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Zazdravnykh E, Aistov A, Aleksandrova E. Total expenditure elasticity of spending on self-treatment and professional healthcare: a case of Russia. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2024; 24:81-105. [PMID: 37022649 DOI: 10.1007/s10754-023-09353-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
The studies on the demand for healthcare in low- and middle-income countries rarely take into consideration the fact that many people spend their income on self-treatment and professional treatment. The estimation of the income elasticity of demand for self-treatment and professional treatment can show a more precise picture of the affordability of professional care. This paper contributes to the discussion around estimates of income elasticity of health spending and discussion whether professional care and self-treatment are close to a luxury good and inferior good respectively in a middle-income country. We apply the switching regression model to explain the choice between self-treatment and professional healthcare via estimates of the income elasticity. Estimates are made with the use of the Russian Longitudinal Monitoring Survey - Higher School of Economics (RLMS-HSE), a nationally representative survey. While individual expenditure on professional treatment is higher than that on self-treatment, our estimates show that expenses on professional treatment can be income inelastic except when spending on medicines prescribed by a physician that are elastic. The results also indicate that cost of self-treatment is income elastic. In all cases, the considered income elasticities are statistically insignificant between professional and self-treatment.
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Affiliation(s)
- Evguenii Zazdravnykh
- Evguenii Zazdravnykh, HSE University, Saint Petersburg, Russia.
- Graduate School of Management, St. Petersburg University, Saint-Petersburg, Russia.
| | - Andrey Aistov
- Andrey Aistov, HSE University, Niznhy Novgorod, Russia
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Chiang V, Kan AKC, Saha C, Au EYL, Li PH. Identifying the most at-risk age-group and longitudinal trends of drug allergy labeling amongst 7.3 million individuals in Hong Kong. BMC Med 2024; 22:30. [PMID: 38273323 PMCID: PMC10811878 DOI: 10.1186/s12916-024-03250-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/08/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Incorrect drug 'allergy' labels remain a global public health concern. Identifying regional trends of drug allergy labeling can guide appropriate public health interventions, but longitudinal or population drug allergy studies remain scarce. We analysed the serial epidemiology of drug allergy labeling to identify specific subgroups at highest risk of drug allergy labeling for potential interventions. METHODS Longitudinal, population-wide drug allergy labels and clinical data from over 7,337,778 individuals in Hong Kong between 2016 and 2021 were analysed. RESULTS The absolute prevalence and incidence of documented drug allergy were 5.61% and 277/100,000 population, respectively. Annual incidence of new allergy labels was stable between 2016 and 2019, until a significant drop in 2020 (-16.3%) during the COVID19 pandemic. The most common allergy labels were anti-infectives (245,832 [44.5%]), non-steroidal anti-inflammatory (106,843 [19.3%]), and nervous system drugs (45,802 [8.3%]). The most common labeled culprits for the most severe immediate-type (anaphylaxis) and non-immediate-type (Stevens-Johnson syndrome) reactions were beta-lactams and nervous system drugs, respectively. For individuals at highest risk of labeling, there was significantly higher incidence of overall drug and beta-lactam allergy labeling amongst individuals aged > 40 years which contributed to the majority of newly labeled allergies (377,004, 68.2%). CONCLUSIONS Contrary to traditional dogma, we identified disproportionately higher incidence of drug allergy labeling amongst older individuals, rather than the paediatric age group. We advocate for more population-wide drug allergy studies to investigate this phenomenon in other cohorts as well as future preventative and delabeling efforts focusing on the adult population.
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Affiliation(s)
- Valerie Chiang
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Andy Ka Chun Kan
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong
| | - Chinmoy Saha
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong
| | - Elaine Y L Au
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Philip H Li
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong.
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Dutta S, Kaur RJ, Bhardwaj P, Ambwani S, Godman B, Jha PA, Sukhija S, Venkatesh SS, Lugova H, Islam S, Charan J, Haque M. Demand of COVID-19 medicines without prescription among community pharmacies in Jodhpur, India: Findings and implications. J Family Med Prim Care 2022; 11:503-511. [PMID: 35360769 PMCID: PMC8963618 DOI: 10.4103/jfmpc.jfmpc_1250_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/14/2021] [Accepted: 09/30/2021] [Indexed: 02/07/2023] Open
Abstract
Background: COVID-19 pandemic led to increased self-medication of antimicrobials, vitamins, and immune boosters among the common people and consuming without prescription can lead to adverse consequences including antimicrobial resistance. Methods: A cross-sectional study was conducted on community pharmacies in Jodhpur, India. They were inquired regarding the prescription and increased sales (<25%, 25—50%, 50--75%, or 75--100%) of various medicines (Hydroxychloroquine, Azithromycin, Ivermectin, and Vitamin C) during the COVID-19 pandemic. Logistic regression analysis was conducted to assess the relationship between requests for certain COVID-19 medications and an increase in their sale. Results: A total of 204 pharmacies took part, and 88.23% reported patients to approach them without prescriptions. Most of the pharmacies revealed that <25% of patients came without prescription. The majority came for azithromycin (68%) and vitamin C (92%). Increased sales of the four targeted medications were seen by 85.92% of pharmacies compared to last year. A majority (51.5%) reported <25% increased sales of azithromycin, but no change in the sale of hydroxychloroquine and ivermectin. However, 39.6% reported >75% increase in vitamin C sales. Conclusion: There was an increase in the demand for COVID-19 medications without prescription. This study was unable to detect a significant increase in sales of antimicrobials, which is encouraging.
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Affiliation(s)
- Siddhartha Dutta
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Rimple J Kaur
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- Community and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sneha Ambwani
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, United Kingdom.,Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Pallavi A Jha
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sanchi Sukhija
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Suman S Venkatesh
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Halyna Lugova
- Unit of Community Medicine, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
| | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
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Vahedi S, Jalali FS, Bayati M, Delavari S. Predictors of Self-medication in Iran: A Notional Survey Study. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2021; 20:348-358. [PMID: 34400964 PMCID: PMC8170743 DOI: 10.22037/ijpr.2020.113601.14394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
While logical use of medicine is a priority in all health systems, people do self-medication- mainly using Nonprescription Drugs or Over the Counter (OTC) drugs- for different reasons. Self-medication is rising in many developing countries that could increase healthcare expenditure. The present study aimed to find the self-medication rate and predisposing, enabling, and need factors affecting it based on the Anderson behavioral model in the Iranian population. The present study uses 22470 households’ data acquired from Iranian utilization of healthcare survey at the national level (2016). Due to the study objective, the data of 13005 people who were over 15 years old and had outpatient healthcare needs two weeks before the survey. The survey included a binary question about self-medication, which is considered a dependent variable. Age, gender, marital status, literacy, job status, socio-economic status, location, basic health insurance, complementary health insurance, and need for health services were considered as independent variables. Data were analyzed using logistic regression. The self-medication rate was calculated at 26.3% that was different among different subgroups of the population. According to the model estimates, married (OR = 0.80, CI = 0.71-0.91) and housekeepers (OR = 0.79, CI = 0.67-0.93) had significantly lower self-medication. Moreover, the urban population (OR = 1.29, CI = 1.17-1.43), people without basic (OR = 1.32, CI = 1.10-1.58), and supplementary (OR = 1.18, CI = 1.04-1.35) health insurance and also people who had two or higher number of outpatient healthcare needs had significantly more self-medication (OR = 2.96, CI = 2.67-3.29). It can be concluded that need, enabling, and predisposing factors are respectively the main determinants of self-medication behavior. From a policy point of view, increasing effective health insurance coverage with a focus on people who have more health care needs can be helpful.
