A systematic review of self-medication practices among adolescents

Prescription Trends for Primary Headache in Children and Adolescents in China During 2019-2023: A Retrospective Study

BACKGROUND AND OBJECTIVE

Globally, primary headache disorders, including migraine, tension type headache and cluster headache, are a leading cause of disability in children and adolescents. However, there has been a paucity of large-scale population-based studies to inform clinical decision making for paediatric patients. Consequently, we undertook a nationwide study to ascertain the current status of primary headache treatment in children and adolescents in China.

METHODS

The study was based on the Hospital Prescription Analysis Cooperative Project of China, in which prescription data were extracted from a database of adolescent and child patients with a primary headache disorder from 160 hospitals in nine major Chinese cities from 2019 to 2023. In this study, we first analysed the trends in children and adolescents with primary headache in China over the past 5 years, stratified by age and sex, and analysed the trends in prescribing patterns. We then explored the differences in prescribing patterns among different populations and patients with different types of diagnoses, with the aim of analysing the current status of treatment for children and adolescents with primary headache in Chinese healthcare institutions in a multi-dimensional approach.

RESULTS

A total of 1735 outpatients were included. The majority of patients were 15-17 years of age (65.0% in 2023). Migraine (66.1%) and tension-type headache (33.5%) were the predominant headache types. Calcium channel blockers, vitamins, antidepressants, analgesics and anticonvulsants were the most commonly prescribed classes of drugs. Flunarizine was the most widely prescribed drug, with a 5-year average proportion of 23.6%. The majority of drugs prescribed to children were vitamins (30.9%) and calcium channel blockers (28.7%). Differences in prescribing between patients with migraine and patients with tension-type headache were evident, with patients with migraine using predominantly calcium channel blockers (35.9%) and analgesics (20.8%), whereas patients with tension-type headache had a predominance of antidepressants (28.9%) and muscle relaxants (19.2%).

CONCLUSIONS

The prevalence of primary headaches progressively increased with age in children and adolescents. Migraine and tension-type headache were the predominant headache diagnoses at this stage. Flunarizine was the most prescribed drug for both children and adolescents, typically indicated for the preventive treatment of migraine, whereas antidepressants were the most commonly prescribed drug for the preventive treatment of tension-type headache. The majority of treatments were aligned with the available evidence and guideline recommendations. Nevertheless, there is still a paucity of evidence regarding the use of some drugs; these require further attention and clarification.

Impact of Headache and Over-the-Counter Treatment on Pain and Functional and Cognitive Parameters: A Real-World Study across Three Geographies

INTRODUCTION

Individuals with headache choose over-the-counter (OTC) medications to relieve pain and associated symptoms. This real-world evidence study investigated the effect of three OTC headache treatments on headache intensity and the associated impairment of cognitive and functional parameters in headache sufferers in Germany, Brazil, and Japan.

METHODS

This prospective, multinational, observational eDiary-based study included adults experiencing headache for ≥ 6 months, with ≥ 2 headache episodes per month requiring treatment and using one of the three OTC headache treatments (Germany: ibuprofen 400 mg + caffeine 100 mg; Brazil: dipyrone 1 g; Japan: ibuprofen 100 mg + caffeine 40 mg). The primary endpoint was change in headache intensity (11-point numeric rating scale [NRS]) from baseline (headache onset) to 2 h post-treatment. Secondary endpoints were association between NRS scores for headache intensity and for cognitive and functional parameters and change in these parameters from baseline to 2 h post-treatment.

RESULTS

Of the 32,623 individuals screened, 1239 were enrolled in the study, with 607 having their first headache episode treated using one of the OTC treatments. Baseline demographics and characteristics were similar across the cohorts. At 2 h post-treatment, headache intensity significantly improved, with the mean change from baseline being 3.4 (3.1, 3.7, 95% confidence interval), 4.2 (3.9, 4.5), and 3.0 (2.7, 3.3) for German, Brazilian, and Japanese cohorts, respectively. Improvement was observed in all cognitive and functional parameters. The NRS score for headache intensity significantly predicted NRS scores of all cognitive and functional parameters (P < 0.0001).

CONCLUSIONS

The study shows that headache intensity significantly affects cognitive and functional aspects, as well as overall quality of life, for sufferers globally. It confirms the effectiveness of OTC medications and suggests using headache intensity as a self-assessment tool for symptom severity, highlighting the need for new parameters in the OTC domain to improve public health benefits.

Use of over-the-counter analgesics in Norwegian children - a national cross-sectional study

AIMS

We aimed to examine the proportion of recent use of over-the-counter (OTC) analgesics among Norwegian children aged 10 to 12, and explore the relationship between a wide array of factors, both within and outside the indications for use of the medication and recent use of OTC analgesics in this age group.

METHODS

Data were drawn from the nationwide, population-based Ungdata Junior study in Norway, encompassing children aged 10 to 12 (N = 102,919). We examined factors both within (recurrent pain in different parts of the body) and beyond (repeated bullying, depressive symptoms, screen time and organised activity frequency) medication indications by means of logistic regression. Covariates and background variables included sleep duration, frequency of sports activities, gender, age and socioeconomic status.

RESULTS

The results revealed a high prevalence of recent OTC analgesic use (23.7%). Associations were noted with factors both within and beyond the medication's indications for use. Specifically, adjusted for all variables, recurrent headache (OR = 2.93, 95% CI = 2.81-3.05) and pain (OR = 1.16, 95% CI = 1.11-1.21), depressive symptoms (OR = 1.19, 95% CI = 1.15-1.22) and repeated bullying (OR = 1.07, 95% CI = 1.02-1.14) were significantly linked with an increased risk of recent OTC analgesic use.

CONCLUSIONS

Our findings suggest a potential misuse of OTC analgesics early in life and raise concerns about potential overuse and unhealthy coping strategies. Enhancing children's and parents' understanding of pain and stress management may improve health behaviours and mitigate potential adverse effects from OTC analgesic use.

Effect of comorbid psychologic and somatic symptom trajectories on early onset substance use among U.S. youth in the ABCD study

BACKGROUND

Adolescent substance use (SU) is often motivated by a desire to alleviate undesirable symptoms. To test the self-medication hypothesis, we examined associations between comorbid psychologic and somatic symptom trajectories across early adolescence and early onset SU.

METHODS

Using Adolescent Brain Cognitive Development Study® data, we differentiated youth who reported no SU at baseline based on their comorbid anxiety, depression, pain, somatic and somnolence symptom trajectories. The outcome, early onset SU (by age 13-14 years) was derived from self-reported alcohol (≥full drink), tobacco (full regular/e-cigarette), marijuana, or other drug use over 5 years.

RESULTS

8311 participants were classified with Asymptomatic (27.8 %), Low/stable (39 %), Moderate/persistent (25.3 %) or High/worsening trajectories (7.9 %) from age 9.97 ± 0.74 to 13.57 ± 0.88 years. Early onset SU was 56 % higher for Moderate-High compared to Asymptomatic-Low symptom trajectory groups (12.5 % vs. 8.5 %; OR 1.56 [95 % CI 1.33, 1.79]). Adjusted for covariates, the High/worsening group was more likely than the Asymptomatic group to report use of any substance (adj.OR 2.13 [95 % CI 1.40, 3.25], Alcohol (adj.OR 2.80 [95 % CI 1.56, 5.02]), Tobacco (adj.OR 2.09 [95 % CI 1.23, 3.55]), and Marijuana (adj.OR 2.33 [95 % CI 1.36, 3.99]). Longitudinal, time-lagged analyses revealed potential feedback effects of earlier depression on subsequent SU, and earlier SU on later depression (p < 0.001).

CONCLUSION

Higher comorbid symptom trajectories emerging in late childhood increased the likelihood of early onset SU. Since negative feedback loops may contribute to symptom persistency, ongoing and potentially harmful SU for at-risk youth, addressing comorbid symptoms that emerge during late childhood is warranted.

Could be better: adolescent access to health information and care

Many adolescents must overcome a broad range of barriers to access health information and care and are consequently reluctant to pursue assistance for their health concerns. In this review, we examine from whom and how adolescents seek help (for example, by consulting with friends and family members and by searching for health information using online platforms) and how adolescents treat symptoms without consulting with a clinician by engaging in self-medication. Next, we suggest ways to help adolescents receive accurate health information and access to healthcare through school-based health education programs and health centers. We also discuss how to improve the experience of care for adolescents by collaboratively engaging young patients with their physicians and caregivers using shared decision-making. Finally, we propose developing and posting accurate and engaging multilingual materials on popular online platforms to improve adolescent access to accurate health information and knowledge of how to engage with the healthcare system.

CONCLUSION

The purpose of this review is to examine how adolescents seek, and propose ways to help adolescents access, health information and care despite the many barriers they face.

