drugs (vitamins and minerals), medication for chronic disease such as hypertension, diabetes and asthma, making medications easily, readily accessible to far-flung communities as self-medication is also included as a primary health care activity. This project goal to promote equal health services guaranteeing the availability and accessibility of cost effective and safe drugs especially to those indigent constituents as a Presidential Mandate in year 2001 of Pharma 50 (Cuevas, F., et., al.,Public Health Nursing in the Philippines 10th edition 2007,Publications Committee, National League of the Philippine Government Nurses, Incorporated) . However, lot of studies showed that a lot of people practicing self- medication were not aware to the other effects the drug may give aside from the therapeutic effect of the medication. In addition, a study found out that people tend to mix two the same indication of medication without knowing it was just the same. (Verma, R., et. al., 2010) Although practicing self- medication had been advocated and has been reported to have several benefits it has been associated with many risks including the lack of appropriate instruction from physicians, increase risk of adverse drug interaction, drug resistance, misdiagnosed and most distressing is an accidental death (Al- Azzam, S.I., et. al., 2007). “Lahat ng gamot effective pero buntis ka,safe ba?”. “Lahat ng gamot effective, eh walang laman ang tiyan mo, safe ba?” –from Paracetamol Commercial The quoted advertisement pointing out that every medication has its due to self- medication person may forget that every medication a person takes in has a component that might interact with other component from other substances such as medication or foods, aside from its therapeutic effects, this drugs may cause other effects which may produce side effects or even the detrimental adverse effects which puts a person at risk when drugs taken inappropriately. Statement of the Problem

A lot of studies were done in self- medication however there no published studies with regards to self- medication practices in a community which focused group or the source of data is family and the factors contributing to practice self- medication in using commercial drugs of Rural Filipino Family. In general, the purpose of the study is to assess the prevalence of self- medication in using commercial drugs practices of the Rural Filipino Family and family who experienced adverse effect.

Specifically, it seeks to answer the following research question:

1. What is the profile of the respondents in terms of:
2.1. Age
2.2. Sex
2.3. Position in the family
2.4. Type of family
2.5. Number of family members
2.6. Educational attainment
2.7. Socio-economic status
2.8.1. Estimated monthly gross family income
2.8. Health Insurance
2. What is the prevalence of Rural Filipino Family practicing self- medication using commercial drugs in terms of:

3.9.2. Commonly used medicines
3.9.3. Accuracy of medication usage
3.9.4. Illnesses that prompted the family to practice self-medication

3. What is the medication knowledge of the family who practice self- medication using commercial drugs which includes the understanding and compliance of the medication instructions, awareness of both drugs indication and non- therapeutic effects? 4. What is the health belief an the experienced prior to illness?

5. What are the experienced non- therapeutic effects of the family as they practice self- medication using commercial drugs taken without prescription?

6. What is the relationship of the contributing factors :

7.9.5. Respondents profile;

7.9.6. medication knowledge;

7.9.7. health belief and experience of prior illness; 7.9.8. and prevalence of experienced adverse effect;

Significance of Study

This study therefore will result to the enhancement of Nursing Profession regarding with the self- medication practices of the rural Filipino families by assessing the incidence which will reveal the real situation of rural Filipino families practicing self- medication. In addition, through this study it will disclose the occurrence of adverse effects experience by the family practicing self- medication which usually unreported. The current study will not only add to the current existing of knowledge but further advance the field by discussing and knowing the relationship of the factors that affecting the prevalence of self- medication practices of the family and understanding these contributing factors will lead health practitioners to address the problem accordingly, preventing the occurrence of adverse
effects that can risk the health status of the community people through educational awareness. Moreover, researcher believe that trough the study health practitioner will be aware of the weak points of inappropriate usage of the over-the-counter drugs which they can established interventions to eradicate inappropriate used or correct the wrong practice. Also it will be used to assess the policies available to control medication around the country.

Socio-Economic Status:

Based from the study made by Andualem, T. (2004) declaring that the self-medication occurs in a wide range of ages around the globe, which includes students ranging from high school to tertiary levels, non- medical or medical students, together with professionals, urban or rural community, even lactating mothers and adolescence were seen that prevalence in self- medication were high ( Almasdy, D.,et.al., 2011; Boateng, D.P., et. al,2012; Banarfee, I., et. al., 2012). In addition, older adults(more than 65 year old) who leaves alone with low level of education was found more probably to practice self- medication than those who were married and with secondary educational attainment or high school degrees (Lam, P., 2011). In addition, a study by Zagreb (2001) point out that self- medication in household was a routinely practice since 1977. Aside from that, adolescence was found that the source of drug information was their parents with regard to self- medication as Allebeck, (2005) and Llyod (2005) revealed. According a lot of literatures that economically depressed countries associate to increase prevalence of self- medication (Abay, S.M., et. al, 2000;) wherein regulation of the dispensing of medication without prescription were rampant . However, a study says that the more developed the countries the more prevalence of self- medication practices due to the easily availability and accessibility of medications. With the cross- sectional study by Puspa R.,et. al.(2012) which aims to know the prevalence and predictors of self- medication in both rural and urban as sample finds out that rural community clings to such practice due to unaffordability of the health facility but they have a positive approval with technical competence of the pharmacy staff. While the urban community have preference that medicines should be sold outside the pharmacy making it more accessible. Moreover, Balamurugan, E., et. al.(2010) study shows that females and urban people more likely to practice self- medication compare to males and rural community. With the same study, the most reason they cited was lack of time, perceived minor illness and quick relief. With the study of Landers, T. F., et. al. 2010 shows that women were likely to self- medicate than the other gender. There was also a study saying that the higher the educational acquisition increases the likeness to practice self- medication (Afolabi, O., et. al., 2008). Wherein a study which compared the medical student in first year with third year level student affirms the above statement wherein they found out that third year student more likely to practice self- medication and this occurrence was result from the related knowledge they acquired and continue to gain both in lectures and literatures however the knowledge they have was revealed to be inappropriate knowledge about proper self- medication and including the risk of self- medication ( Verma, R. K., et. al., 2010). There was also a study saying that not having health insurance has a relationship to practice self- medication (Widayati, A., 20011) H1: there is a positive relationship between socio- economic status with the prevalence of self- medication in the Rural Filipino Family.

Medication Knowledge:

World Self Medication Industry (WSMI) a non-government organization having an official relationship with World Health Organization (WHO) says thru their official journal that people are cautious and careful when they use over-the- counter medication (OTC’s) and not prompted to an over reliance as a result of advertising in addition they claimed that people read labels carefully before taking this non- prescribed medication. Aside from that, the same organization commended that the readily availability and accessibility of medications even without prescription has helped to educate people to practice self- care. Therefore, independence towards personal healthcare develops and there is an increasing demand by consumers for reliable information. Self- medication is included to the first level of care, under prevention of illness and promotion of health, thus, practicing so will lead a person to an optimum wellness. However, with the study made by Handu, H.(2006) showed that the knowledge about appropriate self- medication was poor, and the study of Verma, R.(2010) concludes that even professional student have inadequate knowledge about the risk or adverse
effect the medication they were taking. With the same result was reveled with the study made by Balamurugan, E. (2011) wherein majority of the respondent (93%) were not aware with other effects of self- medication practices. While the result was found out in the study of Balbuena, F., (2009) were clients diagnosed with hypertension were not aware to the drug interaction and contraindication of some OTC’s to their health status case for example OTC’s like nasal decongestant was indeed contraindicated to hypertensive for it can cause further vasoconstriction of peripheral blood vessels that can aggravate high blood pressure. In addition, 68% of the respondent from the study of Indermiitte, J. (2007) were exposed to potential drug interaction between the OTC’s medication and their prescribed medications. Aside from that, there was a study reveals that parents was the source of medication knowledge b adolescence were their parents wherein the misuse and misconception of parents towards self- medication were adopted b their children (Allebeck, 2005). Another study exposed that (Andualem, T. 2004), even lactating or pregnant mothers practice self- medication without an advised of physician wherein their case were delicate for there were a various medication which can cross the placenta or the breast milk which can cause harm or toward effect towards the fetal development or infant. A lot of study exposes that, antibiotics used were rampant without an advised by physicians, inappropriate used and non- adherence to the specific dosage, length and frequency of the medication were done, wherein this can lead to drug resistance and risk for occurrence of adverse effects (Haaijer, 2005; Awad, et. al., 2005; Widayati, 2011;Basco, 2004).Sarahroodi(2000), disclosed that there is an inappropriate information about analgesic usage. H2: Low medication knowledge of rural Filipino family is more likely to practice self-medication.

Health belief and Experienced of prior illness:

Majority of the study gathered were saying that the most cited common reason of adhering to self- medication was the perceived signs and symptoms as minor and they experienced it before and were relief with the same medication. However, the signs and symptoms such pain, fever, coughs and flu alike symptoms which prompted them to self- medication can be misdiagnosed for these set of signs and symptoms were alike to the
manifestation of major diseases such as cancer. But, if these signs and symptoms will not be controlled it may lead to further illnesses. The WSMI organization also says that person consulted first to health care giver when they experienced it for the first time and if they self- medicated yet the symptoms persisted. H3: health belief and experienced prior illness has a positive relationship with prevalence of self- medication practice of rural Filipino Family. Theoretical Framework

The Self Care Deficit theory of Dorothea Orem includes the theory of self - care which “comprises the practice of activities that nurturing and mature persons initials and performs with in time frames, on their own behalf of interest of maintaining life, healthful functioning , continuing person with development and well- being through meeting known requisites for functional and developmental regulation”. Moreover, one of her Universal Self Care Requisites says “prevention of hazards to human life, human functioning and human well-being”. The theory advocates independence of person to achieve its own well- being thru self- care.