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Affiliation(s)
- Sajad Vahedi
- Department of Health Service Management, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Faride Sadat Jalali
- Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Delavari
- Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Kifle ZD, Mekuria AB, Anteneh DA, Enyew EF. Self-medication Practice and Associated Factors among Private Health Sciences Students in Gondar Town, North West Ethiopia. A Cross-sectional Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211005188. [PMID: 33759621 PMCID: PMC7995453 DOI: 10.1177/00469580211005188] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Self-medication is the most common practice worldwide and it may lead to irrational use of drugs. Therefore, this study aimed to assess the prevalence of self-medication practice and its associated factors among health science students. A cross-sectional study was conducted on 600 health science students in Gondar town. The data regarding self-medication practice and its associated factors were collected using a face-to-face interview on a structured questionnaire. SPSS −24 was used for data analysis and explained with univariate, and multivariate logistic regression analysis to determine the factors associated with self-medication practice (sex, age, religion, marital status, residence, department, year of study, monthly income, access to pharmacy, and peer/family pressure). A total of 554 students responded to the questionnaire with a response rate of 92.3%. Out of 554 respondents, 78.2% were practiced self-medication. Headache/fever 37.88% (n = 164) was reported as the most common complaint to practice self-medication. Among the reasons for self-medication practice, similarity of symptoms with past illness 33.49% (n = 145) was the most frequently reported. In current study, Females (AOR = 3.11, 95% CI = 1.55, 6.25), Muslim followers (AOR = 2.78, 95% CI = 1.30, 5.91), Protestant followers (AOR = 4.25, 95% CI = 1.38, 13.07), pharmacy students (AOR = 3.72, 95% CI = 1.97, 9.30), clinical nursing students (AOR = 2.88, 95% CI = 1.87, 14.48), monthly income (>500ETB) (AOR = 2.49, 95% CI = 1.12, 5.56), distance of health institution (<30 min) (AOR = 2.79, 95% CI = 1.39, 5.61), and accessibility of pharmacy (AOR = 4.85, 95% CI = 2.08, 11.29) were the independent predictors of self-medication practice. Self-medication is common in health science students in Gondar town. Health professionals should educate students on the risks and benefits of self-medication to encourage responsible self-medication. National guidelines on medicine access should be developed and strong measures should be implemented to halt the selling of medications without a proper prescription.
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Hashemzaei M, Afshari M, Koohkan Z, Bazi A, Rezaee R, Tabrizian K. Knowledge, attitude, and practice of pharmacy and medical students regarding self-medication, a study in Zabol University of Medical Sciences; Sistan and Baluchestan province in south-east of Iran. BMC MEDICAL EDUCATION 2021; 21:49. [PMID: 33446190 PMCID: PMC7807440 DOI: 10.1186/s12909-020-02374-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/10/2020] [Indexed: 06/01/2023]
Abstract
BACKGROUND Self-medication is defined as using medicinal products to treat the disorders or symptoms diagnosed by oneself. Although informed self-medication is one of the ways to reduce health care costs, inappropriate self-treatment can pose various risks including drug side effects, recurrence of symptoms, drug resistance, etc. The purpose of this study was to investigate the knowledge, attitude, and practice of pharmacy and medical students toward self-medication. METHODS This study was conducted in Zabol University of Medical Sciences in 2018. Overall, 170 pharmacy and medical students were included. A three-part researcher-made questionnaire was designed to address the students' knowledge, attitude, and practice. Statistical analysis was performed in SPSS 25 software. RESULTS According to the results, 97 (57.1%) students had carried out self-medication within the past 6 months. Overall, the students self-medicated on average 4.2 ± 2.9 times per year. Self-medication was more common in male students (65.4%, P = 0.043). Cold was the most common ailment treated with self-medication (93.2%), and antibiotics (74.4%) were the most commonly used drugs. The primary information sources used by the students were their previous prescriptions (47.4%). Pharmacy students had a higher level of drug information (P < 0.001). There was a statistically significant association between the level of drug information and the tendency for self-medication (P = 0.005). Disease recurrence was the most common negative complication of self-medication. CONCLUSION There is a need to educate pharmacy and medical students regarding self-medication and its side effects. The high prevalence of self-medication and the overuse of antibiotics can pose a significant risk of drug resistance.
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Affiliation(s)
- Mahmoud Hashemzaei
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran
- Toxicology and Addiction Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahdi Afshari
- Department of Community Medicine, Faculty of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Zahra Koohkan
- Students Research Committee, Faculty of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran
| | - Ali Bazi
- Faculty of Allied Medical Sciences, Zabol University of Medical Sciences, Zabol, Iran
| | - Ramin Rezaee
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kaveh Tabrizian
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran.
- Toxicology and Addiction Research Center, Zabol University of Medical Sciences, Zabol, Iran.
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Rangari GM, Bhaisare RG, Korukonda V, Chaitanya YL, N H. Prevalence of self-medication in rural area of Andhra Pradesh. J Family Med Prim Care 2020; 9:2891-2898. [PMID: 32984145 PMCID: PMC7491850 DOI: 10.4103/jfmpc.jfmpc_204_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 11/22/2022] Open
Abstract
Background: The consumption of medicine without consulting a doctor is called self-medication. In the recent decade, the prevalence of self-medication was increased mainly in the developing countries. The reason varies from the nonavailability of doctors to economical reason. But people are not aware of the side effects and interactions of drugs. This is risky behavior and may lead to death. The objective of this study is to find out the prevalence and various reasons, sources, and common drugs used for self-medication. Materials and Methods: A cross-sectional community-based study conducted in Visakhapatnam district, Andhra Pradesh. 166 houses were selected by using a simple random sampling method. One respondent from one household was interviewed by using a semi-structured questionnaire. The data obtained were analyzed by using SPSS V22. Chi-square and Fisher exact tests were applied to find associations. Phi, Cramer Rao V, and contingency coefficient were applied to find the strength of association. A value of P < 0.05 was considered significant. Results: Among 166 subjects, the majority (58.4%) of participants were in the age group between 18-30 and most of them were female 142 (85.5%). The prevalence of self-medication was 68.1%. The main source of self-medication was directly from the pharmacy, that is, pharmacists (72.6%). Analgesics were commonly (85%) self-medicated drug. The main indication for self-medication was headache (78.8%) and fever (66.4%). Conclusion: The prevalence of self-medication was high and which is hazardous to health. This needs prompt legislative action.
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Affiliation(s)
- Gaurav M Rangari
- Department of Pharmacology, All India Institute of Medical Science, Mangalagiri, Andhra Pradesh, India
| | - Roza G Bhaisare
- Department of Community Medicine, Nimra Institute of Medical Science, Vijayawada, Andhra Pradesh, India
| | - Venkatasandhya Korukonda
- Department of Community Medicine, Medical Student, GVP IHC and MT, Visakhapatnam, Andhra Pradesh, India
| | - Y Lakshmi Chaitanya
- Department of Community Medicine, Medical Student, GVP IHC and MT, Visakhapatnam, Andhra Pradesh, India
| | - Hanumanth N
- Department of Community Medicine, GVP IHC and MT, Visakhapatnam, Andhra Pradesh, India
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Mensah BN, Agyemang IB, Afriyie DK, Amponsah SK. Self-medication practice in Akuse, a rural setting in Ghana. Niger Postgrad Med J 2019; 26:189-194. [PMID: 31441458 DOI: 10.4103/npmj.npmj_87_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective In most resource-poor settings, there is a paucity of data on self-medication and possible factors that influence this practice. The current study assesses self-medication among the people of Akuse, a rural setting in the Eastern Region of Ghana. Methods A quantitative cross-sectional study was carried out in Akuse from 4th January 2016 to 27th February 2016. Using a questionnaire, interviews were conducted to assess self-medication: class of drugs taken, sources of drugs, knowledge of potential adverse effects, among others. Results Of the 363 participants enrolled, 361 completed questionnaires administered. Of the 361 respondents, 58.4% were female. A majority of the respondents were within the ages of 30 and 45 years. Respondents were mainly farmers (40.2%), and a majority (44.6%) had primary level as the highest education. One major reason for self-medication was influence from family and friends (32.7%). Antibiotics (32.1%) and analgesics (21.0%) were the most common self-medicated drugs, and these drugs were mostly obtained from licenced chemical sellers (32.5%). A little more than a third (39.9%) of the respondents said that their condition did not change after self-medication. A greater number of the respondents (81.7%) did not have knowledge of potential adverse reactions associated with self-medicated drugs. However, respondents with high educational level had the most knowledge of adverse drug reactions. Conclusion The study found self-medication as a common practice among a number of residents of Akuse. Findings from this study provide data that could be used for targeted education and sensitisation of self-medication and its demerits in similar resource-poor rural settings.