WHAT IS KNOWN

• Adolescents encounter a broad range of barriers to access health information and care and turn to family members and friends, and search online, for health information. In addition, adolescents benefit from school-based health education programs and health centers that reduce barriers to healthcare access.

WHAT IS NEW

• Adolescents engage in self-medication, including with cannabis use, to treat self-diagnosed illness or symptoms in a potentially harmful manner. • While many adolescents distrust health information shared on social media, recent evidence suggests adolescents are receptive to, and will change some beliefs, in response to health information posted on social media platforms.

Self-medication practice among the general public in Jordan: a cross-sectional study

Objectives

The phenomenon of self-medication is a noteworthy public health concern that is increasingly prevalent on a global level, particularly in developing nations. This study aims to explore the prevalence of self-medication of over-the-counter (OTC) medications among the general public in Jordan.

Materials and methods

This cross-sectional online survey study was conducted in Jordan between November and December 2022. An online questionnaire link was distributed to the study participants through social media platforms (Facebook, WhatsApp, and Instagram). The questionnaire tool for this study was adapted from a previously developed questionnaire by Tesfamariam et al. The questionnaire tool comprised four sections that examined participants' demographic characteristics, knowledge of OTC self-medication, attitudes toward OTC self-medication, and associated practices. Binary logistic regression analysis was used to identify predictors of OTC self-medication practice.

Results

A total of 1,218 individuals participated in this study. More than half of the study participants (56.9%) confirmed that they were currently using or had in the past year used medication(s) not prescribed by a healthcare specialist. Participants' agreement level on statements that reflected a positive attitude toward self-medication practice ranged between 13.1 and 33.0%. The statement most commonly agreed with was that 'OTC medications are safe but I would seek a physician's advice before using them' (57.7%). Individuals aged 36-40 years and 51 years and over, those who were married or divorced, those who were employed, and those who had chronic diseases were more likely to practice self-medication compared to others (p < 0.05).

Conclusion

The current study findings suggest a significant lack of awareness among the general population in Jordan regarding the expected efficacy of OTC medications. A restricted level of agreement was observed among the participants concerning the behavior of self-medication.

Use of Over-The-Counter Analgesics Is Associated with Pain, Stress, and Quality of Life in Norwegian Adolescents: A Cross-Sectional Study

Introduction: Approximately 20% of Norwegian adolescents are frequently using Over-the-Counter Analgesics (OTCAs). The WHO emphasizes the need for research to identify the key determinants of health problems in adolescence. Thus, our aim was to describe and explore pain, stress, and Health-Related Quality of Life (HRQOL) in Norwegian adolescents and investigate possible associations upon high/low usage of OTCAs. Methods: This cross-sectional study included 315 adolescents (92 boys, 223 girls) with an average age of 14.1 years (13-15 years). All participants reported using OTCAs. Weekly usage was categorized as high and less than weekly as low. Using a validated questionnaire, we explored the following variables: pain, as measured using the Brief Pain Inventory, stress (Perceived Stress Questionnaire), and HRQOL (KIDSSCREEN-27). Binary logistic regression models were conducted using IBM SPSS Statistics (version 27). Results: Our descriptive findings reveal that high users of OTCAs reported higher pain intensity of 3.4 (SD = 1.9) and perceived stress of 0.38 (SD = 0.18) compared to low users, who reported 2.5 (SD = 1.9) and 0.32 (SD = 0.16), respectively. High OTCA users reported lower average scores than low users across all HRQOL subscales. Binary logistic regression revealed 30% higher odds for higher levels of pain intensity and 14 times higher odds of perceived stress associated with being a high user of OTCAs compared to a low user. Conclusions: Our study shows significantly higher odds for experiencing pain and stress among adolescents using OTCAs daily-to-weekly, compared to those seldom using such medicines. Health professionals should be aware of young people who have a high consumption of OTCAs and investigate whether the use is related to pain or stress. This might be important in designing a personalized and appropriate intervention. Parents and caregivers have an important responsibility in supporting adolescents' appropriate pain management. Longitudinal studies are needed to better explore predictive factors of OTCA use in adolescents, particularly in relation to psychological variables such as stress and quality of life.

Mental Health and Medicine Use for Headache: A Nationally Representative Study of Adolescents in Denmark

PURPOSE

This study examined the prevalence of headache medicine use among Danish adolescents and explores the link between mental health, frequent headaches, and medicine use for headache. We hypothesized that poor mental health increases headache occurrence, leading to greater medicine use.

METHODS

The 2022 Danish Health Behaviour in School-aged Children (HBSC) study surveyed 5292 students aged 11, 13, and 15. Self-reported data included headache frequency, medicine use for headache, and five mental health indicators: life satisfaction, emotional symptoms, loneliness, self-efficacy, and self-esteem. Multivariate logistic regression analyses assessed the association between mental health indicators and headache medicine use, adjusting for headache frequency.

RESULTS

Weekly headaches were reported by 33.1%, and 43.6% used headache medicine in the past month. Poor mental health correlated with higher headache and medicine use rates. Analyses adjusted for sex, age group, and occupational social class found significantly increased odds ratios (95% confidence interval) for medicine use for headache among students with low life satisfaction (2.27; 1.88-2.75), among students with 2+ emotional symptoms (2.28; 1.92-2.69), students who often felt lonely (2.08; 1.69-2.55), students with low self-efficacy (1.37; 1.16-1.61) and students with low self-esteem (1.59; 1.36-1.85). When accounting for headache frequency, the association between poor mental health and medicine use diminished and became nonsignificant.

CONCLUSIONS

Poor mental health was linked to increased medicine use for headache. The findings suggest that frequent headaches may explain the association between poor mental health and the use of headache medicine. Promoting rational medicine use and enhancing mental health among adolescents is essential.

Key modifiable risk factors for self-medication among university students: An observational study

Background

Self-medication among university students is becoming a health concern, especially during examinations and stress. This pattern of medication use among students could lead to adverse health consequences if it is not addressed and tackled. Thus, this study investigated the most associated factors with this practice among students.

Methods

An observational cross-sectional study was conducted among university students in Northern Borders Province, Saudi Arabia. A total of 220 students were selected and took part in the survey. Data was collected through a self-administered questionnaire. The survey was distributed among participants to answer five sections: demographic and socioeconomic characteristics, health status problems, satisfaction with academic performance, and self-medication questions. The content validity was tested using a pilot sample of 30 students. The descriptive, univariate, and multivariate analyses were conducted using the Statistical Package for Social Science program.

Results

In the present sample of university students, the response rate was 100%. Approximately one-third reported using medications without prescriptions, and 83% of them have used medications three times at most during the past 12 months. Headache was the most common reason for use (59%), followed by fever (20%). Adjusted multivariate analysis showed that students who were 21-24 years of age (OR = 3.79, 95% CI = 1.21-11.82), female (OR = 2.43, 95% CI = 1.03-5.72), and living alone in private housing (OR = 3.62, 95% CI = 1.32-9.90) were at high risk of self-medication as compared to their counterparts. However, students in the last years of college (fourth (OR = 0.14, 95% CI = 0.03-0.62), fifth (OR = 0.21, 95% CI = 0.05-0.95), sixth (OR = 0.05, 95% CI = 0.01-0.35)) were at lower risk as compared to their counterparts.

Conclusion

The study found that self-medication was common among university students, with higher rates among those who were 21-24 years old, female, and living alone in private housing, but lower rates among students in the later years of college. Educational programs and awareness campaigns should target students who are at higher risk of practicing self-medication to avoid misuse of over-the-counter medications.

Self-medication of adults and children in Poland - results from outpatient health care physicians online questionnaire

Introduction: In Poland, the area of self-medication requires scientific and organizational evaluation. So far, no solutions sanctioning self-medication have been introduced. Therefore, the aim of this study was to recognize and analyze the practical experience of outpatient physicians regarding self-medication of their patients, as well as self-medication of children by their caregivers. Methods: This study enrolled 386 participants and used a Computer-Assisted Web Interview that was disseminated online from 4th of July 2023 to 23rd of August 2023. The survey was addressed to outpatient healthcare physicians working in Poland. Results: In doctors' perspective the main three reasons for choosing self-medication in Poland were: taking advice from other people - family members or friends (59.1%), finding information regarding treatment online (52.9%) and ability to self-medicate in this kind of symptoms/disease (51.6%). Among adult patients, in 72.1% of cases, an independent decision to start antibiotic therapy was made. Such a decision occurred in 39.8% of pediatric patients. Children caregivers were more likely to visit the physician immediately with symptoms than in the case of adult patients (42.2% vs. 22.1%, p < 0.001). Conclusions: Self-medication in Poland requires educational and organizational support at various levels - both social (information campaigns, school education), the healthcare system (increasing the role of medical professionals, including pharmacists), and finally in the area of legislation. Two areas seem to be particularly alarming - the use of antibiotics by adults and children and the mental health of both populations.