Research Paradigm

• Contributing Factors:
  * Socio- economic Status
  * Medication knowledge
  * Health belief and experienced of prior illness
  * Prevalence of Adverse Effect
• Prevalence of Self Medication
• Contributing Factors:
  * Socio- economic Status
  * Medication knowledge
  * Health belief and experienced of prior illness
  * Prevalence of Adverse Effect
  Prevalence of Self Medication
• Independent Variable
• Dependent Variables

Methods

This study was a descriptive cross-sectional question based study. The study was conducted in 3 rural agricultural lands, municipality of three different provinces wherein 2 municipalities were accomplished around the region while the remaining one was conducted in Cordillera Administrative Region. The 300 respondents of the study was family in a rural community was randomly selected obtained thru systematic sampling. A semi-constructed questionnaire needed to gather necessary data was approved by the research protocols. After a courtesy measures done and given permission from municipal mayors and to specific barangay captains to do the study, the questionnaire was given to the family and their medical-decision- giver as representative of the family completed the said questionnaire with the assistance of a researcher. Respondents were assured that all of the gathered data were treated with utmost confidentiality. The semi-structured questionnaire was given to a member of the family, probably the medical- decision maker of the family. The questionnaire measured the respondent’s profile which includes the respondents’ age, sex, position in the family, educational attainment, number of members, estimated gross family monthly income and presence of health insurance was collected. The medication knowledge was measured assessed through a semi-structured questionnaire it involved the family knowledge about the commercial medications they used in practicing self- medications in which includes drugs indication, therapeutic effect, side effects, adverse effect, contraindication , if they easily understand when to take it including its suggested frequency. The Health belief and experienced prior illness was measured through a semi-structured questionnaire to determine how the family perceives and manages their health, and to assess the compliance with current and past nursing and medical recommendation. Prevalence of Self- medication Using Commercial Drugs was the percentage that the rural Filipino family practicing self –medication using commercial drugs, including the most commonly used medications and the common illnesses that prompted the family to practice self- medication and it also assessed the percentage of commercial medications used, and the medication usage of the family if they used commercial medication indication correctly or not. The data were analyzed using Statistical Package for Social Sciences or SPSS version 13.0. Descriptive data were expressed as percentage, frequency and mean. Pearson-r was utilized in assessing correlation of the contributing factors to the prevalence of self-medication using commercial drugs.

Results

Table 1: The Respondents Profile

Table 1 shows the respondent’s profile, wherein majority of them who accomplished the semi- constructed and assisted questionnaire were females, predominantly were mothers, with a mean age of 39 years, and primarily of them were nuclear type of family composing an average family members of 5 people. In the aspect of educational attainment, most of them finished a college degree, and most of the family earned a range of ₱1001- ₱P5000 with a mean estimated gross monthly family income amounting of ₱4,476.11. And majority was enrolled in a health insurance.

Table 2. Prevalence of Rural Filipino Family Practicing Self-Medication Using Commercial Drugs

Table 2 reveals the prevalence of rural Filipino family practicing self-medication using commercial drugs. And found out that almost of them practices Self- medication using commercial drugs due to it easy accessibility and readily availability in the community as evidence by Pharmaceutical establishment including the DOH program instituted Botika ng Barangay to address equity of health service to its constituents were around the community.

Table 3. Frequency of Commonly Used Commercial Medications and Accuracy of Commercial Medication Usage

Table 3 represents the Frequency of Commonly Used Commercial Medications and the Accuracy of Commercial Medication Usage wherein the most commonly used medication were paracetamol which rank first followed by Ibuprofen, both commercial drugs falls under the classification of analgesics and or antipyretic while the third one was amoxicillin an antibiotics. On the aspect of the accuracy of medication usage, paracetamol, Ibuprofen and loperamide were the topmost correctly used. On the other hand, most of the commercial medications incorrectly used were antibiotics wherein amoxicillin was the leading medication that was wrongly used then cotrimoxazole and cephalexin. The antipyretic/ analgesics classification leads due to its indications were for the common and simple symptoms aside from its rampant availability in the community for this commercial drugs were enlisted to the approved over- the – counter drugs or also preferred as non- prescription medications. However, the most incorrect usage medication were antibiotics due to the fact that this class of drugs needs an advice and guidance of medical team on its proper utilization.

Table 4. Common Illnesses that prompted the family to practice self-medication

Table 4 indicates the common illnesses prompted the family to self- medicate, in which fever was the main illness, followed by headache and cough and colds. These illnesses were perceived by the family as a minor and common illness occurrence which primary care as self-medications can alleviate it accordingly.

Table 5: Medication Knowledge in Using Commercial Drugs in Practicing Self- Medication Understanding and Compliance to Medication

The table 5 represents the family medication knowledge in using commercial medication it involves the understanding of the medication and compliance to the instructions in which majority of them have a good understanding and
compliance. In aspect of awareness to the commercial drugs indication most of them knows about the use of such commercial drugs in practicing self- medication on the contrary the non- awareness of the no therapeutic effects of commercial drugs were predominant as the study revealed.

Table 6: Health Belief and Experience Prior to Illness

Table 6 discloses the health belief and experience prior to illness, wherein majority perceived health as the most important in their family and for the most their health was is good aspect. Moreover, in times that a member in the family got ill most of them intervened thru self- medication using commercially drugs rather going in health facilities or utilization of available herbal decoctions or other herbal preparations.

Table 7: Prevalence of Rural Family Experienced Non- Therapeutic Effects

Table 7 presents those minor who experienced non- therapeutic reactions.

Table 8. Experienced Non- Therapeutic Effect Manifestations

Table 8 shows the list of experienced non- therapeutic effects manifested by the minor who experience such occurrence, wherein both dizziness and epigastric pain were experienced by the family, followed by the occurrence of rash or itchiness and ringing of ears.

Table 9. Correlation of the Contributing Factors in the Prevalence of Self- Medication Practices of Rural Filipino

Table 8 discloses the correlation of the contributing factors in the prevalence of self- medication in a rural Filipino family. Wherein there was a negative correlation between the prevalence of self-medication with prevalence of adverse effect. This means that the more rural people practice self-medication due to the lesser the prevalence of adverse effect. This further connotes that the self- medication usually practiced by rural folks is effective since there are less prevalence of adverse effect they experience from self-medication.

Discussion

Self-medication practices is an essential component primary health care as the World Health Organization with World Self- medication Industry revealed. Furthermore, the said practice promotes self- determination or independence in managing ones’ health. Aside from that a qualitative study about self- medication in a community among vendors in China founds out that self- medication is an important and common seeking behavior (Wen, Y.2011). The same study also showed that the importance perceiving the manifestation felt will identify the health seeking behavior of a client. Which means the perceived severity or the commonness of the felt manifestation will be the basis in how they will address such symptoms. In addition, if the felt symptoms was experienced before the higher the incidence of practicing self- medication. However if they felt it for the first time they tend to consult health practitioner and tend to do the same if they confuse of what will be given as a remedy or the manifestation is worsening. Thus, self-medication was earned through a prior experience of illness and after a consultation to a doctor (Verma, 2010). Aside from that, medications used by self- medication consumers were been utilized and efficiently treated them.

In the study of Hussain (2010) which aims to assess the prevalence of self- medication in developing countries in which he cited that a physician caters about a thousand populations thus decreasing its valuable time to health educate clients. Thus, self- medication was regarded as cost effective, time saving and important especially to in emergency cases for health units may not available or within reach for consultation. Self-medication found to be time saving, economical, convenient and providing quick relief in common illnesses (Handu, H. S. et. Al 2006).Furthermore, the WHO regards self- medication as an effective way to expand the health budget to a larger population due to the savings they will remain if responsible self- medication established According to study conducted by James, Henry et. Al (Med Princ Pract 2006) and According to a worldwide review of consumer surveys in different countries shows that mild illnesses, knowledge, experienced with the drugs commonly used and common practice significantly increase the practice of self-medication. It is also supported by the study of Abay, S. conducted in GCMHS (Gondar College of Medicine and Health Sciences) and Ethiop J. (Health dev 2003) shows that prior experience, non-seriousness of the illness and availability of medication to pharmacy or drug shops were associated to increase self-medication. Landers (2004) said that sociocultural belief greatly affects the behavior of self- medication practices.

The study illustrates a high prevalence of self- medication alike to the previous studies done in different population in the community in either developing or developed countries. As prospective study of Andualem which assesses self- medication practices in Addis Ababa concluded that self- medication is widely practice by different population for wide spread of illnesses. A lot of studies made by James, H. et.al, Handu, H., et. al., Abay, S., et. al., Ethiop J., et. al., Worku, S. et. al.,revealed that the increase in self-medication was due to a number of factors.

