Practice of Self-medication Among Undergraduates
CHAPTER ONE
Purpose of the Study
The purpose of the study is to examine those factors that influence the practice of self-medication among undergraduate of University of Lagos. The following are the specific objectives of the study:
- To describe the magnitude of self-medication practice among undergraduates and cure rate following self-medication
- To determine the type and pattern of drugs which the students frequently self-medicate and the side effects faced due to consumption of the self-prescribed medicines
- To determine the factors that are responsible for self-prescription among the undergraduates
CHAPTER TWO
LITERATURE REVIEW
Prevalence of self-Medication in the general population
As far as its prevalence is concerned, self-medication has high rate all over the world. It has high prevalence rate that is ranging from 32.5- 81.5%. Self-medication prevalence rate in developing countries is alarming that is 92%, prevalence rate in European countries is 68 % and in countries like India and Nepal are 31 % & 59 % respectively (Bollu et al, 2014).
In a study done to assess self-medication awareness and attitude among Malaysian urban population overall 83.9% of participants consumed OTC medications. The commonly consumed OTC drugs were supplements and vitamins followed by painkillers, flu/ cough remedies and sore throat products. Easy access, convenience and time saving were the most frequent reasons for self-medication (Azhar et al, 2013).
A study of the prevalence of self-medication practice among University Students in Southwestern Nigeria indicated that majority of the respondents (91.4 %) were involved in self-medication practices. Fifty three point eight percent of the students used antibiotics while 46.3 % used anti-malarial drugs for self-medication (Osemene et al, 2012)
In Ethiopia, the magnitude of general self-medication practice among the general population was studied and results showed that the majority of illnesses were treated without consultation of professionals. Previous studies in Addis Ababa and central Ethiopia showed that, the magnitude of self-medication was as high as 50% (Kitaw, 1987).
A study done in the three Gondar towns (i.e., Gondar, Dabark, & Kola-Diba), North West Ethiopia found that, the prevalence of self-medication was 27.5% in two week recall period (Abula and Worku, 2001). Similarly, another community based survey done in Jimma town showed that the prevalence of self-medication was 27.6%. (Worku et al, 2003).
Another study done to assess medication knowledge, attitude and practice among Gondar university fresh man students showed that 74% of the respondents intended to self-medicate on minor ailments like cold. Regarding where they get the medicines from, more than 75% of the students seek for non-prescription medicines in the community pharmacy (Berhanemeskel & Seada, 2008).
A community based cross-sectional survey conducted to assess self-medication practices with antibiotics among urban dwellers of Bahir dar town, North West Ethiopia, showed that prevalence of self-medication was 23.3% and out of these 17 (12.8%) of them use antibiotics for self medication. Among them, 14 (82.4%) obtained drugs from private pharmacy or drug shop without prescription and 3 (17.6%) from their friends or relatives. Respiratory tract disease10 (58.8%), diarrhea 7 (41.2%), fever 3 (17.6), headache 2 (11.8), gastro intestinal tract disease 1 (5.9%) were reported symptoms of illness for the practice of self-medication. The reasons given for selfmedication are previous experience with similar illness (82.2%), minor problem (17%), less expensive (11.8%) & urgency of problem (5.9%) (Tena, 2014).
CHAPTER THREE
METHODOLOGY
Study Design
A facility-based cross-sectional quantitative and qualitative study design was used to assess self-medication practice among undergraduates attending University of Lagos Akoka, Lagos State
It is described as quantitative study because it attempts to measure self-medication practices among undergraduates through the use of a questionnaire. On the other hand, it is also described as a cross-sectional survey since the study involves the administration of the research instrument (questionnaires) once only to the sample and the data generated on the measured characteristics are limited only to the specific period of the study.
Study Population
The study population was the undergraduate undergraduates; both residents and nonresidents. This is an ideal group because they spend most of their time in their respective rotations, therefore are accessible. The students were sampled from their different rotations to give a representative sample.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
Socio-demographic characteristics of the study population
A total of 268 respondents with response rate of 91.2% participated in the study. The median age of respondents was 27 years with the minimum and maximum age of 24 and 39 years respectively. From the respondents, 153 (57%) were females, 209(78%) of the respondents were Christians and 185 (69%) of the study subjects were single.
Self-Medication practice of study participants
When asked about the time when they got sick recently 142 (53%) of the study participants said a week ago. Concerning the immediate action they took when they got sick, 241 (90%) responded they self-medicated of which 108 (43%) said they selfmedicated once for their last illness (Table 2).
Among those who practice self-medication, 151 (60%) did so for headache/fever whereas, 10 (4%) mentioned other reason which is back pain. Regarding the question which asks what type of medication they use for self-medication, 193 (77%) said painkillers and 1 (0.4%) said other type of medication which is folic acid (Table 2).