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Affiliation(s)
| | | | | | - Seth Kwabena Amponsah
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Ghana, Accra, Ghana
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Ha TV, Nguyen AMT, Nguyen HST. Self-medication practices among Vietnamese residents in highland provinces. J Multidiscip Healthc 2019; 12:493-502. [PMID: 31456640 PMCID: PMC6620316 DOI: 10.2147/jmdh.s211420] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 05/16/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Monitoring self-medication practice, which refers to individuals using medicine without instructions of physicians, is critical to control its harmful effects. However, in Vietnam, evidence about self-medication among individuals in highland areas is constrained. This study examined self-medication practice among residents living in highland areas in Vietnam and determined associated factors. Materials and methods: A cross-sectional study was performed in five highland provinces with 1000 individuals. Information about individual and household's socioeconomic status and self-medication practice in the last 12 months was surveyed. Multivariate logistic and Poisson regressions were used to identify associated factors with self-medication. Results: 83.3% reported self-medication in the last 12 months, with the mean times of self-medication being 4.5 times (SD=4.1). Female (OR=0.62, p<0.01), ethnic minorities, higher number of members having health insurance in family (OR=0.82, p<0.01) and higher annual household income (OR=0.78, p<0.05) were associated with the lower likelihood of "Only buy medicines at pharmacy stores when having illness in the last 12 month". Moreover, people who were females (OR=0.59, p<0.05), white-collar worker (OR=0.25, p<0.01) and had higher number of children in the family (OR=0.68, p<0.05) were less likely to practice self-medication. People who were ethnic minorities, white-collar worker (Coef.=-0.32, p<0.01) and higher number of members having health insurance in family had lower times of self-medication in the last 12 months compared to other groups. Meanwhile, individuals having higher number of members in the family (Coef.=0.07, p<0.01) and higher annual household income (Coef.=0.08, p<0.01) had highertimes of self-medication in the last 12 months. Conclusion: Residents in highland areas in Vietnam had a considerably high 12-month prevalence of self-medication. Medical products quality management and self-medication guideline are potential to maximize the effects of self-medication. Moreover, promoting the use of health insurance should also be concerned as a solution to address this issue.
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Affiliation(s)
- Thuy Van Ha
- Department of Health Insurance, Ministry of Health of Vietnam, Hanoi 100000, Vietnam
| | - An Mai Thi Nguyen
- Department of Planning and Financing, Ministry of Health of Vietnam, Hanoi 100000, Vietnam
| | - Ha Song Thi Nguyen
- Department of Pharmacoeconomics and Management, Hanoi University of Pharmacy, Hanoi 100000, Vietnam
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Public Awareness about Antibiotic Use and Resistance among Residents in Highland Areas of Vietnam. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9398536. [PMID: 31223624 PMCID: PMC6541961 DOI: 10.1155/2019/9398536] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 03/31/2019] [Accepted: 04/22/2019] [Indexed: 11/18/2022]
Abstract
Background Antibiotic resistance (AR) remains a global crisis. However, the literature on public awareness about antibiotic use and AR in the highland provinces of Vietnam has been constrained. This study explores the awareness of antibiotic use and resistance among general people in highland provinces in Vietnam and detects associated factors. Methods A cross-sectional study was performed in five highland provinces with 1000 households. Information about socioeconomic status and awareness regarding prescription medicine use, antibiotic use, and AR was surveyed. Multivariate logistic regression was used to identify associated factors with awareness. Results 64.2% of people were aware of prescription drugs. More than two-thirds (67.4%) of participants were aware of antibiotic use, of whom only 55.8% were aware of AR. Higher age, education, and family income were positively associated with being aware of prescription medicine, antibiotic, and AR. Females had a lower likelihood of being aware of prescription medicine (OR=0.64; 95%CI=0.45-0.90) compared to male counterparts. Those being freelancers were more likely to be aware of antibiotic resistance (OR=2.30; 95%CI=1.13-4.67) compared to those working in agriculture/fishery/forestry sector. Compared to Kinh ethnic, most ethnic minorities were less likely to be aware of prescription medicine, antibiotic, and AR. Conclusions This study showed a low awareness regarding prescription medicine, antibiotic use, and AR among public people in the highland provinces of Vietnam. Further systemic and didactic educational interventions targeting females, low education, low income, ethnic minorities, and those working in agriculture/fishery/forestry sector in this setting should be performed and evaluated to improve the awareness about antibiotic use and resistance.
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Albadr BO, Alrukban M, Almajed J, Alotaibi K, Alangari A, Bawazir A, Aljasser A. Attitude of Saudi medical students towards complementary and alternative medicine. J Family Community Med 2018; 25:120-126. [PMID: 29922113 PMCID: PMC5958523 DOI: 10.4103/jfcm.jfcm_98_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Alternative medicine is defined as medical therapies that are not regarded as orthodox by the medical profession. The teaching of complementary and alternative medicine (CAM) in medical schools is becoming prevalent worldwide. Only a few studies have been done to assess medical students' attitude toward CAM and the need for CAM courses. MATERIALS AND METHODS An observational, descriptive, cross-sectional study was conducted on medical students in two universities, King Saud (KSU) and Majmaah (MU) medical colleges, between February and April 2015. A survey was developed and validated by a pilot study. Data were gathered from both colleges by means of hard and soft copy surveys. Medical students of both genders from the 1st year to the 5th year from both universities were targeted in this study. Fifth-year students from Majmaah and students from the preparatory year were excluded from the study. KSU students comprised 1433, while MU students comprised only 180. The sample size was 384. Data were analyzed using SPSS software. RESULTS The study included 399 medical students. Bloodletting is the most known modality (80.7%), while homeopathy is the least known with a percentage of 7.47%. The overall assessment of the attitude toward CAM was neutral, with a mean of 3.1. Students who had taken a CAM course previously were more satisfied with their knowledge than those who had not, showing a statistical significance of P = 0.0001. CONCLUSION This study showed a lack of knowledge of CAM among medical students. There was an association between taking a CAM course and students' satisfaction with their knowledge. Most of the students agreed with the inclusion of CAM courses in the medical curriculum.