These included socioeconomic factors, readily access to drugs, and the increased potential to manage certain illnesses through self-care. It was found in this study that its prevalence is affected by common illnesses experienced, previous experienced with the drugs, availability of the drugs, acquired knowledge about the medications, cost of healthcare, socio-economic status and
widespread of self-medication practices. Since most of the studies conducted shows that these factors affects the prevalence of self-medication .According to a worldwide review of consumer surveys in different countries (1995-2005) that self-medication practices is associated with previous experienced of the illnesses and the drugs .Like the study of Abay, S. conducted in GCMHS and Ethiop J shows that prior experience, non-seriousness of the illness and availability of medication to pharmacy or drug shops were associated to practice self-medication and it is also supported by the study. Moreover, this study showed that the estimated family income per month was amounting ₱4,476.11 which is relatively small to provide a well life and not enough especially in times of illness to consult for medical attention, thus uses of otc’s which were rampantly available to the community wherein Botika ng Barangay sells lesser cost drugs to provide the marginal constituents of the country. On the other hand, the present study is consistent to previous studies exposing the usual commercial medications use to practice self- medication (Hussain, S., et.al.,2011 Balbuena, F. 2009, Dagan et.al., 2008; Kardas et.al.,2007; Larson, 2007; Handu, H.S. et., al., 2006; Llyod, E.A, et., al., 2005). This current study shows that antibiotics are included to the topmost drugs used in the self- medication practice of rural Filipino families matching to the study done by Berzanskyte (2006) which revealed that antibiotic use was higher to the rural rather than the urban this was associated to the high availability of the said drug around the community. However, even antibiotics are rampantly use in this study, antibiotics rank first in medication which are wrongly used for the misconception off the proper utilization of antibiotics wherein the thru this study revealed that antibiotic was used to any kind of illness felt by the family. Furthermore, some of them using oral antibiotics crushing it and putting to the affected area as a topical treatment especially in the incidence of wounds or allergic blisters. This occurrence happen due to the low level of medication identification of antibiotics wherein the correct identification is an important component to Medication Management Capacity (MMC), MMC is the ability to self-administer the medication regimen, and the low MMC was correlated to poor adherence to the regimen or non- compliance on its indicated duration of taking of such drug, this is according to study done by Landers, T. F., et., al., 2009 which
supported by the study made by Sweileh, W. (2004) that only 1/3 of therapeutic dose is just given increasing the occurrence of non- compliance . The same study added that a high antibiotic usage the lower they recognized non- antibiotic drugs for even symptomatic illness was aided with antibiotics rather than medications that addresses the symptoms directly, presence of misconception between usage of antibiotics to treat viral illnesses and the study showed that the main source of the antibiotics were the left overs of prescribed medications.

Furthermore, this study showed that the unused antibiotics from their past illness were utilized. A study says that there is lack of correct information about appropriate use of antibiotic including its side effects and sited that the failure of health practitioners to provide health education has been associated to the high risk of utilizing left over antibiotics. A lot of studies done suggested health education to the population may decrease inappropriate usage of antibiotics but a community intervention study by Mainous, A., et., al.,2009 says that education is not enough to prevent erroneous self- medication of antibiotics while Landers, T. F.(2009) added that sociocultural must be considered to analyze antibiotic usage pattern. Even though majority of the respondents has a good understanding to the medication used in self- medication an updated knowledge must be given also for changes and new innovations occurs as advancement of technology and numerous evidenced researches were being published to correct previous knowledge we have nowadays. On the other hand, this study also reveals that medication use to practice self- medication does not only involved over- the counter or OTC’s but also drugs needing of prescription before a person can purchase. Thus poor regulations of medications occur around a rural community. Including those not approved medication was present in the community in which the assurance of safety from this drug is in doubt. Furthermore, a lot of medication that needing a guidance of health practitioners are rampantly utilized wherein drugs such corticosteroids a hormonal drugs if use inappropriately causes renal and liver dysfunction wherein they mistaken it as vitamins for the side effects are increase appetite and water retention so weight gain happen. These situations were alarming that needing to be address to ensure public safety. The table 4 of the present study complement to the commonly used medications as presented to the table 3, this also
affirms the studies made by Ali, A. N. (2012); Alsmasdy, D.(2011), Hussain, S. (2011), Balbuena, F. R.(2009), Berzanskyte, A. (2006) and many more. This means that the topmost symptoms are very common and it is the initial manifestation of illnesses. Wherein the qualitative study of Wen, Y. et., al.,(2011) it’s a usual activity to perform symptom- based self – evaluation, it’s the perceived understanding of the disease they experiencing then the result of it will be the determinants of whether to self- medicate or not. A study by Tenaw, A., et., al., 2004 aims to assess self- medication practices tells that aside from telling specific brand or generic name in acquiring drugs for self- medication they described their symptoms to the person who accommodate as they buy medications.

Alike with the previous studies done , this study agrees that majority practicing self- medication using the commercial drugs cannot recognized of aware of the non- therapeutic effects of medication being used. The occurrence of such non- therapeutic effects may due to the inappropriate usage of medications and unfamiliarity of the other effects rather than the therapeutic effect of medications taken. Moreover the low ability of to self- administer the medication regimen also called Medication management Capacity (MMC) as the study of Landers, T. F., et., al., 2009 explained. Aside from that, a self- medication consumers request drugs for self- medication by describing its physical appearance or characteristic as the study of Tenaw, A., et., al.,(2004) declared.

This may contribute the risk of medication confusion and a sign of inappropriateness that can lead to errors. This table exposes that there are family who experienced non- therapeutic effects however not significantly high but the presence of it is still need to address for public safe. These manifestations can lead a person to permanent damage and at risk to injury such as hear loss, hemorrhage and anaphylactic shock or else death (Davis, F. A. 2008, Drugs Guide.) In addition the experience adverse effects may vary from a person to other.

In the study conducted by R. Verma, L. Mohan, and M. Pandey, it is stated that the previous experience and with mild illness were more likely to practice self- medication. It implies that self-medication is prevailing in connection to their past experience of such illness with a lesser adverse effects from the drugs they took. Haider and Thaver stated that good past experience with the medicine was the main reason for self-medication. Moreover, consumer information is an extreme important component of responsible self-medication therefore consumer information and role of proper labeling was formally approved and released. Role of labeling provides all the information for an individual without medical training to use the medicine appropriately (WSMI, 2010 the Story of Self Mediation).

According to International Pharmaceutical Federation (FIP), safe medication is safe with corresponding requirements that medicines used are of proven safety, quality and efficacy and medicines used are those indicated for conditions that are self-recognizable and for some chronic or recurrent conditions. As the World self- medication Industry revealed that such medicines should be supported by information which includes the method of usage, its effects and possible side-effects, how to monitor the effects, possible interactions, precautions and warnings, duration of use, and when to seek professional advice. Self-medication is safe since it empowers patients to treat or prevent short term or chronic illnesses as affirmed by the Communication of the European Commission, this suggests that with self-medication patients tend to become more responsible with their health conditions thus familiarizing more their symptoms and its corresponding medications. It was reported that self-medication is safely used with the findings that people suffer common health problems and their symptoms at roughly the same frequency, people tend to read the label completely before taking a nonprescription medicine the first time, and people are overwhelmingly satisfied with self-medication or taking nonprescription medicines believing that it is just effective as prescribed medicines.

As stated, responsible self-medication with nonprescription medicines is increasingly being recognized as the first line of treatment and as a foundation of public health and healthcare systems thus motivating people to undertake other positive health care behaviors thereby preventing future diseases. Over-the-counter drugs are proven safe and effective with medical
intervention supported by numerous and still continuous researches and monitored by drug regulation.

Conclusion

In this study, the researchers concluded that self-medication is still a safe practice of self- care as the occurrence of non- therapeutic effects are low and negatively correlated to the prevalence of self- medication. May be due to the fact that families tend to use over the counter medications they usually use and uses the common medications for the common illnesses they felt. However, the revealed number of family experienced adverse effect as they practiced self- medication must not be ignored for the public health safety will be at risk and in jeopardy. Especially that the medication used without prescription ranges from not only to approved over-the-counter drugs (otc’s) but the study had showed numerous drug which need physicians order before taking such medications. This can further risk vulnerable people of the community to occurrence of non- therapeutic effects in which can be a detrimental if not attended accordingly. Usage of antibiotics should be with prescription to avoid bacterial resistance, and so with corticosteroids that affects kidney and liver if taken inappropriately (David Drug Guide, 2008 ). Moreover, the study presented the consumption of Chinese pills bought in the non- pharmaceutical area in which these pills containing creosote, a component in which is possible carcinogenic and it may harm our body (Mediscape). Furthermore, the said pills was not included to the approved medication of the country thus its safety is not guaranteed.

Recommendation

The researchers’ suggest the following:
1.There must be further study utilizing a standardized gathering tool to facilitate more efficient result.

2.There must be further study to be conduct to further assess the community, to increase their knowledge about the different adverse effect of such medication that they take without the guidance of the medical team.

3. Deductive community intervention addressing the erroneous usage of medications to decrease the inappropriate usage of
medication drugs in self- medication practices such as an appropriate health awareness.

4. An ordinance should be available to guide or regulate pharmaceutical or Botika ng Barangay. There should be strict checking of the Sari-sari store who’s selling antibiotics without licensed. Appropriate action should be imposed to those who violate such law.

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Appendix A: Related Literature Matrix

BIBLIOGRAPHY| MAJOR OBJECTIVES| VARIABLES| METHODS| MAJOR FINDINGS|

Abahussain, E., et., al., 2005, : Self-Reported Medication Use among Adolescents in Kuwait, Medicine Principles and PracticeMed, Princ Pract 2005;14:161–164 DOI: 10.1159/000084633| The objectives of this study were to describe and examine the pattern of medication use, including age and gender differences among adolescents in Kuwait, and to establish the sources of information on medicines in this age group.| Age GenderNationalityEducation level| Method specified in the study: Cross sectional surveyParticipants/ subject: Secondary school students in 10 government schools in Kuwait.Locale: KuwaitData Gathering Tool: questionnaire Data Analysis: Chi-squared test| The prevalence of self-medication among the high school students was 92%. The prevalence increased by age from 87% among 14-yearolds to 95% among 18-year-olds. Sixty-fi ve percent of medicines used were for pain relief, 54% for respiratory conditions, 39% for allergic conditions, and 37% for dermatological conditions. Twenty-two percent of medicineswere nutritional supplements and vitamins, 21%gastrointestinal products, 17% antidandruff products,15% hair products, 13% for migraine while 8% were for athlete’s foot. Pain relief, respiratory, dermatologic and hair products were more prevalent in female adolescents than in male while antidandruff and athlete’s foot preparations were used more by male adolescents. The most common sources of information on medicines were parents. The prevalence of self-medication among adolescents in Kuwait has been shown to be high. Self-medication use tended to increase with age and differed between male and female students. Few adolescents consult pharmacists on drug information. This issue needs to be addressed by the responsible authorities in Kuwait.