Patterns of self-medication and intention to seek pharmacist guidance among older adults during the COVID-19 pandemic in Macao: a cross-sectional study

INTRODUCTION

Self-medication was remarkably popular during the COVID-19 pandemic. In older populations, the risk of self-medication is higher. Pharmacists are well positioned to provide public health education and disease prevention. This study aims to explore the self-medication patterns and intention to seek pharmacist guidance among older adults in Macao.

METHODS

A face-to-face cross-sectional survey was subsequently performed in March-April 2023 among older adults in Macao. The questionnaire was designed based on the Theory of Planned Behavior (TPB) framework. Multiple logistic regression was used to analyze predictors of self-medication behavior and multiple linear regression analysis to determine whether the TPB construct was the predictor of older adults' intention to seek guidance from pharmacists.

RESULTS

A total of 412 participants completed the questionnaire. The self-medication rate among older adults in Macao was 64.2%. The most commonly used types of medications were over-the-counter and traditional Chinese medicine, mainly from government anti-pandemic packages. The majority of individuals engaged in self-medication to treat COVID-19 symptoms or prevent COVID-19 infection. The prevalent reasons for self-medication were the perceived non-seriousness of the illness. 85 years old or older and university degree were significantly associated with self-medication behavior. Older adults had moderate intention to seek pharmacist guidance on medication use. The average scores (standard deviation) were 3.43 (1.10) for Attitude, 2.69 (0.99) for Subjective Norm, 3.56 (1.04) for Perceived Behavioral Control, and 3.07 (1.43) for Intention. Attitude, Subjective Norm, and Perceived Behavioral Control were all strong predictors of intention, which explained 53% of the variance in intention. In demographic factors, age was identified as a significant predictor of intentions.

CONCLUSIONS

Self-medication was widely practiced in Macao during the COVID-19 pandemic. To better control the risks associated with self-medication, the role of pharmacists is paramount. Enhancing the recognition and trust of pharmacists within society, modifying pharmacy management models, and strengthening pharmacists' self-perception of their profession are all pivotal directions areas to further enhance their role.

Prevalence, practice, determinants and adverse effects of self-medication among young people living in a suburban community of Ekiti, Nigeria: A community-based cross-sectional study

Objectives

Health hazards such as adverse drug reactions and prolonged morbidity are fallouts of self-medication among young people in sub-Saharan Africa. The aim of this study was to assess the prevalence, practice, determinants, and adverse effects of self-medication among young people living in a suburban community of Ekiti, Nigeria.

Methods

This survey was a descriptive, cross-sectional study of 602 young people aged 16-24 years., who were randomly selected in the community. A predesigned self-administered questionnaire was used for data collection. The study was conducted from 1st March to 31st May 2023. The independent variables measured include the sociodemographic characteristics, while the dependent variables are the practice of self-medication and factors that predisposes to self-medication. The general characteristics of the participants were analyzed using descriptive statistics. The categorical variables were reported as frequency distribution and proportions with 95% confidence intervals and were compared using the Chi-square test or Fisher's exact test. A p-value of <0.05 was considered statistically significant.

Results

Over 30% (31.7%) of the participants engage in self-medication. A larger proportion of the people who practiced self-medication lived a trekking distance of less than 1 km from the nearest health facility with a doctor (p = 0.044). The practice of self-medication was statistically related with being a student when compared with gainfully employed and unemployed people (p = 0.006). Fever (39.8%), abdominal pain (17.3%) and headaches (16.2%) were the topmost three ailments that necessitated self-medication. Antimalarials (44.0%), antibiotics (25.1%), and antipyretics (16.8%) were high on the list of drugs used for self-medication. Headache (34.0%) was the most common adverse reaction from self-medication among the participants studied.

Conclusion

Adverse reactions and drug addiction were negative fallouts of self-medication, which can affect the health of young people as they grow into adulthood. Therefore, monitoring of drug outlets must be taken seriously by government agencies to prevent the worsening of the negative effects of self-medication.

Status of self-medication and the relevant factors regarding drug efficacy and safety as important considerations among adolescents aged 12-18 in China: a cross-sectional study

The objective of this study was to investigate self-medication behavior among Chinese adolescents aged 12-18 years and explore the factors associated with whether adolescents prioritize drug efficacy or safety when engaging in self-medication behavior. In 2021, a questionnaire investigation was conducted in the Chinese mainland using a multi-stage sampling approach. After a statistical description, logistic regression was used to analyze the factors associated with considering drug efficacy and safety. The self-medication rate among Chinese adolescents aged 12-18 years was 96.61%. Of these, 65.84% considered drug safety to be essential, while 58.72% prioritized drug efficacy. Regression analysis showed that individuals with better healthcare were more likely to consider drug efficacy an important factor. Additionally, those with a healthier family lifestyle were more likely to prioritize efficacy. When individuals engage in self-medication, those residing in urban areas and possessing advanced preventive health literacy and ample family health resources tend to prioritize drug safety to a greater extent. Conversely, those with higher monthly household incomes and only children exhibit a decreased inclination towards prioritizing safety during self-medication. Self-medication is a frequently observed practice among Chinese adolescents aged 12-18. Several factors, such as demographic and sociological characteristics, health literacy, and family health status, have been found to be associated with the extent to which adolescents prioritize medication safety and efficacy when engaging in self-medication practices. Higher levels of health literacy and better family health status were positively correlated with considering both the efficacy and safety of drugs as important factors when self-medicating.

Prevalence, Characteristics, and Treatment Pattern of Menstrual-Related Headache Among Undergraduate Health Sciences Students at Addis Ababa University, Ethiopia

Background

Menstrual-related headache (MRH) is the most prevalent health condition among young females that limits productivity and social life. However, the magnitude of the problem and its characteristics have not been studied in Ethiopia.

Objective

This study aimed to assess the prevalence, characteristics, and treatment of MRH among undergraduate female students at the College of Health Sciences, Addis Ababa University, Ethiopia.

Methods

A cross-sectional study was conducted among undergraduate female students from May to June 2023. A random sample of 1000 females were approached who fulfilled the eligibility criteria using the online electronic method. Descriptive statistics were used to summarize participant characteristics. Multivariate logistic regression analysis was performed to identify factors associated with the severity of pain. All statistical analyses were performed using SPSS version 26. A p-value ≤ 0.05 was considered statistically significant.

Results

Of the 1000 students who approached online, 757 were included in the final analyses. The prevalence of MRH was (86, 11.4%) and 32.6% of them has experienced the headache before two to three days of menses. The median number of days of missed social activities and reduced productivity was three and one day, respectively. Being single was 6.24 times more likely to have severe MRH (AOR = 6.24, 95% CI: 2.73-14.26, p=0.001) and pharmacy students were less likely (AOR = 0.31, 95% CI: 0.16-0.61, p = 0.001) to have severe pain.

Conclusion

Our findings illustrated that MRH among young female students adversely affects students' productivity and social life. This demands interventions to reduce the impact and should pay attention in the future, particularly to create awareness to enhance screening and rendering various treatment options for the target population.

Relation of poverty with treatment-seeking behavior and antibiotic misuse among UTI patients in Pakistan

Objective

The current study aimed to assess the relation between multi-dimension poverty, treatment-seeking behavior, and antibiotic misuse among urinary tract infection (UTI) patients.

Method

A cross-sectional approach was utilized to recruit patients who had a history of UTI in the previous month from two provinces of Pakistan. The treatment-seeking behavior and antibiotic misuse data were collected on a self-developed questionnaire, whereas the poverty data were collected on a modified multi-dimension poverty index (MPI). Descriptive statistics were applied to summarize the data. The logistic regression analysis was carried out to assess the association of multi-dimension poverty with patient treatment-seeking behavior and antibiotic misuse.

Results

A total of 461 participants who had UTI symptoms in the previous month were recruited. Most of the participants in the severely deprived stage treated the UTI (p < 0.001); however, there was a high proportion of the participants who consulted with friends and family for UTI treatment (p < 0.001). The patients with deprivation status (deprived and severely deprived) were less associated with formal consultation. The poorer subgroups were less likely to practice antibiotic course completion.

Conclusion

The current study highlighted that poverty plays an important role in antibiotic misuse. Poorer subgroups were associated with informal consultations and the incompletion of the antibiotic course. Further studies are needed to explore the potential role of poverty in treatment-seeking behavior and antibiotic misuse.

Differentiating the association between age of alcohol use initiation and conditional suicidal behaviors among adolescents

INTRODUCTION

Suicide and early alcohol use initiation are public health concerns. Previous studies have explored the associations between age of alcohol use initiation and suicidal behaviors, which progresses from ideation to action. Distinguishing between the various associations can help gain a deeper understanding of suicidal behaviors and aid in developing social suicide prevention strategies.