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Affiliation(s)
- Badr O Albadr
- Department of Family Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammed Alrukban
- Professor of Family Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jawad Almajed
- Medical Students at King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alotaibi
- Medical Students at King Saud University, Riyadh, Saudi Arabia
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Kassie AD, Bifftu BB, Mekonnen HS. Self-medication practice and associated factors among adult household members in Meket district, Northeast Ethiopia, 2017. BMC Pharmacol Toxicol 2018; 19:15. [PMID: 29636092 PMCID: PMC5894137 DOI: 10.1186/s40360-018-0205-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 03/26/2018] [Indexed: 11/26/2022] Open
Abstract
Background Self-medication practice (SMP) is the use of medication without the prescription of health care professionals. The major problems associated with self-medication practice have been drug resistance, drug side effects, wastage of resources, and serious health hazards including death. Thus, the main purpose of this study was to assess the prevalence of self-medication practice and its associated factors among adult household members in Meket District, Northeast Ethiopia. Methods A community based cross-sectional study was conducted among 722 adult household members in Meket District, from April 5 to May 5, 2017. The systematic random sampling method was used to select study participants. A pre-tested, structured questionnaire was used for data collection using an interviewer-administered technique. Epi-info version and SPSS version 22 were utilized for data entry and analysis, respectively. Univariate and multivariate logistic regression was used to identify association factors. Results The overall prevalence of self-medication was found to be 35.9%. Unmarried status (AOR = 2.17, 95% CI = 1.18, 4.01), previous experience of self-medication (AOR = 1.78, 95% CI = 1.22, 2.61), accessibility of pharmacies (AOR = 3.71, 95% CI = 1.31, 10.51), peer/family pressure (AOR = 2.88, 95% CI = 1.98, 4.18) and presence of medication at home (AOR = 1.80, 95% CI = 1.11, 2.92) were factors associated with self-medication practices. Conclusion More than one-third of the study participants practiced self-medication. Thus, strengthening communities awareness on drug side effects and integrated efforts of individuals, communities, health facilities, and regulatory bodies are highly necessary. Electronic supplementary material The online version of this article (10.1186/s40360-018-0205-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aster Desalew Kassie
- Boru Meda District Hospital, South Wollo Zone, Amhara Region, Southeast, Ethiopia
| | - Berhanu Boru Bifftu
- University of Gondar, College of Medicine and Health Science, School of Nursing, Gondar, Ethiopia
| | - Habtamu Sewunet Mekonnen
- University of Gondar, College of Medicine and Health Science, School of Nursing, Gondar, Ethiopia.
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Sousa LAOD, Fonteles MMDF, Monteiro MP, Mengue SS, Bertoldi AD, Pizzol TDSD, Tavares NUL, Oliveira MA, Luiza VL, Ramos LR, Farias MR, Arrais PSD. Prevalence and characteristics of adverse drug events in Brazil. CAD SAUDE PUBLICA 2018; 34:e00040017. [PMID: 29617479 DOI: 10.1590/0102-311x00040017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 10/02/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to describe the prevalence of adverse drug events (ADEs) and associated factors reported by users of medicines in Brazil. This was a cross-sectional population-based study conducted from September 2013 to February 2014 with data from the Brazilian National Survey on Access, Use, and Promotion of Rational Use of Medicines (PNAUM). The study included all individuals that reported the use of medicines and identified, among them, all those reporting at least one problem with the medicine's use. A descriptive analysis was performed to estimate ADE prevalence and 95% confidence intervals (95%CI) among the target variables. Crude and adjusted prevalence ratios were calculated using Poisson regression to investigate factors associated with ADEs. Overall ADE prevalence in Brazil was 6.6% (95%CI: 5.89-7.41), and after multivariate analysis, higher prevalence was associated with female gender, residence in the Central and Northeast regions, consumption of more medicines, "bad" self-rated health, and self-medication. The drugs most frequently reported with ADEs were fluoxetine, diclofenac, and amitriptyline. The most frequent ADEs were somnolence, epigastric pain, and nausea. Most reported ADEs were mild, avoidable, and associated with medicines used frequently by the population. The study provided knowledge on the size of the problem with use of medicines in Brazil.
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Affiliation(s)
| | | | - Mirian Parente Monteiro
- Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, Brasil
| | - Sotero Serrate Mengue
- Departamento de Medicina Social, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | | | | | | | | | - Vera Lucia Luiza
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Luiz Roberto Ramos
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Mareni Rocha Farias
- Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil
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Quynh Nguyen T, Tran TTT, Le TV, Quyen TTB, Trinh VH, Tran HB. Prevalence of Self-Treatment Practice and Related Factors Among Workers Aged 15 to 60 Years in Chi Linh Town, Hai Duong Province, Vietnam. Asia Pac J Public Health 2017; 29:62S-71S. [PMID: 28719771 DOI: 10.1177/1010539517718332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Self-treatment is particularly prevalent in Vietnam. However, the prevalence of this practice among the working population is unclear. This study aims to describe the prevalence of self-treatment and related factors among workers aged 15 to 60 years in the suburban area of Chi Linh, Hai Duong, Vietnam. Secondary data of 3128 respondents was retrieved from the CHILILAB HDSS 2016 survey for analysis using logistic regression with a significance level of .05. Results show that 47.5% of respondents treated themselves at least once during one previous year. While rural residence and the presence of acute health symptoms and chronic diseases significantly associate with the choice of self-treatment among all investigated workers, lower education level and health insurance status only significantly relate to this practice among the formally employed workers. The findings imply the need for specific measures to manage self-treatment practices among different groups of workers.
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Affiliation(s)
| | | | - Thi Vui Le
- 1 Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Van Hung Trinh
- 2 Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
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Pons EDS, Knauth DR, Vigo Á, Mengue SS. Predisposing factors to the practice of self-medication in Brazil: Results from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM). PLoS One 2017; 12:e0189098. [PMID: 29220378 PMCID: PMC5722370 DOI: 10.1371/journal.pone.0189098] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/18/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To understand the predisposing factors that lead to the practice of self-medication and the factors associated with the use of medicines via self-medication in the adult population of Brazil. METHODS The analyzed data are part of the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), a survey whose population consisted of individual residents permanently domiciled in urban areas in Brazil. In this work, the data references the 31 573 respondents aged 20 or higher (76.2% of the final PNAUM sample). Poisson regression models with robust variance were used for estimating the independent effect of each variable with medicine use via self-medication. RESULTS Of the interviewees, 73.6% stated they had used some medication without medical recommendation if they had previously used the same product; 73.8% stated they had used non-prescribed medicine when the medicine was already present at home; and 35.5% stated they had used some non-prescribed medication when they knew someone who had already taken the same medication. The prevalence of self-medication was 18.3%. The variables associated with the highest probability of using medicine via self-medication were: geographic region within Brazil, gender, age group, per capita income, self-assessment of health, self-reported use of previously used non-prescribed medication, and self-reported use of non-prescribed medication when that medication was already present at home. CONCLUSIONS The use of medicines via self-medication in Brazil is relatively frequent and influenced by previous experience and familiarity with the medications, and is more common among women and individuals with low self-assessment of health.
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Affiliation(s)
- Emilia da Silva Pons
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
| | - Daniela Riva Knauth
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Álvaro Vigo
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - PNAUM Research Group
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sotero Serrate Mengue
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Domingues PHF, Galvão TF, Andrade KRCD, Sá PTTD, Silva MT, Pereira MG. Prevalence of self-medication in the adult population of Brazil: a systematic review. Rev Saude Publica 2016; 49:36. [PMID: 26083944 PMCID: PMC4544343 DOI: 10.1590/s0034-8910.2015049005709] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 10/10/2014] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence of self-medication in Brazil’s adult population. METHODS Systematic review of cross-sectional population-based studies. The following databases were used: Medline, Embase, Scopus, ISI, CINAHL, Cochrane Library, CRD, Lilacs, SciELO, the Banco de teses brasileiras (Brazilian theses database) (Capes) and files from the Portal Domínio Público (Brazilian Public Domain). In addition, the reference lists from relevant studies were examined to identify potentially eligible articles. There were no applied restrictions in terms of the publication date, language or publication status. Data related to publication, population, methods and prevalence of self-medication were extracted by three independent researchers. Methodological quality was assessed following eight criteria related to sampling, measurement and presentation of results. The prevalences were measured from participants who used at least one medication during the recall period of the studies. RESULTS The literature screening identified 2,778 records, from which 12 were included for analysis. Most studies were conducted in the Southeastern region of Brazil, after 2000 and with a 15-day recall period. Only five studies achieved high methodological quality, of which one study had a 7-day recall period, in which the prevalence of self-medication was 22.9% (95%CI 14.6;33.9). The prevalence of self-medication in three studies of high methodological quality with a 15-day recall period was 35.0% (95%CI 29.0;40.0, I2 = 83.9%) in the adult Brazilian population. CONCLUSIONS Despite differences in the methodologies of the included studies, the results of this systematic review indicate that a significant proportion of the adult Brazilian population self-medicates. It is suggested that future research projects that assess self-medication in Brazil standardize their methods.