Afolabi, O., 2008, Factors Influencing the Pattern of self-medication in an adult Nigerian population. Annals of African Medicine Vol. 7, 120-127.| To determine the major factors that influences the pattern of self-medication in a population of market women in Ifako-Ijaiye area of Lagos, Nigeria.| Self-medicationNigerian populationMarket women| Method specified in the study:Pretested semi-structured questionnaireLocale: Pen Cinema area of Agege, Lagos StateParticipants/Subjects:Market women within the local government, 205 market womenData Gathering used:Multi-stage sampling techniqueData Analysis used:Statistical package for social sciences (SPSS version 12.0.1)| The patent medicine dealers were the commonest source of information on medications (31.4%) and where they were obtained (52.2%). The exceptions were the educated (62.5) respondents who obtained theirs from hospitals and pharmacies. Trade and generic names (61.1%) were common names means of drug recognition especially among the educated respondents (P˂ .05). Education of the respondents was the major factor influencing the practice of self-medication though the pattern was descriptively associated with the marital status and educational level of the respondents (P ˂ .05). Benefits of the practice includes in the order: curing of ailments (58.0%), saving time and money (32.0%) and independence of care (7.0%).|

Al-azzam, S.I., et.al., 2007, Self-medication with antibiotics in Jordanian population, International Journal of Occupational Medicine and Environmental Health 2007;20(4);373-380 DOI 10.2478/v10001-007-0038-9| A survey was conducted to estimate the prevalence of self-medication with antibiotics in Jordan and evaluate the factors associated with antibiotic misuse.| Prescription period/timePerception to antibioticsAgeIncomeEducational level| Method specified in the study:Survey Locale: Jordan Participants/Subjects:Households (9281 persons) selected from among different cities in Jordan.Data Gathering Instruments:Validated questionnaireData Analysis used:Means, Standard Deviation, Frequency, Percentage| The prevalence of self-medication among the high school students was 92%. The prevalence increased by age from 87% among 14-yearolds to 95% among 18-year-olds. Sixty-five percent of medicines used were for pain relief, 54% for respiratory conditions, 39% for allergic conditions, and 37% for dermatological conditions. Twenty-two percent of medicines were nutritional supplements and vitamins, 21% gastrointestinal products, 17% antidandruff products, 15% hair products, 13% for migraine while 8% were for athlete’s foot. Pain relief, respiratory, dermatologic and hair products were more prevalent in female adolescents than in male while antidandruff and athlete’s foot preparations were used more by male adolescents. The most common sources of information on medicines were parents.

Aljinoviæ-Vuèiæ ,V., et., al., 2005, Content of Home Pharmacies and Self-Medication Practices inHouseholds of Pharmacy and Medical Students in Zagreb,Croatia: Findings in 2001 with a Croatia: Findings in 2001 with a Reference to 1977, Croat Med J 2005;46(1):74-80| To evaluate the content of household drug supplies and self-medication practice among medical and pharmacy students at Zagreb University in 2001, and to relate the findings to a previous survey in 1977.| presence of a healthcare professionalin the family or householdextent of self-medicationof a particular drug| Method specified in the study: cross- sectional anonymous questionnairre- based survey Locale:Zagreb, Croatia Participants/Subjects:287 studentswho inventoried drugsupplies in their family households and interviewed the household members on drug keeping andself-medication practiceData Gathering: questionnaire and interviewData Analysis used:SPSS version 16, and analysis was conducted with descriptive analysis procedures.| In 2001, healthcare professionals were present in 37% of the surveyed households (33% in 1977). At least one drug was found in every household. Drugs were kept at a designated place (“home pharmacy”) in 68% of the households (65% in 1977). Drugs past expiry dates and/or with purpose unknown to the household members were reported in 27% of the households (32% in 1977). The most frequently found drugs were non-steroidal anti-inflammatory drugs (NSAIDs) that were present in 97% of the households (93% in 1977), and were followed by antibiotics found in 46% of the households (40% in 1977). Self-medication of NSAIDs was practiced in 88% of the households in which they were found (95% in 1977), whereas self-medication of antibiotics was practiced in37%of the households in which they were found (41% in 1977).

Ali, A. N. et. al., 2012,Self-medication practices among health care professionals in a Private University, Malaysia International Current Pharmaceutical Journal 2012, 1(10): 302-310| The purpose of this study was to evaluate and analyzed the prevalence of self-medication practice among healthcare professionals in a private university, Malaysia.| AgeSexField of professionLevel of professional qualificationProfessional experience| Method specified in the study:Prospective, quantitative, cross-sectional design Locale:AIMST University, 08100 Bedong, Kedah Darul Aman, MalaysiaParticipants/Subjects:Teaching HCPData Gathering instrument:Questionnaire survey formData Analysis used:Statistical Package for Social Sciences (SPSS) version 15| Among respondents, 77.6% were practicing self-medication. The reasons were, familiar with treatment options (23.5%) and mild illness (20%) and the highest practicing respondents were 30-39 years (76.3%). The reason among those who did not practice self-medication was risk of adverse reactions (31.6%). Self-medication practice was more prevalent among medical professionals (86.5%) followed by pharmacy and dentistry (70%). Headache (15.7%, cough and cold (15%) among illness and analgesics (13.1%) and antipyretic (12.7%) among drugs induced most respondents to practice self-medication. This study reveals very high prevalence of self-medication practice among healthcare professionals in the local private university. Exposure to drugs, knowledge of their illness and treatment choice remains main contributors. The healthcare professionals must be encouraged to enter the patient role.

Andualem, T.,et.,al, 2004, Self-medication practices in Addis, Ababa: a prospective study. Ethiop J Health Sci. Vol. 14, No. 1 January | To analyse self-medication, which is one form of self-care, is an important initial response to illness, and many illnesses can be successfully treated at this stage.To assess self-medication practices in the sampled population of Addis Ababa. This study deals with self-medication on modern drugs and it attempts to assess self-medication practices of drug consumers.| AgeSex Educational levelSpecial drug consumersSelf- medicationSelf -careSelf -diagnosisDrug consumers| Method specified in the study: A multi-stage stratified sampling of drug retail outlets in Addis Ababa was employed. Participants/Subject:Convenient sampling was used to select respondents from among those who came to the community pharmacies to purchase drugs for self-medication. Respondents were interviewed after they made their requests but before they were provided with information on the drugs they
requested.Data Gathering: Data were collected using a pre-tested semi-structured questionnaire.Data analysis used: | Socio-demographic characteristics of respondents revealed that drug consumers consisted of all age categories of both genders; as well as pregnant and breast-feeding mothers of varying educational background levels. The most frequently reported illnesses that prompted self-medication of respondents were gastrointestinal diseases, headache, fever and respiratory tract infections. Slightly greater than 30% of illnesses/symptoms of illnesses were less than 24 hours and around one-fifth, one or more weeks of duration. The most common reasons reported for self-diagnosis and self-medication were non-seriousness of the disease, emergency use and prior experience on the drug. Two-thirds of the drug consumers requested drugs by specifically mentioning the name of the drug or category to which it belongs and 20.7% by telling their illness or symptoms of illnesses. More than 100 different types of drugs were requested, the most frequent category of drugs being analgesics or antipyretics 30.1%, antimicrobials (26.4%) and gastrointestinal drugs (17.7%). Self-medication is widely practised for a wide range of illnesses or symptoms of illnesses, and for both over-the-counter and prescription only drugs. The public as well as the health care providers have to be educated on the scopes of self-medication; i.e., the type of illnesses to be self-diagnosed and self-treated, and the type of drug products to be used in order to promote responsible self-medication.

Awad, et., al 2000 Self-medication practices with antibiotics and anti-malarial among Sudanese undergraduate university students.Faculty of Pharmacy, Department of Pharmacy Practice, Kuwait University, Kuwait City, Kuwait.| To estimate the prevalence of self-medication with antibiotics and/or antimalarials and identify factors promoting such use among university students in Sudan.| AgeSex Experienceand attitude| Method specified in the study:A descriptive cross-sectional study was performed.Locale:Khartoum State, Sudan.Participants/Subject: 1300 students selected from 5 universities in Khartoum State, Sudan.Data Gathering instrument:Using a pretested questionnaire on a sample.| Eight hundred ninety-one (79.5%; 95% CI 77.0 to 81.8) students from the study population had used antibiotics or antimalarials without a prescription within 1-2 months prior to the study. Four hundred ninety (55%; 95% CI 51.7 to 58.3) of the respondents stated that they had used antibiotics, 39 (4.4%; 95% CI 3.2 to 6.0) had used antimalarials, and 362 (40.6%; 95% CI 37.4 to 43.9) had used both. Overall, self-medication with antibiotics or antimalarials was significantly more common among students 21 years of age or older compared with those 20 years of age or younger (OR 1.55; 95% CI 1.15 to 2.09; p = 0.004) and among students attending private universities compared with those attending public universities (OR 1.42; 95% CI 1.04 to 1.95; p = 0.028). Self-medication with antibiotics followed a similar pattern, which was significantly more common among students 21 years of age or older (OR 1.36; 95% CI 1.03 to 1.81; p = 0.03) and private university respondents (OR 1.52; 95% CI 1.15 to 2.02; p = 0.003). Self-medication with antimalarials was found to be significantly less common among females (OR 0.76; 95% CI 0.59 to 0.97; p = 0.028) and higher among the 21 years or older age group (OR 1.84; 95% CI 1.42 to 2.40; p < 0.001). The most common reason indicated for self-medication was the respondents' previous experiences with similar ailments. The main source of drugs was community pharmacies.The prevalence of self-medication with antibiotics/antimalarials among undergraduate university students in Khartoum State is high. Our findings highlight the need for planning interventions to promote the judicious use of antibiotics/antimicrobials.|