METHODS

The study utilized the Youth Risk Behavior Survey to investigate this association. A total of 17 209 students were finally included in the study. Conditional suicidal behaviors included no suicidal behavior (NS), suicidal ideation without a plan or attempt (SINPA), suicide plan without an attempt (SPNA) and suicide attempt (SA).

RESULTS

Among 17 209 students, the prevalence of suicidal ideation, suicide plan, and suicide attempt were 21.4%, 17.3%, and 11.1%, respectively. Moreover, 15.2% of the students used alcohol before age 13, whereas 31.7% of students used alcohol at age 13 or older. Compared to NS, students using alcohol showed significant associations with SA (OR = 2.34, p < .001; OR = 1.29, p < .01), SPNA (OR = 1.68, p < .001; OR = 1.19, p < .05) and SINPA (OR = 1.55, p < .001; OR = 1.40, p < .001). Comparing with SINPA and SNPA, students using alcohol before age 13 were associated with SA (OR = 1.61, p < .001; OR = 1.46, p < .001), whereas those using alcohol at or after the age 13 were not associated with SA (OR = 0.98, p > .05; OR = 1.09, p > .05).

DISCUSSION

This study demonstrated that early alcohol use initiation was significantly associated with suicide attempts among students with suicidal ideations or plans.

Parents' perspectives on using a Family Medication Safety Plan designed to promote appropriate opioid prescription practices with adolescents

BACKGROUND

Research has underscored the vulnerability of adolescents to opioid misuse, creating a call to action for researchers and practitioners to identify ways to reduce the youths' risk of opioid misuse. Although strategies have previously been proposed, few studies have targeted and designed interventions for adolescents and their families. The Family Medication Safety Plan (FMSP) was developed to provide families with a tool to encourage early education and conversation and promote safe use of prescription opioid medications in their homes.

OBJECTIVES

This study aimed to understand parent perceptions of using the FMSP for potential opioid prescriptions and identify opportunities for widespread application and improvement.

METHODS

Parents living in the United States with access to a webcam-enabled computer were recruited via social media, e-mail listservs, snowball sampling, and Qualtrics research panels. Parents were given the FMSP and asked to complete the worksheet with their child aged 12-18 years. Parents were then scheduled for a 30-minute, semistructured interview to elicit feedback. Interviews were transcribed verbatim by professional transcriptionists before being uploaded to NVivo for thematic and content analysis.

RESULTS

Parents (N = 59) were interviewed and had positive impressions of using the FMSP in their homes. Prevalent themes identified included how the FMSP format could be modified and how the parents would use it in their family. Many participants identified ways in which different health care providers could be used as a resource to make the FMSP more accessible and useful for their family unit.

CONCLUSION

Parents indicated that the FMSP was a beneficial tool for integration and evaluation of safe medication practices in homes. Participants suggested that this tool was most valuable when used for the specific needs of each family, indicating that modifying the FMSP to make it in a more flexible format such that it may improve uptake.

Development of a Remote Health Support Program by Pharmacists and Elucidation of Its Effectiveness: A Randomized Controlled Study

No progress has been made in using remote communication tools for less urgent but equally important health support services, such as preventive medicine and health education. In this study, we developed a remote health support program by pharmacists for community residents and conducted a randomized controlled study on its effectiveness in proper self-medication through pharmacists. People over the age of 20 years who lived in the vicinity of Gifu City, Japan were eligible to participate in this study. Participants were recruited using posters and brochures. This program comprised a lecture, based on the health belief model and behavioral economics, and access to remote health support. The participants were randomly assigned to two groups: the medicine/health class only (control) and the medicine/health class along with the program (intervention) groups. The participants were administered questionnaire surveys immediately before (the first survey) and 2 months after (the second survey) the medicine/health class, which allowed us to compare the changes in the two groups' behavior regarding performing proper self-medication through pharmacists. The percentage of individuals who started consulting pharmacists about self-medication in the intervention group (63.9%, 23/36) was significantly higher than that in the control group (15.2%, 5/33; p < 0.001). The percentage of individuals who started recording information about their self-medication in their medication notebooks in the intervention group (16.7%, 6/36) was significantly higher than that in the control group (0%, 0/33; p = 0.026). We clarified the effectiveness of this program for behavioral changes toward proper self-medication using support from pharmacists.

Self-Medication with Antibiotics Among Children in China: A Cross-Sectional Study of Parents' Knowledge, Attitudes, and Practices

Background

Self-medication with antibiotics (SMA) among children is a common practice in low-income and middle-income countries, which has accelerated antibacterial abuse.

Objective

This study aimed to estimate the prevalence and associated factors of SMA among children in China, including parents' knowledge, attitudes, and practices towards antibiotic use.

Methods

A cross-sectional study based on a structured questionnaire survey of parents was conducted in Nantong between July and September 2020. A total of 1699 respondents participated. Information on participants' demographic and family characteristics, knowledge, attitudes, and practices towards antibiotics use was collected. Hierarchical binary logistic regression was used to examine the predictors of SMA among children.

Results

Among 1699 participants, 23.31% practiced SMA to their children in the past year. Cough (59.6%) was the most common symptom leading to self-medication and penicillins (85.4%) were the most commonly used drugs. Hierarchical regression indicated that parents with higher level of antibiotic knowledge scores (OR=1.163, 95% CI: 1.067-1.268) and buying antibiotics without a prescription from pharmacy (OR=1.475, 95% CI: 1.097-1.983) were more likely to practice SMA to their children both in urban and in rural areas. Storing antibiotics at home resulted in an increased likelihood of self-medication in urban areas but not in rural areas. In addition, there was also a higher probability of non-prescribed antibiotics in children without chronic diseases (OR=1.959, 95% CI:1.072-3.578).

Conclusion

The prevalence of SMA in children is high in China. Higher knowledge scores and practices of buying and storing non-prescribed antibiotics behaviors increased parents' antibiotic self-medication in their children. Practical and effective education intervention for children's rational use of antibiotics is urgently strengthened.

Patterns of Drug Utilization and Self-Medication Practices: A Cross Sectional Study

BACKGROUND

Self-medication (SM) is a growing phenomenon worldwide that has recently been classified as one of the most serious public health problems. SM can result in an incorrect self-diagnosis, inappropriate treatment, potential adverse reactions, interactions, and the masking of more sinister disease.

OBJECTIVES

To assess the prevalence of SM practices amongst healthcare professionals and the general population in Saudi Arabia and to identify the sociodemographic contributing factors to this practice.

METHODS

A total of 540 participants were enrolled in this study. Participants were asked to complete the study questionnaire comprising two sections to gather demographic information and to collect data regarding SM practice.

RESULTS

The prevalence of SM practice among the study participants was 78.6%, and it was the highest among the middle age groups of (21-40 years) 82% compared to the younger and older age groups. The observed prevalence was higher in the female participants (53.7%) and those who live alone. Type of education did not affect the attitude of SM (p = 0.374); however, level of education strongly affected the prevalence of the SM, with higher incidence among university graduates (p < 0.001). Analgesics with antipyretics properties were the most self-medicated drugs. Patients considering their illnesses minor was the main reason behind the high prevalence of this practice. Among healthcare professions the highest prevalence of SM was found among pharmacists (95%), followed by physicians, nurses, and other medical practitioners.

CONCLUSION

The general population should be better educated and made conscious about the consequences, risks, and side effects of SM. Awareness campaigns may prove to be useful in this matter, allowing the patient to consider the appropriateness of this practice. Individuals in the age group of 21-40 years, females, and those who live alone should be considered priority target populations in the design and implementation of SM awareness projects.

Non-prescribed pharmaceutical stimulants use among adolescents: A way to self-care or peer success?

BACKGROUND

the use of pharmaceutical stimulants without a medical prescription (PSWMP) among adolescents is considered an established public health issue. The present study aimed to investigate the potential links between different patterns of non-medical use of pharmaceutical stimulants, psycho-social factors, and other risky behaviours (e.g. psychoactive substance use).

METHODS

For this purpose, data from a sample of 14,685 adolescents aged 15-19 participating in the ESPAD®Italia 2019 study were analysed by conducting descriptive analyses and multinomial logistic regressions.

RESULTS

The findings highlight the key role of psycho-social factors and engagement in other risky behaviours in either reducing or promoting the risk of PSWMP use. Particularly, being satisfied with peer relationships and with oneself is significantly associated with lower use of PSWMP. Conversely, the consumption of other psychoactive substances (both legal and illegal) and engagement in other risky behaviours (e.g., gambling and cyberbullying) may increase this phenomenon.