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Chan CC, Zhang HW, Chan K, Lin ZX. Xiaoke Pill () and anti-diabetic drugs: A review on clinical evidence of possible herb-drug interactions. Chin J Integr Med 2016:10.1007/s11655-015-2106-5. [PMID: 26825080 DOI: 10.1007/s11655-015-2106-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To critically analyze the clinically-based evidence of herb-drug interaction on Xiaoke Pill () and its concomitant use with anti-diabetic drugs. METHODS MEDLINE, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), International Pharmaceutical Abstracts (IPA), Chinese BioMedical Literature Database (CBM), Traditional Chinese Medical Database System (TCMDS), China National Knowledge Infrastructure Database (CNKI) and Wangfang Databases were searched. Levels of Evidence and Severity Level of Interaction were used to evaluate the quality of the included studies. RESULTS A total of 27 studies published in Chinese, including 2 randomized controlled trials, 3 case series and 22 case reports, were included. Eighteen herbdrug interactions were reported involving Xiaoke Pill as monotherapy, while 6 herb-drug interactions occurred associated with Xiaoke Pill in combination with anti-diabetic drugs. The clinical results of herb-drug interaction of Xiaoke Pill were reported as additive blood glucose-lowering effects with anti-diabetic drugs, including benefifi cial and adverse hypoglycemic effects, anaphylactic shock and severe hair loss. Of these interactions 82.8% were reported to be associated with potential deterioration of the patients' conditions including hypoglycemic coma, stroke, mental disorder and even death. CONCLUSIONS This review helped establish the clinically-based evidence about herb-drug interaction of Xiaoke Pill and its concomitant use with anti-diabetic drugs. The fifi ndings would help arouse the awareness of both health professionals and the general public to avoid the adverse herb-drug interactions of Xiaoke Pill in healthcare and community settings.
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Affiliation(s)
- Chuk-Ching Chan
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hong-Wei Zhang
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kelvin Chan
- Faculty of Pharmacy, the University of Sydney, Sydney, NSW2006, Australia.
| | - Zhi-Xiu Lin
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Chio PH, Zaroff CM. Traditional Chinese medicinal herbal tea consumption, self-reported somatization, and alexithymia. Asia Pac Psychiatry 2015; 7:127-34. [PMID: 25355450 DOI: 10.1111/appy.12161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 10/02/2014] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Somatic presentations of distress are common cross-culturally, although perhaps more so in Asian cultures. Somatic presentations of distress may be associated with alexithymia, a difficulty in experiencing and expressing emotions. Although the constructs of somatization and alexithymia have been examined in depth both within and across cultures, there is minimal information on culture-specific behaviors utilized to cope with stress in individuals who tend to somaticize distress or are alexithymic. The current report investigates the association between somatization and alexithymia, and a culture-specific behavior of traditional Chinese medicinal herbal tea consumption, in a nonclinical, young adult sample. METHODS A sample of 222 undergraduate university students of Chinese ethnicity completed self-report measures of somatization and the related construct of somatosensory amplification, alexithymia, and attitude toward the consumption of herbal tea possessing traditional Chinese medicinal value. RESULTS After controlling for gender, alexithymia was significantly correlated with somatization (r[220] = 0.29, P < 0.05) and somatosensory amplification (r[220] = 0.19, P < 0.05). Attitudes toward herbal tea consumption were significantly correlated with somatosensory amplification (r[220] = 0.16, P < 0.05). DISCUSSION The connection between alexithymia and somatization was confirmed in the current report in a nonclinical sample. A culture-specific behavior (consumption of traditional Chinese medicinal herbal tea) was significantly associated with somatosensory amplification. Potential etiologies and implications of the current findings are discussed.
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Affiliation(s)
- Pit Hoi Chio
- Department of Psychology, University of Macau, Taipa, Macao, China
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Wee LE, Lim LY, Shen T, Lee EY, Chia YH, Tan AYS, Koh GCH. Choice of primary health care source in an urbanized low-income community in Singapore: a mixed-methods study. Fam Pract 2014; 31:81-91. [PMID: 24253204 DOI: 10.1093/fampra/cmt064] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Cost and misperceptions may discourage lower income Singaporeans from utilizing primary care. We investigated sources of primary care in a low-income Singaporean community in a mixed-methods study. METHODS Residents of a low-income public rental flat neighbourhood were asked for sociodemographic details and preferred source of primary care relative to their higher income neighbours. In the qualitative component, interviewers elicited, from patients and health care providers, barriers/enablers to seeking care from Western-trained doctors. Interviewees were selected via purposive sampling. Transcripts were analyzed thematically, and iterative analysis was carried out using established qualitative method. RESULTS Participation was 89.8% (359/400). Only 11.1% (40/359) preferred to approach Western-trained doctors, 29.5% (106/359) preferred alternative medicine, 6.7% (24/359) approached family/friends and 52.6% (189/359) preferred self-reliance. Comparing against higher income neighbours, rental flat residents were more likely to turn to alternative medicine and family members but less likely to turn to Western-trained doctors (P < 0.001). For the qualitative component, a total of 20 patients and 9 providers were interviewed before data saturation was reached. Patient and provider comments fell into the following content areas: primary care characteristics, knowledge, costs, priorities, attitudes and information sources. Self-reliance was perceived as acceptable for 'small' illnesses but not for 'big' ones, communal spirit was cited as a reason for consulting family/friends and social distance from primary care practitioners was highlighted as a reason for not consulting Western-trained doctors. CONCLUSION Western-trained physicians are not the first choice of lower income Singaporeans for seeking primary care. Knowledge, primary care characteristics and costs were identified as potential barriers/enablers.
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Yuefeng L, Keqin R, Xiaowei R. Use of and factors associated with self-treatment in China. BMC Public Health 2012; 12:995. [PMID: 23158841 PMCID: PMC3534538 DOI: 10.1186/1471-2458-12-995] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 11/14/2012] [Indexed: 11/18/2022] Open
Abstract
Background When an individual is ill or symptomatic, they have the options of seeking professional health care, self-treating or doing nothing. In China, some studies suggest that the number of individuals opting to self-treat has been rapidly increasing in recent years. Therefore, the aim of this study was to analyze the trends of and factors related to self-treatment in China. Methods Self-treatment was measured based the concept and data of the China National Health Survey (CNHS), which covers 802,454 individuals. We used CNHS data from 1993, 1998, 2003, and 2008, and a Multinomial Logit Selection Model to estimate the factors influencing the decision to self-treat. Results The prevalences of self-treatment with a recall period of two-weeks were significantly higher in urban compared with rural areas (31.2% vs 14.9% in 1993, 43.5% vs 21.4% in 1998, 47.2% vs 31.4% in 2003, 31.0% vs 25.3% in 2008) in China. Economic (per capita income, TV, sanitary water) and individual (education, profession, family members, exercise) factors, as well as accessibility to drugs had a positive association with the probability of self-treating. Different illness symptoms, severity, and duration show a negative association with the probability of self-treating, showing a degree of rationality in decision-making. Different insurance systems were also found to have an effect on self-treatment decision-making. Conclusions Self-treatment and professional medical services have shared the incremental medical needs of residents in recent years in China. Self-perceived illness status, economic circumstances, and education play important roles in health care decision-making.