Balamurugan, E., et., al., 2011, Prevalence and Pattern of Self Medication use in coastal regions of South India, BJMP 2011;4(3):a428. To determine the prevalence and pattern of self-medication in both rural and urban communities.| Prevalence of self-medication.Pattern of self-medication| Method specified in the study: Cross-sectional surveyLocale:Coastal regions of south India.Participants/Subjects:Sample size of 200 participants randomly from the coastal regions of south India.Data Gathering instrument: Each participant underwent a face to face interview with the help of a structured questionnaire; Data analysis used:Data collected was analyzed using descriptive and inferential statics in SPSS.| SM use was reported by 71% of the subjects, which ranged from a frequency of at least one time to a maximum of 5 times and above. Lack of time (41.5%), minor illness (10.5%) and quick relief (10%) was cited as the most common reason for SM use. The majority of the participants (93.5%) were not aware about the side effects of SM. Findings revealed females and people living in urban areas are more likely to use SM than males and people in rural areas (P<0.001)|

Balbuena, F. R, et., al.,2009Self-Medication in Older Urban Mexicans DíUQS Aflino 2009: 26 (1): S-iO 1170-229X/09/0001-OP51/S49.95/ | To quantify and describe the demographic, socioeconomic and pharmacologicalcharacteristics of self-medication among a geriatric urban populationin Chiapas, Mexico,| Older urban Mexicans.Self-medication| Method specified in the study:An observational, descriptive, cross-sectional study was conducted. Locale:Chiapas, Mexico.Participants/Subject:A total of 245 older (aged >65 years) residents in the downtown area of Tuxtla Gutierrez (Chiapas, Mexico) participated in the study. Data Gathering instrument:using a conglomerate sampling techniqueData analysis used:Information on self-medication and demographic and socioeconomic variables was obtained from a specific structured interview that was conducted by a single specially trained physician.| More than half of the 245 interviewed older adults (131 [53,5%; 95% CI47,2, 59.7]) reported taking a medicine without prescription during the last 30 days. Self-medication was significantly more frequent among older adults who lived alone compared with married people (p = 0,0274) and among the illiterate or those with a low level of education compared with people with secondary and high-school degrees (p = 0.0036).|

Banerjee, I., Bhadury, T. 2012 Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal Journal of Postgraduate Medicine April 2012 Volume 58 Issue 2| To assess the pattern of self-medication practice among undergraduate medical students.| AgeSexMedical condition nature of illness Pattern of self-medication| Method specified in the study:Cross-sectionalQuestionnaire-based studyLocale:Tertiary care district medical college and hospital in West Bengal.Participants/Subjects:Undergraduate medical studentsData Gathering instrument: QuestionnaireData Analysis used:Statistical Package for Social Sciences (SPSS) program Version 10 statistical analysis such as percentage, frequency and mean Chi-square test| Out of 500 of the institute, 482 consented for the study and filled in the supplied questionnaire. Fourteen incomplete questionnaires were excluded and the remaining 469 analyzed. It was found that 267 (57.05%) respondents practiced self-medication. The principal morbidities for seeking self-medication include cough and common colds as reported by 94 students (35.21%) followed by diarrhea (68 students) (25.47%) fever (42 students) (15.73%), headache (40 students) (14.98%) and pain abdomen due to heartburn/peptic ulcer (23 students) (8.61%). Drugs/drug groups commonly used for self-medication included antibiotics (31.09%) followed by analgesics (23.21%), antipyretics (17.98%), antiulcer agents (8.99%), cough suppressant (7.87%), multivitamins (6.37%) and antihelmentics (4.49%). Among reasons for seeking self-medication, 126 students (47.19%) felt that their illness was mild while 76 (28.46%) preferred as it is time-saving. About 42 students (15.73%) cited cost-effectiveness as the primary reason while 23 (8.62%) preferred because of urgency.|

Berzanskye, A, 2006, Self-medication with Antibiotics in Lithuania Ijomeh: International Journal of Occupational Medicine and Environmental Health 2006;19(4):246 – 53| This study was performed to estimate the prevalence of antibiotic use in the general population of Lithuania with special interest in self-medication with antibiotics and sources of their acquisition| Demographic Data (age, gender, residence area, occupation, Level of education) Prevalence of Antibiotic usePresence of chronic diseasePractice of self-medication with antibiotics| Method specified in the study:European survey “Self-Medication with Antibiotics and Resistance Levels in Europe”(SAR Project)Locale:Lithuania Participants/Subjects:General population of LithuaniaData Gathering instrument:Structured QuestionnairesData Analysis used:Multiple logistics regression estimated by the Chi-square and Wald statistics.| It was found that 39% of respondents reported antibiotics used during the last 12 months preceding the study and 53.2% of those used them in self-medication. In general, 22.05% (95%Cl: 19.1-25.1) of respondents used antibiotics without prescription, whereas 45.0% (95%Cl: 41.3-48.7) of them used antibiotics for intended self-administration. Adjustment for all the factors revealed the impact of the occupation, place of residence and presence of chronic disease on self-medication with antibiotics. Representative of managerial, executive and professional occupations used non-prescribed antibiotics 8.38 times, more often (95%Cl: 1.76-39.91, p=0.01) than retired people. Healthy people showed the tendency to self-medication 2.04 times more frequently than those with chronic diseases (95%Cl: 1.11-3.75, p=0.02). Rural people used non-prescribed antibiotics 1.79 times more often than inhabitants of urban areas (95%Cl: 1.00-3.18, p=0.049). Community pharmacies proved to be the most frequent (86.0%) source of over-the-counter antibiotics. Tonsillitis, bronchitis, and upper respiratory infections were the major reasons for self-medication with antibiotics.The high prevalence of self-medication with antibiotics was found in Lithuania. The study indicated the need for more strict control of antibiotics sales and promotion of education of the correct use of antibiotic among Lithuanian people.

Berzanskye, A, 2006, Self-medication with Antibiotics in Lithuania Ijomeh: International Journal of Occupational Medicine and Environmental Health 2006;19(4):246 – 53| This study was performed to estimate the prevalence of antibiotic use in the general population of Lithuania with special interest in self-medication with antibiotics and sources of their acquisition| Demographic Data (age, gender, residence area, occupation, Level of education) Prevalence of Antibiotic usePresence of chronic diseasePractice of self-medication with antibiotics. |Method specified in the study: European survey “Self-Medication with Antibiotics and Resistance Levels in Europe”(SAR Project)Locale:Lithuania Participants/Subjects:General population of LithuaniaData Gathering instrument:Structured QuestionnairesData Analysis used:Multiple logistics regression estimated by the Chi-square and Wald statistics.| It was found that 39% of respondents reported antibiotics used during the last 12 months preceding the study and 53.2% of those used them in self-medication. In general, 22.05% (95%Cl: 19.1-25.1) of respondents used antibiotics without prescription, whereas 45.0% (95%Cl: 41.3-48.7) of them used antibiotics for intended self-administration. Adjustment for all the factors revealed the impact of the occupation, place of residence and presence of chronic disease on self-medication with antibiotics. Representative of managerial, executive and professional occupations used non-prescribed antibiotics 8.38 times, more often (95%Cl: 1.76-39.91, p=0.01) than retired people. Healthy people showed the tendency to self-medication 2.04 times more frequently than those with chronic diseases (95%Cl: 1.11-3.75, p=0.02). Rural people used non-prescribed antibiotics 1.79 times more often than inhabitants of urban areas (95%Cl: 1.00-3.18, p=0.049). Community pharmacies proved to be the most frequent (86.0%) source of over-the-counter antibiotics. Tonsillitis, bronchitis, and upper respiratory infections were the major reasons for self-medication with antibiotics.The high prevalence of self-medication with antibiotics was found in Lithuania. The study indicated the need for more strict control of antibiotics sales and promotion of education of the correct use of antibiotic among Lithuanian people.

Boateng D. A. (2009);Self-medication among Doctors and Pharmacists at the Korle Bu Teaching Hospital; a thesis submitted to the Department of Clinical and Social Pharmacy, Kwame Nkrumah University of Science and Technology| The purpose of this study was to investigate self- prescription practices among pharmacists and physicians of the Korle-bu Teaching Hospital.| Self-medicationDoctorsPharmacist| Method specified in the study:Quantitative cross-sectional surveyLocale: Korbe Bu teaching HospitalParticipants: Doctors and PharmacistsData Gathering instrument:Questionnaire Data analysis:SPSS software| Pharmacists and Physicians are no exception to self-medication or self-prescription. The professional exposure to drugs and knowledge of their treatment of disease remains the fundamental contributor to self-medication among pharmacists and physician, the peculiar demands of their work environment including, excessive work schedules, issues of confidentiality as well as inadequate health care provision for these professionals and their families are factors that further worsen the situation. The higher the practice experience, the higher the tendency to self- medicate.