CONCLUSIONS

Considering their representativeness, the results of the present study could be used as groundwork for the development of effective and targeted prevention programs and interventions.

No prescription? No problem: A qualitative study investigating self-medication with novel psychoactive substances (NPS)

BACKGROUND

The proliferation of Novel Psychoactive Substances (NPS) presents a challenge for global drug policy. The ease of online drug purchase and the emergence of the dark web have created new avenues for the growth of NPS. Despite the global nature of this issue, limited research has examined motivations of use. These include perceived safety or convenience, an interest in novel pharmacology and self-exploration. Recent evidence has suggested individuals may be self-medicating with NPS, however this phenomenon has yet to be thoroughly explored. This study aims to investigate the occurrence of NPS self-medication, identify the specific NPS involved, and understand the motivations behind their use.

METHODS

Discussions surrounding self-medication using NPS were collected between October 2022 and February 2023 via a content analysis of a Reddit community. Ninety-three threads, comprising 182,490 words and 5023 comments, were collected and cleaned. A frequency analysis was conducted to identify the NPS discussed, and data was analysed systematically through the process of iterative categorization (IC).

RESULTS

Our study revealed frequent discussions about the self-medication with several NPS, notably etizolam, clonazolam, diclazepam, flualprazolam, 2-FMA, 4F-MPH, 3-FPM and 3-MeO-PCP. Individuals were mainly self-treating ADHD, anxiety and depression. Motivations for choosing NPS included access, cost, legality and a dissatisfaction with conventional healthcare. Substances were often chosen based on a profile of "Functionality" and outcomes varied. The use of clonazolam was highlighted as particularly problematic.

CONCLUSION

The current study provides insight into the phenomenon of self-medication with NPS within an internet demographic, exploring the motivations behind why individuals choose NPS for a variety of disorders. The easy access to NPS and lack of scientific data pose a significant challenge for drug policy. Future policies should focus on improving healthcare providers knowledge of NPS use, removing barriers to adult ADHD diagnosis and rebuilding trust between individuals and addiction services.

The reality of embedded drug purchasing practices: Understanding the sociocultural and economic aspects of the use of medicines in Bangladesh

BACKGROUND

Purchasing drugs with or without prescription from retail drug shops is common practice in Bangladesh. However, what actually takes place between the drug seller and customer during the transaction is under-researched. This study explores the drug purchasing practices which underlie the socio-cultural and economic aspects of a Bangladeshi city.

METHODS

Adopting ethnographic methods, we conducted thirty in-depth interviews (IDIs) with customers, patients, and sales assistants, and ten key informant interviews (KIIs) with drug sellers, experienced sales assistants and pharmaceutical company representatives. Thirty hours were spent observing drug sellers' and buyers' conversations and interactions for medicine. A total of 40 heterogeneous participants were purposively selected from three drug stores. Transcribed data were coded, and analyzed thematically.

RESULTS

We found through thematic analysis that some individuals visited the drug store with fixed ideas about the name, brand, and dose of the drugs they wanted. Among the 30 IDIs participants, most individuals come without any preconceived ideas, describe their symptoms, and negotiate purchases with the expectation of quick remedies. Cultural practices of buying medicines in full or partial course of doses, with or without prescription, trust in sellers, and positive previous experiences of medications shape the drug purchasing behavior, regardless of any preconceived ideas concerning brand name, and dose. Few customers (n = 7) sought drugs by trade name, but most drug sellers often offered a generic substitute because selling non-brand drugs is more profitable. Notably, many of the clients (n = 13) bought drugs through installment payments and with loans.

CONCLUSION

Community people choose and purchase the most necessary medicines in a self-medicated way from shortly trained drug sellers that can harm individuals' health and reduce the effectiveness of medication. In addition, the results of buying medicine through installments and loans suggest further research on the financial burden of consumers' purchasing behavior. Policymakers, regulators, and healthcare professionals might implicate the study findings to deliver practical information on the rational use of medicines to sellers and customers.

A systematic review of self-medication practice during the COVID-19 pandemic: implications for pharmacy practice in supporting public health measures

Introduction

Since the COVID-19 pandemic, self-medication had become highly popular due to the risk of virus infection and overwhelming medical resources. Pharmacists are well-positioned to provide public health education and disease prevention. This study aims to provide an overview of the research about self-medication during COVID-19 and the role of pharmacists in ensuring the drug safety related to self-medication.

Methods

Databases (PubMed, Google Scholar, Scopus, EBSCO host, and Web of Science) were searched for published studies on the practice of self-medication in COVID-19 pandemic without restriction in population and location. Primary search terms were "self-medication," "self-care," "self-management," "non-prescription drugs," "2019nCoV," and "COVID-19." Studies conducted during the pandemic but not exclusively for COVID-19 disease were eligible for inclusion.

Results

The database search yielded a total of 4,752 papers. After appropriate screening, 62 articles met the inclusion criteria. Most of the studies were cross-sectional in nature. The review highlighted a very high prevalence of self-medication during COVID-19, ranging from 7.14 to 88.3%. The purpose of self-medication was mainly to treat and prevent COVID-19; fever, body aches, cough, headache, and sore throat were the most frequently mentioned indications. Categories of drugs commonly used in self-medication included antibiotics, herbs, vitamins, and analgesics, most of which came from pharmacies. Information about self-medication usually obtained from relatives and friends, social networks and health care professionals. Common reasons for self-medication included saving money and time, prior experience and mild illness; reasons associated with COVID-19 were mainly fear of contracting the virus and poor access to doctors. Gender, age, education, marital status, and concern about COVID-19 were the most usual associated factors. The role of pharmacists in self-medication included sources of information, advice on medication use, and management of adverse reactions.

Conclusion

During the COVID-19 pandemic, self-medication practices were widespread and varied across countries and populations. Self-medication has emerged as an important component of health care, but also as a huge global challenge. The engagement of healthcare administrators and policy makers are essential to regulate self-medication practices. The expertise and favorable conditions of pharmacists make them positioned as key roles in public health interventions for self-medication.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=395423, identifier CRD42023395423.

A Cross-Sectional Study to Investigate the Prevalence of Self-Medication of Non-Opioid Analgesics Among Medical Students at Qassim University, Saudi Arabia

Purpose

Self-medication (SM) using non-opioid analgesics (NOA) is contentious and increasingly recognized as a major public health concern with severe consequences, including masking of malignant and fatal diseases, risk of misdiagnosis, problems relating to over- and under-dosing, drug interactions, incorrect dosage, and choice of therapy. Herein, we aim to determine the prevalence of SM with NOA among pharmacy and medical students at Unaizah College, Qassim University, Saudi Arabia.

Patients and Methods

A cross-sectional study using a validated self-administered questionnaire was conducted on 709 pharmacy and medicine students belonging to an age group of 21-24 years from Unaizah Colleges. Data were statistically analyzed using SPSS version 21.

Results

Of 709 participants, 635 responded to the questionnaire. Our results showed a prevalence percentage of 89.6% using self-medicated NOA for pain management. The most common factor leading to SM in NOA was the mild nature of the illness (50.6%), and headache/migraine (66.8%) was the dominant health problem. Paracetamol (acetaminophen, 73.7%) was the most commonly used analgesic, followed by ibuprofen (16.5%). The most common and reliable sources of drug information were pharmacists (51.5%).

Conclusion

We observed a high rate of SM for NOA among undergraduate students. We believe that the adverse consequences of SM could be controlled through educational, regulatory, and administrative strategies by providing appropriate awareness sessions, and the role of pharmacists should be highlighted in preventing SM from NOA.

Awareness and Knowledge of Antibiotic Resistance and Risks of Self-Medication With Antibiotics Among the Aseer Region Population, Saudi Arabia, 2023

BACKGROUND

Antibiotics are a groundbreaking discovery that revolutionized the treatment of infectious diseases in both humans and animals during the 20th century. However, their overuse and misuse led to serious public health threats, causing widespread concern and significant social and economic consequences. Microorganisms have a natural ability to develop resistance to antibiotics over time through genetic mechanisms, which has further exacerbated the problem. Unfortunately, in the last two decades, there has been a dearth of new antibacterial substances discovered, which has only worsened the situation.

AIM

This study aims to assess the awareness and knowledge of antibiotic resistance and risks of self-medication with antibiotics among the Aseer region population, Saudi Arabia 2023.

METHODS

An observational cross-sectional survey was conducted in Saudi Arabia targeting persons aged 18 to 80 years old living in the Aseer region, Southern of Saudi Arabia. The data were collected using a pre-structured questionnaire after an intensive literature review and expert's consultation. The questionnaire was distributed throughout the social medial channels. The study questionnaire was uploaded online till no more new cases participated and no new answers were obtained.  Results: A total of 300 participants completed the study questionnaire. Participants' ages ranged from 18 to 80 years with a mean age of 31.5 ± 12.9 years old. Exactly 200 participants (66.7%) were females. As for the educational level, 209 (69.7%) had a university level of education. Two-hundred and three (67.7%) participants had an overall poor knowledge and awareness about antibiotic resistance and risks of self-medication. Also, 103 (34.3%) participants used antibiotics without prescription before and 100 (33.3%) used leftover antibiotics from a previous infection.