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Affiliation(s)
- Li Yuefeng
- Center for Health Statistics and Information, Ministry of Health, Xizhimen South Road, Beijing 100044, China
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Chung VCH, Ma PHX, Lau CH, Wong SYS, Yeoh EK, Griffiths SM. Views on traditional Chinese medicine amongst Chinese population: a systematic review of qualitative and quantitative studies. Health Expect 2012; 17:622-36. [PMID: 22647085 DOI: 10.1111/j.1369-7625.2012.00794.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2012] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Health-care professionals worldwide have started to appreciate patients' perspectives on the use of complementary and alternative medicine (CAM) particularly given its popularity. However, cultural perspectives may vary and it may not be possible to apply research findings on the use of CAM from the west to the east. OBJECTIVE This systematic review aims to synthesize usage patterns of traditional Chinese medicine (TCM) amongst Chinese populations in different parts of the world and explore potential geographical variations. SEARCH STRATEGY Six international and four Chinese databases were searched, and manual searches of relevant monographs and government publications were carried out. INCLUSION CRITERIA Quantitative, qualitative or mixed-method research that aimed to investigate Chinese patients' perception of, and perspectives on, TCM was included. DATA EXTRACTION AND SYNTHESIS For each study included, texts under the headings of 'results' or 'findings' were extracted and subjected to analysis. A thematic synthesis approach was adopted for synthesizing qualitative and quantitative studies. MAIN RESULTS Amongst the 28 studies included, twenty were quantitative surveys, six were qualitative studies and two were mixed-method studies. The overall methodological quality was mediocre. Data synthesis suggested that patients from all regions share a common cultural affinity to TCM and consider it to be an effective complement to western medicine (WM) for treating chronic or serious diseases. However, heterogeneous views on (i) disclosing TCM use to WM doctors and (ii) the potential harm of herbs emerged across different study locations. DISCUSSION AND CONCLUSIONS Future research should explore how variation in health systems may influence patients' perception of CAM in different countries.
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Affiliation(s)
- Vincent C H Chung
- School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
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Padoveze EH, Nascimento LFC, Ferreira FR, Neves VSDC. Cross-sectional descriptive study of topical self-medication in a hospital dermatology department in the state of São Paulo. An Bras Dermatol 2012; 87:163-5. [DOI: 10.1590/s0365-05962012000100030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 03/13/2011] [Indexed: 11/21/2022] Open
Abstract
Self-medication involves individuals or their carers administering a medical drug of their own choice for symptomatic relief and in the hope of a "cure", without seeking professional medical advice.The aim of this descriptive cross-sectional study conducted at the Dermatology Department of the Taubaté University Hospital was to identify the occurrence of self-medication for the topical treatment of skin diseases in young people under 18, and to analyze the difficulties encountered in the clinical diagnosis of these individuals.We examined 29 cases of self-medication (from a total of 480 attendances). Although self-medication is a common practice in Brazil our study showed that users were not significantly harmed by it.
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Wijesinghe PR, Jayakody RL, de A Seneviratne R. Prevalence and predictors of self-medication in a selected urban and rural district of Sri Lanka. WHO South East Asia J Public Health 2012; 1:28-41. [PMID: 28612776 DOI: 10.4103/2224-3151.206911] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Self-medication is widely practised in many developing countries. The determinants of self-medication need to be understood to design adequate medicine information policies and patient-dispenser education strategies. Hence, the prevalence of medicine use and predictors of self-medication were determined in Sri Lanka. METHODS In a community-based cross- sectional study, 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. 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. RESULTS 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. CONCLUSIONS Self-medication prevalence was higher in urban compared to rural areas in Sri Lanka. Some aspects of access to medical care, satisfaction with pharmacy services and perceived severity of the disease were found to be important determinants of self-medication.
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Affiliation(s)
- Pushpa R Wijesinghe
- Epidemiology Unit, Ministry of Health, 231, De Saram Place, Colombo 10, Sri Lanka
| | - Ravindra L Jayakody
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Rohini de A Seneviratne
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Chung VC, Ma PH, Tang TS, Lau CH, Kim JH, Griffiths SM. Do patients tell their clinicians they are using both prescribed and over the counter allopathic and traditional medicines? Eur J Integr Med 2011. [DOI: 10.1016/j.eujim.2011.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Chi Ho Chung V, Lau CH, Kin Chan FW, Sze You JH, Yi Wong EL, Yeoh EK, Griffiths SM. Use of chinese and western over-the-counter medications in Hong Kong. Chin Med 2010; 5:41. [PMID: 21143942 PMCID: PMC3004905 DOI: 10.1186/1749-8546-5-41] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2010] [Accepted: 12/10/2010] [Indexed: 11/10/2022] Open
Abstract
Benefits of engaging community pharmacists in providing wider primary care are internationally acknowledged; in Hong Kong, however, strategies for harnessing their potential contributions are yet to be launched. Here, community pharmacist and Chinese medicine retailers are responsible for providing western and Chinese over-the-counter (OTC) medications. Patterns of OTC uses reflect the characteristics of populations who rely on community pharmacists and Chinese medicine retailers as their main point of contact with the healthcare system. Analyzing the data from a Hong Kong survey (n = 33,263) on self medication and medical consultation patterns, we propose, in this article, an extended role for community pharmacists and Chinese medicine retailers, which entails aspects as follows: (1) referring patients to other medical services where appropriate; (2) providing health education and preventative services; (3) safeguarding the use of Chinese herbal medicines.
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Affiliation(s)
- Vincent Chi Ho Chung
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
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Mercer SW, Siu JY, Hillier SM, Lam CLK, Lo YYC, Lam TP, Griffiths SM. A qualitative study of the views of patients with long-term conditions on family doctors in Hong Kong. BMC FAMILY PRACTICE 2010; 11:46. [PMID: 20525340 PMCID: PMC2889885 DOI: 10.1186/1471-2296-11-46] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Accepted: 06/04/2010] [Indexed: 11/10/2022]
Abstract
BACKGROUND Primary care based management of long-term conditions (LTCs) is high on the international healthcare agenda, including the Asia-Pacific region. Hong Kong has a 'mixed economy' healthcare system with both public and private sectors with a range of types of primary care doctors. Recent Hong Kong Government policy aims to enhance the management of LTCs in primary care possibly based on a 'family doctor' model. Patients' views on this are not well documented and the aim of the present study was to explore the views of patients with LTCs on family doctors in Hong Kong. METHODS The views of patients (with a variety of LTCs) on family doctors in Hong Kong were explored. Two groups of participants were interviewed; a) those who considered themselves as having a family doctor, b) those who considered themselves as not having a family doctor (either with a regular primary care doctor but not a family doctor or with no regular primary care doctor). In-depth individual semi-structured interviews were carried out with 28 participants (10 with a family doctor, 10 with a regular doctor, and 8 with no regular doctor) and analysed using the constant comparative method. RESULTS Participants who did not have a family doctor were familiar with the concept but regarded it as a 'luxury item' for the rich within the private healthcare system. Those with a regular family doctor (all private) regarded having one as important to their and their family's health. Participants in both groups felt that as well as the more usual family medicine specialist or general practitioner, traditional Chinese medicine practitioners also had the potential to be family doctors. However most participants attended the public healthcare system for management of their LTCs whether they had a family doctor or not. Cost, perceived need, quality, trust, and choice were all barriers to the use of family doctors for the management of their LTCs. CONCLUSIONS Important barriers to the adoption of a 'family doctor' model of management of LTCs exist in Hong Kong. Effective policy implementation seems unlikely unless these complex barriers are addressed.
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Affiliation(s)
- Stewart W Mercer
- Section of General Practice and Primary Care, Division of Community-based Sciences, Faculty of Medicine, University of Glasgow, UK.