CHAPTER FIVE
DISCUSSION OF RESULTS CONCLUSIONS AND RECOMMENDATIONS
DISCUSSION
Self-medication practice of respondents
Self-medication behavior has become a global trend that has been internationally reported as being on rise and can have positive as well as negative impacts. It has been noted that the increased trend of self-medication practice is not only detected in countries with advanced economy but also in developing countries (Sharif et al, 2015). In this study, the prevalence of self-medication practice of medical students was examined. According to the result, high percentage (90%) of the respondents practiced self-medication as an immediate action for their recent illness. This finding is in agreement with a study done in Malaysia among health care professionals (Ali et al, 2013), in Karachi Pakistan among pharmacists and non-pharmacists (Shoaib et al, 2013), in India among nurses and midwives (Swopna et al, 2016), in United Arab Emirates among pharmacists (Sharif et al, 2015) and in Ghana among doctors and pharmacists (Boateng, 2009). However, this current study included medical students and not specific to the professionals these reviewed studies included.
Association between socio-demographic characteristics and self-medication practice
In the multivariate analysis it was found that respondents who are females were found to be more likely to practice self-medication than their male counterpart. This is in accordance with another study done among medical students of a private institute in Nagpur, India (Kaskular et al, 2015) and a study done on university students in Arsi University, Ethiopia (Bekele et al, 2016). This might be related to the physiological difference they have and how they react to pain. Females have more disease burden than males including pains related to maternal and menstrual effects. However, this issue has to be explored further to reach for possible explanatory reasons.
CONCLUSIONS
In this study self-medication practice among undergraduates was found to be high (90%). From the total respondents, 60% of them responded they practice self medication for headache or fever. And painkillers were the most widely used type of medicine for self-medication followed by antibiotics. This is a serious problem which needs a better focus and intervention keeping in mind the alarming rate of antibiotic resistant pathogens.
The finding of this study showed that ‘mild illness’ is the major reason for self medication practice mentioned by the study participants. And concerning the place of access of drugs for self-medication the majority said from pharmacy followed by their work place. Access of drugs from work place is mentioned in the second place. This might mean that they are taking from what is supposed to be accessed by the clients/patients at the health institution. This calls for a need of better drug control system in the hospital.
From the study participants, 86% agreed that improper self-medication practice has negative consequences both on the health care professional and the patients they care for. From the consequences on health care professionals, 61% of them responded drug resistance. Among the reasons mentioned as a consequence on the patients/clients, 69% accounts for negligence.
This needs to be investigated further by incorporating the views of the patients/clients to reach for a better intervention.
Based on the points mentioned above, it can be concluded that, self-medication practice among medical students is more prevalent which must be explored in detail so as to reach for an effective intervention.
RECOMMENDATIONS
The findings of the study, self-medication practice among undergraduates has the following social work implications with regards to practice, education, research and policy.
Implication for social policy
The health policy and the drug policy of the country are the major policy areas related to this study. The health policy of Nigeria under its general strategies mentioned that health education shall be strengthened for creating awareness in the population about the rational use of drugs. The drug policy of the country also mentioned under its general strategies concerning drug use, that appropriate education, promotion, counseling etc. shall be offered in every possible way to raise the public awareness about drug use. However, both policy documents did not mention specific points regarding self-medication and the drugs that are safe to be utilized without the doctor’s prescription. In this regard, there is a need to reevaluate the policies and formulate rules and regulations regarding drug use.
As we can see from the findings of the study majority of the respondents tend to selfmedicate and get an immediate relief from their symptoms rather than seeking a holistic care like by having discussion with other health care professionals and medical social workers about what causes their problem. The symptom may arise from uncomfortable work environment, stressful conditions, from their social environment etc which means it might be beyond physical need rather psychosocial and spiritual. Hence, the role of social workers in the health care setting is very vital for addressing the psychosocial and spiritual needs of the patients (health care professionals in this case), by participating in multidisciplinary teams so that, they can get service in a holistic approach.
The other thing the medical social workers can do is that encouraging the healthcare professionals to enter the patient role meaning like any other person seeking health care services, health care professionals should also be encouraged through appropriate provision of health care services rather than getting self-medicated. This could be the potential solution to decrease the high prevalence of self-medication among health care professionals.
Implication to social work education
As noted from the findings of the study the involvement of social workers in the health care setting by incorporating them as team members is very important. Since one of the field placement areas for social work students is health institutions, students and their field liaisons should recommend on observed gaps in health care delivery.
Research Implication
To the best of my knowledge, very few studies have been conducted regarding self medication practice among medical students. It is very clear that there is a research gap regarding this issue. Since this research explored prevalence of self-medication among medical students, it can serve as a beginning point for researchers who are interested to do further researches on the issue.
REFERENCES
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