CONCLUSION

In conclusion, the current study showed that nearly one out of three participants in the Aseer region had unprescribed antibiotics. Another unsafe practice was that the same percent used leftover antibiotics from a previous infection. As for participants' knowledge of antibiotic resistance, also one-third of the respondents had good knowledge about the issue.

Perceptions of West Virginia Teens and Adults Regarding the Risks of Over-the-Counter Pain Medications

More than 1 billion people live with chronic pain, including 100 million Americans, with a majority utilizing prescription and over-the-counter (OTC) pain medications. OTC medications are readily available and facilitate generally positive efficacy, yet misuse leads to a high number of medication-related problems, with acetaminophen alone accounting for more than 50,000 emergency department visits annually. The West Virginia Health Sciences and Technology Academy (HSTA) high school student program and the West Virginia University Health Sciences Center collaborated to accomplish 2 objectives: to assess and compare knowledge and perceptions of OTC pain medications in the West Virginia community and to develop and provide educational interventions to high school students regarding knowledge and perceptions of OTC pain medications. Resulting student knowledge data illustrated a statistically significant improvement in knowledge. Community survey screening data resulted in 85% answering two-thirds of the knowledge questions incorrectly, with 12% (140 of 1174 participants) answering every single knowledge survey question incorrectly. These data strongly exhibit not only the incredible need for OTC pain medication community education but also that this study's educational methods were very effective at teaching high school students, with possible applicability to the entirety of society.

Prevalence and Psychiatric Correlates of Illicit Substance Use in UK Undergraduate Students

This study examined the prevalence of illegal drug use in UK students and motivators behind such behavior. Additionally, we explored possible relationships between substance use, psychosocial motivators, and psychiatric distress. A group (n = 543) of students completed online measures of substance use, anxiety, depression, perceived stress, and insomnia. A series of reasons behind their use were ranked based on importance. Reported cannabis, cocaine, nitrous oxide, ketamine, and MDMA use were most prevalent based on lifetime, past year, and month assessments. The experience of anxiety, depression, perceived stress, and insomnia were related to increased reports of substance use. Poor self-confidence and self-medication were key motivators of illicit drug use in those presenting greater psychiatric distress. These outcomes add to the sparse body of literature concerning illicit substance use in relation to psychiatric distress amongst UK students. Furthermore, we provided novel insight into the psychosocial motivators of such use.

Attitude of Self-Medication Among Pharmacy Students in King Abdulaziz University, Jeddah, Saudi Arabia: A Cross-Sectional Survey

Background/purpose Self-medication is a public health concern because of the potential for medication overuse or abuse, as well as the physical, social, and psychological consequences. In Saudi Arabia, self-medication is common, especially among health science students. Inappropriate self-medication can cause several adverse effects, such as increasing the risk of medication abuse or delaying hospital appointments due to concealing specific symptoms with some medications. Therefore, our study aims to investigate and evaluate health science students' practices, awareness, and attitudes towards self-medication in the Faculty of Pharmacy at King Abdulaziz University, Jeddah, Saudi Arabia. Materials and methods A cross-sectional study was conducted using an online self-administered survey to measure the attitude, awareness, and prevalence of self-medication among pharmacy students at King Abdulaziz University in Jeddah, Saudi Arabia. Students in the pharmacy program from the first to the sixth year were invited to participate in the study from April 2019 to June 2019. Raosoft was used to compute the sample size (n = 235) with a 5% margin of error and a 95% confidence range. Results The factors associated with significant effects were an academic year (p = 0.001), smoking (p = 0.018), average sleeping time (p = 0.032), having any headache (p = 0.022), and their opinion about self-medication (p < 0.0001). Conclusion According to the study, the self-medication of analgesics is common among pharmacy students, and the most used medication was paracetamol.

Pattern and predictors of medication use among adults in southwestern Nigeria: A community-based cross-sectional study

Population-based drug utilization studies are scanty in Nigeria. The aim was to determine the pattern and predictors of medication use among adults in the communities of Southwestern Nigeria. A cross-sectional study was conducted among adults selected by multi-stage sampling from Oyo State communities. The questionnaires, adapted from the WHO Students' Drug Use Questionnaire and previous studies, were pretested and interviewer administered. The respondents' socio-demographic characteristics, the pattern of medication use, prescribers, and sources of drug acquisition were obtained. Binary logistic regression was used to determine the predictor of medications used. Of the 999 respondents, 501 resided in rural communities while 498 dwelled in urban areas. The mean (±SD) age of the respondents was 38 ± 15 years. The median (range)% prevalence of medication use were as follows: lifetime use, 58.2 (17.7-81.0); current use, 31.2 (8.9-65.9); and past use, 20.3 (9.2-28.9). Medications were mainly obtained from patent medicine stores, median (range%), 71 (65-80). The commonly used drugs were paracetamol, 626 (67.6); nonsteroidal anti-inflammatory drugs, 174 (18.8); artemether/lumefantrine, 422 (68.2); ampicillin/cloxacillin, 220 (48.6); and chlorpheniramine, 59 (39.9). Factors predictive of current medication use, adjusted odd ratio (95% confidence interval) were as follows: antimalarial [male, 0.7 (0.5, 0.9)]; antibacterial [male, 0.6 (0.4-0.9)]; analgesics [married, 1.5 (1.1-2.2); presence of health facilities, 0.5 (0.3-0.7); and shorter distance to health facility, 1.5 (1.1-2.1)]. Antimalarials, antibacterial, and analgesics were commonly used and inappropriately obtained by adults in Southwestern Nigeria. Factors predictive of current medication use were gender, marital status, the presence of health facilities, and distance to health facilities. There is a need for more extensive countrywide medication use studies and enlightenment programs to ensure the appropriate use of medications.

Norwegian adolescents' use of energy drinks and painkillers and misuse of prescription drugs prior to and during the initial COVID-19 pandemic year: Evidence from the MyLife study

AIMS

This study aimed to examine and compare the use of energy drinks, over-the-counter (OTC) painkillers and misuse of prescription drugs in two cohorts of Norwegian adolescents entering high school (i.e. grade 11) immediately prior to and during the initial year of the COVID-19 pandemic.

METHODS

Accelerated longitudinal design and multi-cohort sampling enabled identification of the two socio-demographically comparable cohorts of grade 11 students: (a) COVID-19 cohort assessed in the autumn of 2020 (n=915) and (b) pre-COVID-19 cohort assessed in the autumn of 2018/19 (n=1621). Unadjusted and adjusted logistic and Poisson models were used to estimate the proportion of (mis)users and use frequencies among (mis)users in two cohorts.

RESULTS

Energy drinks use was both more common in the COVID-19 cohort (60.8% vs. 52.5%; adjusted odds ratio=1.40, 95% confidence interval (CI) 1.18-1.66, p<0.001) and more frequent among users from this cohort than among their pre-COVID-19 counterparts (9.58 vs. 7.79 days past month, adjusted incidence risk ratio (aIRR)=1.23, 95% CI 1.14-1.32, p<0.001). No cohort differences were observed in OTC painkillers use. Prescription drugs misuse was equally common in the two cohorts but was more frequent among misusers from the COVID-19 cohort than among their pre-COVID-19 counterparts (18.94 vs. 12.45 times past year, aIRR=1.52, 95% CI 1.10-2.10, p<0.001).

CONCLUSIONS

Norwegian adolescents from the COVID-19 cohort were more likely to use energy drinks and, once engaged in these behaviours, to use energy drinks and misuse prescription drugs more frequently than their pre-COVID-19 counterparts.

Antibiotics Self Medication among Children: A Systematic Review

The phenomenon of bacterial antimicrobial resistance (AMR) is a rapidly growing global problem. Overuse and misuse of antibiotics as well as self-prescription are among the most important causes contributing to the growth of antibiotic resistance in humans. This systematic review describes the phenomenon of antibiotics self-medication (ASM) in children. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist by searching PubMed, Scopus, and Web of Science until July 2022. Published English language studies containing information regarding parents knowledge, attitudes, and behaviors in self-administration of antibiotics in children were included. A total of 702 articles were identified, and 57 were selected. A higher prevalence of ASM among children was found in the Middle-East (34%), Africa (22%), Asia (20%) and South America (17%), while the lowest prevalence was found in Europe (8%). High distance from hospital, and low income, such as having more than one child, are related with an increased risk of ASM in children. Fever and cough can also promote the misuse of antibiotics by parents. A greater attention to the regulation of the sale of antimicrobial drugs can certainly limit the risk of self-medicating behavior.