Bradley,C. P., et.al, 1998, Patient attitudes to over the counter drugs and possible professional responses to self-medication, Family Practice, Oxford University Press 1998| The aim of the study was to ascertain the attitudes of patients to OTC drugs.| AgeGenderSocial classesEmployment statusAttitude | Method specified in the study:SurveyLocale: BritainParticipants/Subjects:505 consecutive patients from each of 6 participating practices.Data Gathering used:Likert scale QuestionnaireData Analysis used:Means, Standard deviation, Frequencies, percentage| There were generally positive attitudes to doctors enquiring about prior OTC use as well as to doctors making OTC recommendations in the consultation.Patients expressed fairly negative attitudes towards pharmacists making generic substitutions and were even more hostile to the idea that pharmacists should make therapeutic substitutions.|

Du, Yong, et., al. Self- Medication among Children and Adolescents in Germany: result of the National Health Survey for Children and Adolescents (KiGGS) (2009).British Journal of Clinical Pharmacology DOI:10.1111/j.1365-2125.2009.03477.x| The study aims to investigate the prevalence and correlates of self- medication use among non-institutionalized children in Germany, focusing on the pediatric self- medications that are most frequently used | Self- medication Children and Adolescents| Method specified in the study: Quantitative survey method (German Health interview and examination survey for Children and adolescents)Locale:GermanyParticipants/ Subjects:17 641 children and adolescents (8985 boys, 8656 girls)Data gathering instrument: Questionaire and interviewData Analysis used:All statistical analyses were performed using SPSS statistical software(release 15.0;SPSS Inc.,Chicago,IL,USA)| Self-medication use is highly prevalent in Germany, particularly among children and adolescents from families with higher socio-economic status. Self- medications cover drugs of all therapeutic classes, but cluster among vitamin and mineral supplements, CCMs and non- addictive analgesics, most of which are used for a short period, either for disease prevention or to treat self-medication in younger children using inappropriate drug use gives potential risks factors.

Hussain S., et., al., 2011 Prevalence of self-medication and health seeking behavior in a developing country, African Journal of Pharmacy and Pharmacology Vol. 5(7), pp. 972-978| To ascertain the health seeking behavior and self-medication by members of the community | Health seekingBehaviorSelf-MedicationRural CommunityUrban Community| Method specified in the study:A randomized, cross-sectional, Multi-center studyLocal: PakistanParticipants: urban and rural household to ascertain the health seeking behavior and self-medication by members of the community.Data Gathering:QuestionnaireData Analysis: Data were analyzed usingSPSS-17.| Self-medicate was reported in 15.7% of urban areas as compared to 8.3% of rural areas. It is difficult to eliminate. However, interventions can be made to discourage the rampant practice by giving awareness and education regarding the pros and cons of self-medication, suggesting Hussain et al. 977 measures to prevent the supply of medicines without prescription at pharmacy level, stringent rules regarding pharmaceutical advertising at the time of market authorization and measures be taken to make healthcare delivery much less difficult especially at primary health care level. The health care professionals should also be targeted through interventions to avoid the irrational use of drugs. Policy makers need to understand the drivers of health seeking behavior of the population in an increasingly pluralistic health care system. Raising the socio-economic status through multi-sectorial development activities such as micro-credit, life-skill training and non-formal education can have a positive impact on health-seeking behavior, morbidity and mortality. Eliminating barriers and the integration of health services among public and private resources are imperative for the regular and sustainable provision of health care to vulnerable, under-served group.

Indermitte, J, et.,al., 2007, Prevalence and patient awareness of selected potential drug interactions with self-medication, Journal of Clinical Pharmacy and Therapeutics (2007) 32, 149–159| To assess the prevalence of potential drug interactions with selected POM and OTC drugs in passer-by and regular customers as well as their awareness of these potential drug interactions.| Patient awarenessDrug interaction between prescription only medicine(POM) and over-the-counter(OTC) | Method specified in the study: SurveyLocale: Basel, SwitzerlandParticipants/Subject:Data were collected in 14 communitypharmacies in the region of Basel, Switzerland Data Gathering: observation of customer contacts and interviewswith passer-by customers purchasing selectedOTC drugs, and telephone-interviews with regular customers treated with selected POMs identified in community pharmacies’ databases.Data Analysis: SPSS| Of 1183 passer-by customers observed,164 (14Æ4%) purchased at least one of the selected OTC drugs. One hundred and two (62Æ2%) of those subjects were interviewed. Forty-three(42Æ2%) mentioned taking prescribed drugs, and three of them were exposed to potential drug interactions of moderate severity. Out of 592 regular customers selected from the community pharmacy database, 434 (73Æ3%) could be interviewed.Sixty-nine (15Æ9%) of them were exposedto a potential drug interaction between purchasedOTC drug for self-medication and their POM.| Landers, T. F., et., al., 2010,Antibiotic identification, use, and self-medication for respiratoryillnesses among urban Latinos, Journal of the Academy of Nurse Practioners 22| The purpose of this study was to describe the extent to which antibiotic and non-antibiotic medications commonly used for upper respiratory infections (URIs) were correctly identified by a sample of urban dwelling Latinasand the association of medication identification with antibiotic use and self-medication.| AgePercentage of correctly identified medicationsEducationKnowledgeExperience |Methods Specific to the study: Cross-sectional surveyParticipants:509 Household latinosLocale: Washington Heights, USAData gathering: Questionnaire Data analysis:SPSS 16.0 version| Overall, participants correctly identified 62% of non-antibiotics and34% of antibiotics. Seventy three (73%) women in the study reported antibioticuse by at least one member of the household in the past year. Amongusers, self-medication was reported in 67.2% of antibiotics for adults, but inonly 2.4% of children. There was no difference in antibiotic recognition between those who self-medicated and those who did not, but antibiotic self-medication was associated with a significantly lower recognition of non-antibiotics|

Le, T. H. , et., al., Drug use and self-medication among children with respiratory illness or diarrhea in a rural district in Vietnam.| To explore the knowledge, attitudes, and behaviours of parents in their use of drugs for respiratory illness or diarrhea among children under 5 years of age, and to understand factors influencing self-medication.| AgePerception of the illnessWaiting timeAttitudeKnowledge| Method specified in the study:A qualitative study was conducted.Locale: rural district in Vietnam.Partners/Subject:Two drug sellers and three health care providers, and four focus-group discussions with mothers of children Under 5 years of age. Data Gathering instrument:Using in-depth interviews Data analysis used:Verbatim transcriptions were analysed, and emerging themes and categories identified, using content analysis.| Use of a number of different drugs was reported, including broad-spectrum antibiotics and corticosteroids. There was poor awareness of side-effects, antibiotic resistance, and drug efficacy. Factors influencing self-medication were perceptions of the illness in the child, waiting time, and convenience, the attitudes of public health medical staff, insufficient drug supply in public health facilities, and poor control of prescribed drugs on the market.Misuse and misconceptions regarding drug use gave rise to considerable problems. Mothers' knowledge and attitudes to illness and health care services played an important role in determining the nature of self-medication. Financial barriers were not the only obstacle to
adequate treatment. Health services should be more accessible and responsive to the needs of the population.|

Le, T. H. , et., al., Drug use and self-medication among children with respiratory illness or diarrhea in a rural district in Vietnam.| To explore the knowledge, attitudes, and behaviours of parents in their use of drugs for respiratory illness or diarrhea among children under 5 years of age, and to understand factors influencing self-medication.| AgePerception of the illnessWaiting timeAttitudeKnowledge| Method specified in the study:A qualitative study was conducted.Locale: rural district in Vietnam.Partners/Subject:Two drug sellers and three health care providers, and four focus-group discussions with mothers of children Under 5 years of age. Data Gathering instrument:Using in-depth interviews Data analysis used:Verbatim transcriptions were analysed, and emerging themes and categories identified, using content analysis.| Use of a number of different drugs was reported, including broad-spectrum antibiotics and corticosteroids. There was poor awareness of side-effects, antibiotic resistance, and drug efficacy. Factors influencing self-medication were perceptions of the illness in the child, waiting time, and convenience, the attitudes of public health medical staff, insufficient drug supply in public health facilities, and poor control of prescribed drugs on the market.Misuse and misconceptions regarding drug use gave rise to considerable problems. Mothers' knowledge and attitudes to illness and health care services played an important role in determining the nature of self-medication. Financial barriers were not the only obstacle to adequate treatment. Health services should be more accessible and responsive to the needs of the population.|

Le, T. H. , et., al., Drug use and self-medication among children with respiratory illness or diarrhea in a rural district in Vietnam.| To explore the knowledge, attitudes, and behaviours of parents in their use of drugs for respiratory illness or diarrhea among children under 5 years of age, and to understand factors influencing self-medication.| AgePerception of the illnessWaiting timeAttitudeKnowledge| Method specified in the study:A qualitative study was conducted.Locale: rural district in Vietnam.Partners/Subject:Two drug sellers and three health care providers, and four focus-group discussions with mothers of children Under 5 years of age. Data Gathering instrument:Using in-depth interviews Data analysis used:Verbatim
transcriptions were analysed, and emerging themes and categories identified, using content analysis.| Use of a number of different drugs was reported, including broad-spectrum antibiotics and corticosteroids. There was poor awareness of side-effects, antibiotic resistance, and drug efficacy. Factors influencing self-medication were perceptions of the illness in the child, waiting time, and convenience, the attitudes of public health medical staff, insufficient drug supply in public health facilities, and poor control of prescribed drugs on the market.Misuse and misconceptions regarding drug use gave rise to considerable problems. Mothers' knowledge and attitudes to illness and health care services played an important role in determining the nature of self-medication. Financial barriers were not the only obstacle to adequate treatment. Health services should be more accessible and responsive to the needs of the population.|