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Albert SM, Musa D, Kwoh CK, Hanlon JT, Silverman M. Self-care and professionally guided care in osteoarthritis: racial differences in a population-based sample. J Aging Health 2008; 20:198-216. [PMID: 18287328 DOI: 10.1177/0898264307310464] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to examine the prevalence of self-management practices among older White and African American persons with osteoarthritis. Self-management was defined broadly to include all behaviors adopted to reduce morbidity, whether recommended by physicians or not. METHODS A population-based sample of Medicare beneficiaries (N = 551) was recruited. An expanded set of self-management behaviors using structured and open-ended inquiry, along with use of arthritis-specific medications was elicited. RESULTS Few differences in self-care behaviors between race groups were found. However, older African American persons were significantly less likely to have prescriptions for nonsteroidal anti-inflammatory agents (NSAIDs) and more likely to use over-the-counter nonprescription analgesics. DISCUSSION Older White and African American persons made similar use of self-care strategies to reduce disease morbidity. African Americans without access to prescription pain relievers substituted nonprescription analgesics. A broader view of self-management is valuable for assessing the ways people may move between professionally guided care and self-care.
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Affiliation(s)
- Steven M Albert
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, A211 Crabtree, 130 DeSoto St., Pittsburgh, PA 15261, USA.
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Suleman S, Ketsela A, Mekonnen Z. Assessment of self-medication practices in Assendabo town, Jimma zone, southwestern Ethiopia. Res Social Adm Pharm 2008; 5:76-81. [PMID: 19285292 DOI: 10.1016/j.sapharm.2008.04.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2008] [Revised: 04/03/2008] [Accepted: 04/03/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND The actions taken for the treatment of illness or symptom of an illness vary depending on the perceptions and experiences of individuals and other factors. A significant portion of all care in illness is self-care. In many cases, self-medication is an important initial response to illness. Although some health-care providers attach negative connotations to it, the World Health Organization acknowledges the existence of a valid role of self-medication. OBJECTIVE This study was aimed at assessing the magnitude, type, and factors of self-medication in Assendabo town, Jimma, southwestern Ethiopia. METHODS A community-based cross-sectional study was conducted in Assendabo town during February and March 2006. Open-ended questionnaire was used to collect data by interviewing heads of households in the study population. The data collected were properly screened before they were analyzed. RESULTS A total of 242 households with 1257 individuals were visited, of which 143 (11.4%) reported at least 1 episode of illness and of whom 56 (39%) used self-medication using both modern pharmaceuticals and traditional medicines. Low severity of illness was a major reason for practicing self-medication; 80.6% of self-medicating individuals had no information on potential drug adverse effect. About 55% of ill persons who treated themselves reported improvement in their condition. CONCLUSIONS There is high prevalence of self-medication in Assendabo town. Lack of drug information and accessibility to over-the-counter drugs without any health professional guide contributed to the high incidence of self-medication. Enforcement of regulations in drug distribution and provision of appropriate health education to the community at large is critical.
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Chui WK, Li SC. Advice-giving on self-medication: perspectives of community pharmacists and consumers in Singapore. J Clin Pharm Ther 2005; 30:225-31. [PMID: 15896239 DOI: 10.1111/j.1365-2710.2005.00637.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Singapore, community pharmacists provide an advice-giving service to consumers who seek self-medication for minor ailments management. This service has not been studied formally from the perspectives of pharmacists and consumers. OBJECTIVES The study aimed to identify (i) the approach taken by pharmacists in providing advice for self-medication and (ii) consumers' behaviour in self-treatment and their perception of the advice-giving role of the community pharmacist. METHOD The pharmacists and consumers were surveyed independently using two structured questionnaires. RESULTS AND DISCUSSION All community pharmacists who participated in the survey were confident in providing advice on self-medication. However, none of them recorded the consultations and only 17.5% of them had documented their general physician referrals. Most consumers (66.3%) would self-medicate and only consult a professional when the desired outcome was not achieved. Less than 10% of consumers would approach the pharmacists as the first option for advice. More than half of the pharmacists felt that the advice they rendered deserved a fee whereas only 28.4% of the consumers were willing to pay. Both parties thought the fee should not be more than S5 dollars (US3 dollars). CONCLUSION Generally, there is congruence in the perspectives on self-medication between the advice-giving pharmacist and the consumer. The consumers still lack awareness that pharmacists can help them to self-medicate more safely and effectively. Therefore, more effort in public education is warranted. The current state of poor documentation of the advisory function of community pharmacists should be improved.
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Affiliation(s)
- W K Chui
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
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Fok MSM, Tsang WYW. The drug utilization patterns of Hong Kong Chinese adults. Complement Ther Clin Pract 2005; 11:190-9. [PMID: 16005836 DOI: 10.1016/j.ctcp.2004.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2004] [Revised: 09/06/2004] [Accepted: 10/26/2004] [Indexed: 10/25/2022]
Abstract
This paper reports the findings of a pilot study on the drug utilization patterns, including both Western and Chinese medications, of Hong Kong Chinese adults with an aim to plan quality community-based safe medication practice education. A tool for collecting the drug utilization patterns was developed for the purpose of the study. One hundred Chinese adults were invited to participate in this pilot study. Structured interviews were used in the study. Drug utilization patterns of the subjects in the preceding 2 weeks were investigated. It was found that 44 adults took Western medications such as cough and cold remedies or analgesics. Nineteen adults took Chinese medications such as tonics or prescriptions for relieving exterior syndrome. Adults who took Western medications understood the effects and side effects of the drugs better than those who took the Chinese medications although their knowledge was not sufficient to allow them to perform safe medication practice. It was concluded that the tool is useful in the future, in large-scale research studies to promote safe medication practice.
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Affiliation(s)
- May Sin-Mai Fok
- The Hong Kong Polytechnic University, School of Nursing, Hung Hom, Kowloon, China.
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Loyola Filho AID, Lima-Costa MF, Uchôa E. Bambuí Project: a qualitative approach to self-medication. CAD SAUDE PUBLICA 2004; 20:1661-9. [PMID: 15608869 DOI: 10.1590/s0102-311x2004000600025] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Representations related to self-medication were investigated, seeking to identify contextual elements that can reinforce or inhibit such practice. An anthropological approach based on the model of signs, meanings, and actions was used. Twenty-nine inhabitants from the town of Bambuí, Minas Gerais State, Brazil, were interviewed (17 women and 12 men), selected among participants in a health survey that had been on medication in the previous 90 days. The research focused on the identification of different types of self-medication practiced by the interviewee or by a relative, and then "ways of thinking and behaving" associated with this practice were investigated. The influence of pharmacists/drugstore sales attendants as well as family and friends, perception of the health problem as transitory and a minor issue, familiarity with and easy access to certain pharmaceuticals, as well as difficulties in access to (and negative assessment of) health care were determinant factors for self-medication.
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Linden K, Jormanainen V, Swigonski NL, Pietilä K. Self-medication among Finnish young men in the beginning of common military service. Pharmacoepidemiol Drug Saf 2004; 14:193-201. [PMID: 15517532 DOI: 10.1002/pds.1040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE Little is known about self-medication in adolescent and young adult males, particularly in ones exposed to increased stress. The objective of this article is to analyze self-medication and its predictors in young Finnish men at entry into common military service. METHODS The responding men (n = 857) from nine brigades anonymously completed a self-administered questionnaire during the first conscription days before active military training in July 1999. The effect of pre-disposing, need and health behavior variables on self-medication was assessed using Andersen et al. theoretical health care utilization model. RESULTS In the 2 weeks preceding the survey, 65% of the men reported self-medication. Self-medication for pain or common cold symptoms was reported by 54% while 8% had taken caffeine tablets or other stimulants. Multivariate analysis on overall self-medication showed an association with brigade and using health services before the conscription. Along with pre-disposing variables, need variables were associated with self-medication for pain or common cold symptoms and self-medication with stimulants. Stimulant use was also associated with health behaviors such as trial with illegal drugs during lifetime. CONCLUSIONS Young men frequently self-medicate at the initial stage of conscription that may pose them at an increased risk for adverse effects of medicines or other medical problems. The military and civilian primary health care providers should discuss the proper use of self-medication with young men.