Prevalence, frequency, adverse events, and reasons for analgesic use in youth athletes: A systematic review and meta-analysis of 44,381 athletes

OBJECTIVES

To identify the prevalence, frequency, adverse effects, and reasons for analgesic use in youth athletes.

DESIGN

Systematic review and meta-analysis.

METHODS

Systematic searches in Embase, Medline, and SPORT-Discus from inception to September 2021, screening of reference lists, and citation tracking were performed to identify observational studies including athletes aged 15-24 years and reporting data on prevalence and/or frequency of analgesic use. Study quality was assessed using the Newcastle-Ottawa Scale. Random-effect proportion meta-analyses, stratified by type of analgesic medication and prevalence measure, estimated the prevalence of analgesic use. Data on usage frequency, adverse events, and reasons for analgesic use was synthesized narratively.

RESULTS

Forty-nine studies were included (44,381 athletes), of which 19 were good/high quality. Seven categories of analgesics were identified across 10 prevalence time-points. Meta-analyses suggested common use of NSAIDs (point prevalence 48 % [95 % CI 23 % to 73 %], in-season prevalence 92 % [95 % CI 88 % to 95 %]). The lowest prevalence was found for use of local anesthetic injections within the previous 12 months (2 % [95 % CI 1 % to 3 %]). Seven to 50 % of athletes reported weekly analgesics use. The proportion of adverse events ranged from 3.3 % to 19.2 %. Reasons for using analgesics included treatment of sports-related pain or injury, to treat illness, and to enhance performance.

CONCLUSIONS

Analgesics are commonly used in youth athletes, but estimates vary depending on type of analgesic and prevalence measure. As the majority of studies were of poor methodological quality, future high-quality research should include prospective data collection of analgesic use to understand consumption trajectories.

Prevalence of Self-Medication in Portuguese Adolescents

Self-medication is considered one of the health-risk behaviours found among adolescents. The main objective of this study is to determine the prevalence of self-medication for Portuguese adolescents. An observational cross-sectional study was carried out. The sample comprised 420 adolescents, of whom 343 (81.7%; 95% CI: 77.8-85.2) had already self-medicated and 277 (66.0%; 95% CI: 61.4-70.5) self-medicated in the last 6 months. The main health problems that motivated self-medication were headache (76.7%), flu (70.6%), sore throat (56%), and fever (54.5%). Paracetamol was the most consumed drug (86.9%) followed by ibuprofen (83.1%). The pharmacy (87.8%) was the preferred place to purchase drugs; however, 221 adolescents (64.4%) reported that they self-medicated with the medicines they had at home. Of the adolescents who resorted to self-medication, only 59.6% sought additional information about the drug and 53.9% referred to the package leaflet of the medicinal product as the main source of clarification. A significant portion of the respondents (84.3%) believed that self-medication might be acceptable to treat minor illnesses. It was observed that self-medication is a very common practice among adolescents, making it an extremely important issue to carry out more studies on this section of the Portuguese population due to the scarcity of existing ones. These data can be used to define strategies for the dissemination of the rational use of the drug in the adolescent population.

Factors associated with self-medication of antibiotics by caregivers in pediatric patients attending the emergency department: a case-control study

Introduction

Antibiotic self-medication is a common practice in pediatric caregivers in low-income countries with limited resources and represents a public health problem. Our study sought to determine what factors are associated with this practice, including differences in knowledge or attitudes of caregivers who attend a pediatric emergency service.

Methods

Case-control study based on surveys of caregivers of pediatric patients brought to the emergency room with clinical symptoms suggestive of acute infection. Cases were defined as those caregivers who reported self-medication of antibiotics for the current illness and controls where those who did not report self-medication. Information was collected through a self-administered questionnaire that inquired about demographic and family characteristics, attitudes and knowledge toward self-medication of antibiotics. Data were compared using logistic regression and are presented with odd ratios and confidence intervals.

Results

A total of 728 caregivers, 182 cases and 546 controls were included. We found that higher parental education, both in mothers (OR 0.56, 95% CI 0.40-0.79) and fathers (OR 0.62, 95% CI 0.43-0.89) was associated with less self-medication. Attitudes such as always requesting antibiotics from their doctors (OR 3.92, 95% CI 1.59-9.66), frequently buying antibiotics without a prescription (OR 23.66, 95% CI 11.76-47.59) and giving advice on antibiotics among family members (OR 2.90, 95% CI 1.75-4.82) resulted in an increased likelihood of self-medication. There was also a higher probability of antibiotic self-medication in older children (OR 1.13, 95% CI 1.09-1.17), those with a greater number of siblings (OR 1.25, 95% CI 1.09-1.43) and in those cases that received antibiotics within the last 3 months (OR 6.27, 95% CI 4.35-9.04). Overall knowledge of risk of antibiotic self-medication was low.

Conclusions

Some patient and family characteristics such as age, number of siblings, recent antibiotic usage and inappropriate attitudes are strongly related to antibiotic self-medication. These findings will inform future interventions to reduce self-medication in children.

Prevalence of self-medication and associated factors in adolescents aged 18-19 years: the 1997/1998 cohort in São Luís-MA, Brazil

This article aims to assess the prevalence and factors associated with self-medication in adolescents. Cross-sectional study, nested in cohort, with 2,515 adolescents aged 18-19 years born in São Luís-MA. The use of medication in the last 15 days without a medical prescription or by a qualified professional was considered self-medication. Factors associated with self-medication were evaluated using Poisson regression with robust variances and hierarchical selection of variables. Medicines were used in the last 15 days by 48.05% of adolescents. Among these, 70.09% use it without a prescription or indication from another health professional. The most used medications for self-medication were "over the counter" (93.68%). Self-medication was positively associated with female gender (PR: 1.41; 95%CI: 1.25-1.59), screen time ≥5h/day (PR: 1.32; 95%CI: 1.05-1.67) and self-reported diagnosis of allergic rhinitis (PR: 1.19; 95%CI: 1.02-1.39); however, negatively associated with self-satisfaction with health (PR: 0.79; 95%CI: 0.67-0.94) and hospitalization in the previous year (PR: 0.70; 95%CI: 0.50-0.97). Self-medication was common among adolescents and to reduce this practice, greater attention should be given to women, individuals with intense exposure to meshes and allergic diseases.

Analgesic use in adolescents with patellofemoral pain or Osgood-Schlatter Disease: a secondary cross-sectional analysis of 323 subjects

OBJECTIVES

The prevalence of pain medication use for adolescent knee pain and factors associated with use are not well understood. This study aimed to determine the self-reported use of pain medication for knee pain and identify factors associated with use in adolescents (age 10-19) with longstanding knee symptoms.

METHODS

In this exploratory cross-sectional study, we performed a secondary analysis of data previously collected in 323 adolescents with longstanding knee pain. Factors associated with pain medication use were assessed using multivariable logistic regressions. Analyses were repeated with stratification by age, sex, sport participation frequency, knee pain duration, and knee pain intensity.

RESULTS

Among 323 adolescents (mean age 14.4 ± 2.5, 73% female), 84% had patellofemoral pain, (peri- or retro-patellar pain during loaded bending of the knee) and 16% had Osgood-Schlatter Disease (apophysitis with swelling and localized pain at the tibial tuberosity). Twenty-one percent (95% CI 16-25%) of adolescents reported pain medication use for their knee pain, with no difference in usage between those ≤ vs. > 15 years of age (21%, 95% CI 16-27% vs. 20%, 95% CI 13-29%). Adolescents with patellofemoral pain reported greater usage than their counterparts with Osgood-Schlatter Disease (22%, 95% CI 17-28% vs. 12%, 95% CI 4.5-24.3%). The most consistent factor associated with use was knee-related symptoms, observed in both the overall (OR 0.97, 95% CI 0.94-0.99) and stratified analyses (ORs ranged from 0.89 to 0.96).

CONCLUSIONS

Approximately one in five adolescents with longstanding knee pain reported pain medication use, particularly in adolescents with patellofemoral pain. Knee-related symptoms most consistently associated with the use of pain medications in this population. Future longitudinal studies with data collected at multiple time-points are needed to validate these findings.

IMPLICATIONS

Self-reported pain medication use is common in adolescents with longstanding knee pain, even though whether pharmacological therapy is the best pain management option at this young age is debatable. Reliance on pain medication at an early age could potentially hamper the development of healthy pain coping strategies and increase the risk of dependence and misuse later in life. Future studies should assess the safety, efficacy, and risks of long-term use of pain medications for adolescent knee pain.

The Quality of Counseling for Headache OTC Medications in German Community Pharmacies Using a Simulated Patient Approach: Are There Differences between Self-Purchase and Purchase for a Third Party?