Pan H., et., al., 2012, Prior Knowledge, Older Age, and Higher Allowance Are Risk Factors for Self-Medication withAntibiotics among University Students in Southern China. PLoS ONE 7(7): e41314. doi:10.1371/journal.pone.0041314| To evaluate knowledge and behaviors ofuniversity students and risk factors concerning SMA| Older age.Risk factors for self-medication| Method specified in the study:Locale:Guangdong, ChinaParticipants/Subject:a university comprising 8 schools/colleges in easternGuangdong, ChinaData Gathering instrument: Using a novel questionnaire-based data collection instrument.Data analysis used:an anonymous onlinesurvey was conducted with the students of Shantou University (STU), | Of 1,300 respondents (13.8% of total eligible participants), 47.8% had self-treated with antibiotics. Logistic regression analysis identified prior knowledge of antibiotics (PKA), older age, and higher monthly allowance as independent risk factors for SMA. PKA significantly influenced students’ knowledge about antibiotics, their uses, and common adverse reactions (all p, 0.05). Among self-medicated students, 61.7% used antibiotics at least twice in the previous year. Community pharmacies were the major source of self-prescribed antibiotics. Reported common indications for SMA were sore throat (59.7%), fever (38.2%), cough (37.4%), runny nose (29.3%), and nasal congestion (28.7%). While 74.1% of self-medication episodes were based on students’ own experiences, only 31.1% of students claimed to understand the package insert. Alteration of antibiotics and dosage during the course of self-treatment was made by 63.8% and 55.6% of students, respectively. At least two kinds of antibiotics were simultaneously taken by 82.6% of students. The majority of self-medicated students failed to complete the course of antibiotics. Adverse reactions were reported by 16.3% of students.Amoxicillin was the most common antibiotic used for self-medication.|

Phalke, V. D., et., al., 2009, Self- medication practices in rural Maharashta, India Community Med 2006; 31:34-5| Present study was carried out to investigate the problem and factors responsible for this practice in Rural area of Karad taluka in Western Maharashtra| Self- medicationRural area| Method specified in the study: Cross sectional surveyParticipants/ subject: 515 households in the villageLocale: IndiaData Gathering Tool: questionnaire Data Analysis: Data was analyzed and suitable tests of significance were applied| Majority (63.0%) of the respondents were in age group 36-55 years. As only heads were interviewed most of them were males. 42% were illiterate & majority of them belonged to class IV (43.17%). Prevalence of self medication was found among 81.5% individuals. 48.78% were practicing self medication for last 5 years and 38.53% for more than 5 years. This may be due to increased advertisement and availability of drugs during last decade. Major reasons for practicing self medication were economic (58.5%) or non availability of health care facility (29.3%). Advertisement in newspaper, TV, Radio and magazines were main sources of information (32.93%), followed by chemist shops (25.61%). Major sources of procurement of drugs were chemist shop (36.1%) and other shops (54.18%) including pan shop, grocery shop etc. Most of the users of self-medication resorted to Allopathic system of medicine (73.17%), 9.76% were using allopathic + others and 9.02% only Ayurvedic medicines. We found that 80.49% respondents used self-medication mainly for the treatment of minor illness such as headache, cough, fever.

Very few (6.34%) had knowledge about correct use and only (19.5%) users had knowledge about side effects. Analgesics, antipyretics and anti-diarrhoeals were most commonly used drugs..|

Pit S., et., al, 2008, Prevalence of self-reported risk factors for medication misadventure among older people in general practice Journal compilation 2008 Blackwell Publishing Ltd, Journal of Evaluation in Clinical Practice 14 (2008) 203–208 doi: 10.1111/j.1365-2753.2007.00833.x| To describe the prevalence of risk factors for medication misadventures amongOlder people in general practice.| Prevalence of self-reported risk factorRisk factors for medicationMisadventure| Method specified in the study: Descriptive cross-sectional analysisLocale: New South Wales, AustraliaParticipants/Subjects:Twenty general practitioners in 16 practices recruited 849 practice attendeesAged 65 years and over.Data Gathering used:Data Analysis used: SPSS software| Almost all participants (95%) had used at least one medication for more than 6 months. More than half of the participants had more than one doctor involved in their care (59%), had three or more health conditions (57%), or used five or more medicines (54%). With regard to potential adverse drug reactions, in the last month 39% of participantsexperienced difficulties sleeping, one-third felt drowsy or dizzy (34%), and about a quarter had a skin rash (28%), leaked urine (27%), had stomach problems (22%) or had been constipated (22%). The most common compliance problems were experiencing side effects (14%) and having difficulties opening bottles or packets/applying the medicine(10%).|

Pit,S. W.et.,al, 2007, Medication review patient selection and general practitioners report of drug related problems an action taken in elderly Australian, Journal Compilation, 55, 927-934.| To investigate which patients’ general practitioners (GPs) selected for medication review based on risk factors for medication problems and patient’s demographics; to describe drug-related problems and actions taken to solve those problems during medication review consultations based on GPs’ self-report. | Drug-related problemsElderly AustraliansGeneral PracticeMedication review| Method specified in the study:Cross-sectionalLocale: Hunter Region, New South Wales, AustraliaParticipants/Subjects:Four hundred fifty-two patients recruited from 11 GPData Gathering used:Descriptive analysisData Analysis used:CROSSTAB procedure in SUDAAN, version 8.0 (Research Triangle Institute, Inc., Research Triangle Park. NC) | GPs complete 124 Medication Review Checklist. The group that had a medication review had a lower proportion of individuals aged 65 to 74 that the group that did not (40% vs. 56%). The proportion of people with risk factors for medication misadventures was consistently higher for patient who received a medication review; GPs found that 88% (95% confidence interval (Cl) 566-97) of patients who had a medication review had at least one problem with use of their medication. GPs reported taking at least one action for 104 (88%) patients (95% Cl565-97) to
rectify medication problems. Most common action taken were monitoring (55%), improving compliance (50%), dose change (37%), cessation of drug (28%), and ordering of pathology test (26%). |Method specified in the study: A randomized, cross-sectional, multicentre study was conducted from December 2009 to February 2010.Locale:Iranian University, Iran Participants/Subjects:-The target population of this study was 564 students out of 10,000 students attending four medical and non-medical science universities in Qom state. Data Analysis used:SPSS version 16, and analysis was conducted with descriptive analysis procedures.| 76.6% of the students had used analgesics in self-medication in the previous 3 months. The frequency of analgesic use in the study period was once in 19.2% of the participants, twice in 22.2%, three times in 16.3% and more than three times in 35.5% of the participants, although 6.8% of them were not sure when they were used. Of all the respondents, 49.8% reported headache as the problem. This was the most common problem, after which came Dysmenorrhea, headache and stomach ache. Bone and joint pains were other problems that led to the use of analgesics. The most commonly used source of information for self-medication with analgesics was advice from friends and family (54.7%), previously prescribed medications (30.1%), their medical knowledge (13.3%) and recommendation of a pharmacist (1.9%)Self-medication with analgesics is very high among Iranian students in Qom city. This could be an index for other parts of the Iranian community. Because the source of information about analgesics is inappropriate, we would recommend education courses about analgesics and self-medication on the radio and television for the entire population|

Sarahroodi S,et., al 2000 Patterns of Self-medication with analgesics among Iranian University students in central Iran Department of Pharmacology, School of Medicine, Qom University of Medical Sciences, Qom, Iran.| This study was performed to evaluate self-medication with analgesics and its pattern among different groups of Iranian University Students.| EducationFamilySocietyLawAvailability of drugs Exposure to advertisements.| Method specified in the study: A randomized, cross-sectional, multicentre study was conducted from December 2009 to February 2010.Locale:Iranian University, Iran Participants/Subjects:-The target population of this study was 564 students out of 10,000 students attending four medical and non-medical science universities in Qom state. Data Analysis used:SPSS version 16, and analysis was conducted with descriptive analysis procedures.| 76.6% of the students had used analgesics in self-medication in the previous 3 months. The frequency of analgesic use in the study period was once in 19.2% of the participants, twice in 22.2%, three times in 16.3% and more than three times in 35.5% of the participants, although 6.8% of them were not sure when they were used. Of all the respondents, 49.8% reported headache as the problem. This was the most common problem, after which came Dysmenorrhea, headache and stomach ache. Bone and joint pains were other problems that led to the use of analgesics. The most commonly used source of information for self-medication with analgesics was advice from friends and family (54.7%), previously prescribed medications (30.1%), their medical knowledge (13.3%) and recommendation of a pharmacist (1.9%)Self-medication with analgesics is very high among Iranian students in Qom city. This could be an index for other parts of the Iranian community. Because the source of information about analgesics is inappropriate, we would recommend education courses about analgesics and self-medication on the radio and television for the entire population|

Shankar P.R. et., al, 2002,Self-medication and non-doctor prescription practices in PokharaValley, Western Nepal: a questionnaire-based studyBMC Family Practice 2002, 3:17 This article is available from:http://www.biomedcentral.com/1471-2296/3/17| To determine Self-medication and non-doctor prescribing of drugs in developing countries.| Practices of non-doctor prescriptionPractices of self-medication| Method specified in the study:semi-structuredquestionnaireLocale: PokharaValley, Western Nepal Participants/Subjects:Carried out the study on 142 respondents. Data Gathering:Questionnaire and InterviewData Analysis used:Analyzed using the z test of proportions. .| >Seventy-six respondents (54%) were aged between 20 to 39 years. The majority of the respondents (72 %) stayed within 30 minutes walking distance of a health post/medical store. 59% of these respondents had taken some form of self-medication in the 6-month period preceding the study. The common reasons given for self-medication were mild illness, previous experience of treating a similar illness, and non-availability of health personnel. 70% of respondents were prescribed allopathic drugs by a non-allopathic doctor. The compounder and health assistant were common sources of medicines. Paracetamol and antimicrobials were the drugs most commonly prescribed. A significantly higher proportion of young (<40 years) male respondents had used self- medication than other groups.|