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Affiliation(s)
- Kari Linden
- Research Institute of Military Medicine, Central Military Hospital, Finnish Defence Forces, Helsinki, Finland.
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Silverman M, Musa D, Kirsch B, Siminoff LA. Self care for chronic illness: older African Americans and whites. J Cross Cult Gerontol 2004; 14:169-89. [PMID: 14617891 DOI: 10.1023/a:1006676416452] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In-person interviews with two hundred and twenty-one older African Americans and whites in Allegheny County, Pennsylvania on their use of self care activities in the care of one of four chronic illnesses (chronic obstructive pulmonary disease (COPD), heart disease, diabetes mellitus, and arthritis, addressed which types of self care they used for each of these illnesses) the similarities and differences between African Americans and whites in their use of self care and how self care is initiated, modified and integrated into a context that includes help from others. The most common response in each of the illnesses was the use of medications or medical treatments by both African Americans and whites. However, there were some differences in the self care practices used by these two groups by illness type. Whites reported monitoring their illness significantly more than African Americans for diabetes and using assistive devices in the management of COPD significantly more than African Americans. While both African Americans and whites practice self care similarly in the management of heart disease, African Americans reported greater use of exercise in their management of arthritis. The amount of assistance provided by others in support of self care varied by illness and by African American and white. The differences in self care usage may be attributed to many factors, among them, differences in cultural experiences with the illness, health beliefs regarding its efficacy and the amount of assistance received from informal supports.
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Affiliation(s)
- M Silverman
- Graduate School of Public Health, Department of Health Services Administration, University of Pittsburgh, Pennsylvania 15261, USA. woman+@pitt.edu
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Martins AP, Miranda ADC, Mendes Z, Soares MA, Ferreira P, Nogueira A. Self-medication in a Portuguese urban population: a prevalence study. Pharmacoepidemiol Drug Saf 2003; 11:409-14. [PMID: 12271884 DOI: 10.1002/pds.711] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To determine the prevalence of self-medication in a Portuguese urban population. To assess the feasibility of performing these studies in community pharmacies. METHODS A cross-sectional study was chosen to collect information about demography, use of health services and drug utilization in a sample of pharmacy user-purchasers in a pre-determined period of time. RESULTS The proportion of pharmacies which participated in the study was 18.3% (11 from 60 invited) in Lisbon and 37.5% (15 of 40 invited) in Porto. Among the 3312 selected patients, only 2.6% (n = 114) refused to participate. The prevalence of self-medication was found to be 26.2%. The distribution of self-medication by gender was 28.4% for males and 25.2% for females. Use of self-medication was statistically significantly higher (p < 0.001) among individuals aged between 10 and 49 years. The main therapeutic groups used for self-medication, according to the ATC classification, were throat preparations, cough and cold preparations, stomatological preparations (antiinfectives and corticosteroides for local oral treatment), laxatives, analgesics, dermatological preparations, vitamins, mineral supplements and other alimentary tract and metabolism products. CONCLUSIONS In the urban areas under study the overall prevalence of self-medication was 26.2%. Predictive factors for self-medication seem to be, a high level of education, professional status and length of waiting times for a medical consultation in cases of a severe health problem. Further research on this subject is needed to confirm the reproducibility of these results, since potential selection bias could have been introduced due to the method used for patient selection. Pharmacoepidemiologic research is feasible in Portuguese community pharmacies.
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Affiliation(s)
- Ana Paula Martins
- Centro de Estudos de Farmacoepidemiologia da Associação Nacional das Farmácias, Lisboa, Portugal.
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Loyola Filho AID, Uchoa E, Guerra HL, Firmo JOA, Lima-Costa MF. [Prevalence and factors associated with self-medication: the Bambuí health survey]. Rev Saude Publica 2002; 36:55-62. [PMID: 11887230 DOI: 10.1590/s0034-89102002000100009] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE A population-based study was carried out in the municipality of Bambuí, Brazil (population: approx. 15,000 inhabitants), to determine the prevalence of self-medication and its associated factors. METHODS A random sample of 1,221 residents aged >18 years was selected. Of these, 796 reported use of medications in the last 90 days and were selected for this study (775 participated). Data was collected through home interviews. Study variables were divided in 3 groups: social and economic, health status and health service use indicators. Statistical analysis was performed using Pearson's Qui-square test, and odds ratios adjusted by multinomial logistic regression. RESULTS Of the total, 419 (54.0%) reported use of only prescribed medications, 133 (17.2%) took prescribed and over-the-counter medications, and 223 (28.8%) took only over-the-counter medications in the last 90 days. After adjusting for confounders, the following variables presented significant associations with exclusive use of self-medication: female sex (OR=0.6; IC95%=0.4 - 0.9); age (OR=0.4; IC95%=0.3 - 0.6 for 40-59 years old and OR=0.2; IC95%=0.1 - 0.5 for >60 years); >5 residents in the household (OR=2.1; 1.1 - 4.0); number of visits to a doctor in the previous 12 months (OR=0.2; IC95%=0.1 - 0.4 and OR=0.1; IC95%=0.0-0.1 for 1 visit and >2 visits, respectively); report of consulting a pharmacist in the previous 12 months (OR=1.9; IC95%=1.1 - 3.3); and reports of financial expenses with medications during this period (OR=0.5; IC95%=0.3 - 0.8). CONCLUSIONS The study results show that the prevalence of self-medication in the studied community was similar to that observed in developed countries. These results also suggest that self-medication works in place of the formal health attention in this community.
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Affiliation(s)
- Antônio Ignácio de Loyola Filho
- Núcleo de Estudos em Saúde Pública e Envelhecimento (Nespe), Centro de Pesquisas René Rachou da Fundação Oswaldo Cruz, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Lim AS, Bishop GD. The role of attitudes and beliefs in differential health care utilisation among Chinese in Singapore. Psychol Health 2000; 14:965-77. [DOI: 10.1080/08870440008407361] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
In 1978, China decided to reform its economy and since then has gradually opened up to the world. The economy has grown rapidly at an average of 9.8% per year from 1978 to 1994. Medical expenditure, especially for drugs, has grown even more rapidly. The increase in medical expenditure can be attributed to changing disease patterns, a higher proportion of older people in the population and fee-for-service incentives for hospitals. Due to the changing economic system and higher cost of health care, the Chinese government has reformed its health care system, including its health and drug policy. The drug policy reform has led to more comprehensive policy elements, including registration, production, distribution, utilization and administration. As a part of drug policy reform, the drug distribution network has also been changed, from a centrally controlled supply system (push system) to a market-oriented demand system (pull system). Hospitals can now purchase drugs directly from drug companies, factories and retailers, leading to increased price competition. Patients have easier access to drugs as more drugs are available on the market. At the same time, this has also entailed negative effects. The old drug administrative system is not suitable for the new drug distribution network. It is easy for people to get drugs on the market and this can lead to overuse and misuse. Marketing factors have influenced drug distribution so strongly that there is a risk of fake or low quality drugs being distributed. The government has taken some measures to fight these negative effects. This paper describes the drug policy reform in China, particularly the distribution of drugs to health care facilities.
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Affiliation(s)
- H Dong
- School of Public Health, Shanghai Medical University, People's Republic of China.
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