Sontakke, S.D. et.,al, 2011, Comparative study of evaluation of self-medication practices in first and third year medical students. Int J Biol Med Res. 2 (2), 561-564. | To compare the pattern of self-medication in first and third year medical students and to evaluate whether medical trainings results in any change in this pattern| Self- medication practicesFirst and third year medical students.| Method specified in the study: Survey-based studyCross- sectional studyLocale:Government Medical College, Nagpur India Participants/Subjects:1st year MBSS Students (2nd semester), 3rd year MBSS students (5th semester)Data Gathering instrument:Open and close-ended questionnaireData Analysis used:Chi square test usingGraph Pad prism version 5.0.| Senior medical students have a better knowledge about certain aspects of self-medication which reflects the influence of medical training. But, even the junior students who are not exposed to the knowledge of drugs and disease are well aware about most of these which may be due to easy availability of information.|

Sweileh, W.M., 2004, Self – Medication and Over-the-Counter Practices: A Studyin Palestine, W. Sweileh, J. Al-Aqsa Unv., 8, 2004 | To describe and analyze the self -medication patterns and over-the-counter practices in Palestine.| Practices of self-medications | Method specified in the study: descriptive study Locale: Palestine.Participants/Subject:A random sample of patients seeking self- medication at community pharmacy was interviewed using a 15-item questionnaire. Social, demographic, diseaseinformation and information on drugs used for self-medication or dispensedover the counter were collectedData Gathering: interviewed using a 15-item questionnaire Data Analysis: descriptive statistic. The percentage of patients who were seeking self- medication study was approximately 60%.Those patients were mostly males, educated, above the age of 40 and have a monthly income of less than 200 USD. Most patients were seeking self- medication for headache, dental pains, muscle/joint pains and throat or respiratory or urinary tract infections.The drugs most commonly dispensed or purchased on a self- medication basis were NSAIDs, paracetamol and anti-microbial drugs. Patient health awareness programs and pharmacist continuing education are necessary in Palestine.|

Verma, R.K., et., al. 2010, Evaluation of self-medication among professional students in North India Proper statury drug control must be implemented. Asian Journal of Pharmaceutical and Clinical, 3, 60-64. | To describe and examine the branded medicines used by professional students, awareness, trust in medicine system, reasons behind self-medication, drug information resources, danger findings and knowledge of drug profile| Self-medication-Professional Students| Method specified in the study: Questionnaire- based surveyLocale:U.P. Technical University, LucknowParticipants/Subjects:Professional Students(Young men and women, all Indian nationals, who had 1-4 years ago joined the professional college)Data Gathering instrument: Self-developed, prevalidated questionnaire consisting of both open-ended and closed-ended itemsData Analysis used:Summarized as counts and percentages.| .The study shows that the majority of professional students had a poor knowledge about appropriate self-medication while the knowledge of the benefits and risks was not adequate|

Wen, Y., et al. A qualitative study about self-medication in the community among marketvendors in Fuzhou, China, 2011, Health and Social Care in the Community 19(5), 504–513 doi: 10.1111/j.1365-2524.2011.01009.x| To understand the factors influencing common self- medication behavior in a community of food market vendors in Fuzhou China, a total of 30 market vendors were randomly recruited from six food markets in 2007| Theme 1:Hospital-based health care was perceivedas having better service quality;Theme 2:Self-medication was perceived as a wayto save money and time;Theme 3: Role of perceived understanding of thedisease;Theme 4: Role of environmental factors;Theme 5: Role of past experience.| Method specified in the study: Qualitative StudyLocale:ChinaParticipants/Subject:Market WomanData Gathering instrument:InterviewData analysis used:ATLAS software| The results showed that hospital-based healthcare services were perceived as better quality. However, self-medication was viewed as more affordable in terms of money and time. Other factors promptingself-medication, included confidence in understanding the health problem, the easy accessibility of local pharmacies and the influences of friends ⁄ peers and advertising. Three broad domains, attitude, cost and effectiveness, were all seen to determine past decisions and experiences with self-medication.Interestingly, the effective management of self-medicationvia pharmacy resources raised particular concern because of perceived variation in quality. In conclusion, self-medicationwas found to be an important and common health-seekingbehaviour driven by multiple factors. A sound and comprehensivepublic health system should systematically attend to these behaviours and the pharmacies, where much of the behavior occurs.|

Widayati, A., et., al., 2011, Self-medication with antibiotics in Yogyakarta City Indonesia: a cross sectional population-based survey, BMC Research Notes 2011, 4:491 doi:10.1186/1756-0500-4-491| To investigate the period prevalence, patterns of use, and socio-demographic factors associated with self-medication with antibiotics in Yogyakarta City Indonesia.| Self-me
dication with antibiotics.Indonesian people.Socio-economic factors.| Method specified in the study: Cross-sectional population-based surveyLocale:Yogyakarta City Indonesia Participants/Subject:self-administered to randomly selected respondents (over 18 years old)Data Gathering instrument:pre-tested questionnaireData analysis used:Descriptive statistics, chi-square and logistic regression were applied.| A total of 559 questionnaires were analyzed (response rate = 90%). The period prevalence of self-medication with antibiotics during the month prior to the study was 7.3%. Amoxicillin was the most popular (77%) antibiotic for self-medication besides ampicillin, fradiomisin-gramisidin, tetracycline, and ciprofloxacin to treat the following symptoms: common-cold including cough and sore throat, headache, and other minor symptoms; with the length of use was mostly less than five days. Doctors or pharmacists were the most common source of information about antibiotics for self-medication (52%). Antibiotics were usually purchased without prescription in pharmacies (64%) and the cost of the purchases was commonly less than US $1 (30%). Previous experience was reported to be the main reason for using non-prescribed antibiotics (54%). There were no socio-demographic variables significantly associated with the actual practice of using non-prescribed antibiotics. However, gender, health insurance, and marital status were significantly associated with the intent to self-medicate with antibiotics (P < 0.05). Being male (Odds Ratio = 1.7 (1.2 - 2.6)) and having no health insurance (Odds Ratio = 1.5 (1.0 -2.3)) is associated with the intent to self-medicate with antibiotics.| Wijesinghea, P.R.,et.,al., 2012, Prevalence and predictors of self-medication in a selected urban and rural district of Sri Lanka, WHO South-East Asia Journal of Public Health 2012;1(1):28-41| To determine the prevalence of medicine use and predictors of self-medication in Sri Lanka.| Prevalence of self-medicationPredictors ofself-medication| Method specified in the study:In a community-based cross- sectional study Locale: Sri Lanka.Participants/Subject:Data were collected from 1800 adults selected from Gampaha and Polonnaruwa districts respectively. Study participants were sampled using a multistage cluster sampling technique. Trained public health midwives administered the questionnaire.Data Gathering:Two Likert scales provided information on access to medical care and satisfaction with available pharmacy services. About 95% of the sampled population participated in the study.Data Analysis: SPSS| Overall, prevalence of medication use (allopathic, traditional, home remedies) in urban and rural population was 33.9% and 35.3%, respectively. Self-medication prevalence of allopathic drugs in the urban sector (12.2%) was significantly higher than in the rural (7.9%) sector (p<0.05). In the urban sector, small household size and preference to have medicines from outside the pharmacies predisposed to self-medication. The higher acceptability of medical services and regularity of medical care decreased the likelihood of self-medication. In the rural sector, lower satisfaction about the healthcare providers’ concern for clients, lower satisfaction about affordability of medical care and higher satisfaction with technical competence of the pharmacy staff increased the likelihood of self-medication. In both urban and rural sectors, when symptom count increased, tendency to self-medicate decreased.

Worku, S., et., al., 2003, Practice of Self-medication in Jimma Town, Ethiop.J.Health Dev. 2003;17(2):111-116| To assess the prevalence of self-medication among residents of Jimma town.| Practice of self-medicationPrevalence of self-medication| Method specified in the study: community based cross-sectionalsurvey Locale: ChinaParticipants/ Subject: 352 households, which were selected systematic- ally.Data Gathering: structured and pre-tested questionnaireData Analysis used: analyzed using SPSS/PC computer statistical software.| Out of the 152 ill people, 27.6% were self-medicated. The most frequent illness reported for self-medication was headache (60%). Most of the drugs for self-medication were obtained from drug retail outlets (52.4%). The relative lesser cost (35.7%) was the major reason for using self- medication.

Zafar, S.N et.,al, 2007, Self -medication among university students of Karachi: Prevalence, knowledge and attitudes.| To determine the prevalence, attitude and knowledge of self-medication among university students of Karachi, Pakistan| KnowledgeAttitudeAgeMedical and non-medical student| Method specific to the study: Cross-sectional studyLocale: Karachi, PakistanParticipants: 2 medical and 2 non- medical students of university in Karachi, PakistanData Gathering: questionnaireData Analysis:SPSS v 14 and associations were tested using the Chi square test| Of the 572 participants (mean age=21 ± 1.8 years, Male: Female ratio=1:1.5), 295 were medical and 277 were non-medical students. The prevalence of self-medication was 76%. Forty three percent students stated that they alter the regimen of prescribed medicines while 61.9% stated that they stop taking a prescribed medicine without consulting a doctor. The most common reason for self-medication was previous experience (50.1%) and the most common symptoms were headache (72.4%), flu (65.5%), and fever (55.2%). Commonly used medicines were analgesics (88.3%), antipyretics (65.1%) and antibiotics (35.2%). Eighty seven percent of students thought self-medication could be harmful and 82.5% students thought that it was necessary to consult a doctor before taking a new medicine. There was no significant difference between the self medication practices of medical and non medical students (p=0.8) The prevalence of self -medication practices is alarmingly high in the educated youth of Pakistan, and is the same in medical and non- medical students despite the majority knowing that it incorrect. We recommend that a holistic approach must be taken to prevent this problem from escalating which would involve (i) awareness and education regarding the implications of self- medication (ii) strategies to prevent the supply of medicines without prescription by pharmacies (iii) strict rules regarding
pharmaceutical advertising and (iv) strategies to make receiving health care much less difficult. Our study has also opened gateways for further research in this issue, besides showing that it is a real problem and should not be ignored.