Background

In Germany-as worldwide-headache is one of the most frequent causes of self-medication. The dispensing of over-the-counter (OTC) medications may only be carried out by community pharmacies (CPs). In doing so, CPs have to ensure "adequate" counseling, for both self-purchase and purchase for a third party, which also occurs in everyday pharmacy practice. The aim of this study was to evaluate the quality of counseling for headache OTC medications in German CPs and, as the first study worldwide, to analyze whether and to what extent there are differences in counseling between self-purchase and purchase for a third party.

Methods

A cross-sectional study was carried out using the covert simulated patient methodology (SPM) in all 42 CPs in the German big city Potsdam. With the help of 8 trained simulated patients (SPs), each CP was visited four times by a different SP. The SPs simulated in each CP two scenarios two times with the demand for an OTC medication against headache, which differed only in whether the demand was for themselves or for their boyfriend/girlfriend.

Results

All 168 planned pharmacy visits (84 visits per scenario) were successfully carried out. Overall, the median counseling score was 3.0 out of 9 points (interquartile range [IQR 2.0]). There were no significant differences between the two scenarios (Wilcoxon signed-rank test; p=0.495, r = 0.053). In a multivariate binary logistic regression analysis, the counseling level and the different scenarios were not significantly associated (adjusted odds ratio [AOR] = 1.635, 95% CI = 0.673-3.972, p=0.278).

Conclusions

Due to the partly considerable deficits in counseling of German CPs, policy-makers and the regional chambers of pharmacists are called upon to take appropriate measures to improve the quality of counseling. It is positive that no differences in counseling between self-purchase and purchase for a third party were found, but further verifying studies with a modified methodology are recommended.

Perception and practice of self-medication with antibiotics among medical students in Sudanese universities: A cross-sectional study

Introduction

The benefits of antibiotics are under threat by self-medication, which culminated in economic burdening of developing countries, treatment failures, the emergence of antibiotic-resistant strains of bacteria and an increased probability of exposure and infection of the general population by antibiotic-resistant bacterial strains.

Objectives

This study aimed to evaluate the knowledge and attitude of medical students in Sudan towards the use of antibiotics, the prevalence of self-medication with antibiotics among medical students in Sudan and to identify risk factors which promote self-medication with antibiotics.

Materials and methods

This was a cross-sectional, descriptive and institution-based study, between November 2020 and May 2021. 1,110 medical students were selected by multistage cluster sampling. Logistic regression was used to identify risk factors of self-medication with antibiotics among the study participants.

Results

The median knowledge score was 7 out of a maximum of 10 (IQR: 5–8). A moderately positive attitude was observed among the participants (Median: 7/10; IQR: 6–8). Knowledge and attitude scores were significantly associated with academic year and monthly allowance (p < 0.05). 675 (60.8%) self-medicated with antibiotics within the previous 12 months, mostly from community pharmacies (321/675; 47.5%). Antibiotics were most commonly used to treat respiratory tract infections (38.1%) and cough (30.4%). Chi-square analysis demonstrated that self-medication with antibiotics was significantly associated with gender, year of study and monthly income.

Conclusions

Undergraduate medical students had moderate knowledge and attitude towards antibiotic use and antibiotic resistance, and an alarmingly high prevalence of self-medication with antibiotics. This highlights the urgent need for tighter legislation regarding the sales of antibiotics in community pharmacies by the state and federal health ministries.

Care-seeking behaviour of adolescents with patellofemoral pain: a retrospective cohort study

AIM

The aim of this study was to assess the care-seeking behaviour among adolescents with patellofemoral pain (PFP).

METHODS

This retrospective study included data on 121 adolescents with PFP enrolled in a randomized controlled trial. A questionnaire was sent to the general practitioner (GP) of each adolescent, assessing information on the consultation dates for knee pain, potential diagnoses, and treatment provided.

RESULTS

106/121 adolescents had been in contact with their GP, and 95 medical records of adolescents were available. Of the 95 adolescents with available medical records 60 had consulted their GP for knee pain. The median number of contacts was 1.5 (range 1-7). The GPs initiated treatment for 48 of the 60 adolescents and in most cases it was information and advice (36/48) or pain medication to a minor extent (6/48). Out of the 60 adolescents who consulted their GP 26 were subsequently referred to different types of health care professionals, in 11 out of 26 to physiotherapy, but also to the department of rheumatology or orthopaedics. Conclusions : 63% of adolescents diagnosed with PFP had previously consulted their GP due to knee pain. Several types of treatments were initiated by the GP, but most commonly advice and information were given. Standardized and evidence-based treatment guidelines for adolescent knee pain in general practice are needed.

Knowledge and Behavior in Rational Drug Use Among College Students in Zunyi City

OBJECTIVE

To investigate the current status of knowledge and behavior about rational drug use in college students in different colleges and universities in a city in southwest China, providing reference for students' education of rational drug use in colleges and universities.

METHODS

A questionnaire survey on knowledge and behavior in rational drug use was carried out on the students recruited by occasional sampling method in 6 colleges and universities in Zunyi, China. Statistical analyses on demographic information and answers to questionnaire questions were carried out with SPSS 18.0.

RESULTS

A total of 865 valid questionnaires were recovered from 923 questionnaires sent out. Some knowledge and behaviors of the students on drug use were irrational. There was statistically significant difference in some specific questions of the knowledge in rational drug use between medical and non-medical students (P<0.05); the average score of rational drug use behavior of medical students was lower than that of non-medical students (P<0.05); the average score of the rational drug use behavior of female students was lower than that of male (P<0.05); the students' major types had significantly different influence on their behavior in rational drug use (P<0.05). The school-carried pharmacy education can effectively improve students' rational medication; the majority of college students believed that it is necessary to popularize the knowledge of rational drug use on campus; and students' favorite way to acquire knowledge about rational drug use was to attend related lectures or elective courses.

CONCLUSION

The knowledge and behavior of rational drug use among college students need to be improved. Professional medical education may exert a positive impact on rational drug use among college students. Thus, it is necessary to popularize the knowledge of rational drug use among college students, especially in non-medical colleges and universities.

Polysubstance Use in Early Adulthood: Patterns and Developmental Precursors in an Urban Cohort

Polysubstance use (i.e., simultaneous or sequential use of different psychoactive substances) is associated with increases in the risk of severe health problems and social impairments. The present study leverages community-representative, long-term longitudinal data from an urban cohort to assess: (a) the prevalence and continuation of polysubstance use between adolescence and early adulthood; (b) different patterns of polysubstance use (i.e., combinations of substances) in early adulthood; and (c) childhood risk factors for polysubstance use in early adulthood. At age 20 (n = 1,180), respondents provided comprehensive self-reported information on past-year substance use, including use of legal and illicit substances (e.g., cannabinoids, stimulants, and hallucinogens), and nonmedical use of prescription drugs (e.g., opioids, tranquilizers). In adolescence (ages 13-17), limited versions of this questionnaire were administered. In childhood (ages 7-11), potential risk factors, including individual-level factors (e.g., sensation-seeking, low self-control, aggression, and internalizing symptoms) and social-environmental factors (e.g., social stressors, exposure to others' substance use), were assessed. We fitted latent class models to identify classes of participants with different substance use profiles in early adulthood. The results show that polysubstance use increased between early adolescence and early adulthood. The continuation of polysubstance use was common (stability between all adjacent assessments: odds ratio >7). At age 20, more than one-third of participants reported polysubstance use (involving illicit substances, nonmedical use of prescription drugs, and cannabidiol). Four latent classes with polysubstance use were identified: (1) broad spectrum of substances; (2) cannabis and club drugs; (3) cannabis and the nonmedical use of prescription drugs; and (4) different cannabinoids. Risk factors for any polysubstance use included childhood sensation-seeking and exposure to others' substance use; some childhood risk factors were differentially associated with the four classes (e.g., low self-control in childhood was associated with an increased likelihood of being in the broad spectrum class). The classes also differed with regard to socio-demographic factors. This study revealed that polysubstance use is a widespread and multifaceted phenomenon that typically emerges during adolescence. To facilitate the design of tailored prevention mechanisms, the heterogeneity of polysubstance use and respective socio-demographic and developmental precursors need to be considered.

Self-Medication Perceptions and Practice of Medical and Pharmacy Students in Serbia

Background. Attitudes towards conventional and complementary medicine among future healthcare professionals can impact their future pharmacotherapy practice. This study aimed to determine the prevalence and predisposing factors related to self-medication among medical and pharmacy students. Methods. This cross-sectional questionnaire-based study was performed at the Faculty of Medicine, University of Novi Sad, Serbia, on first- and final-year students of medicine and pharmacy. The multivariate Poisson regression model with robust variance was used to identify the main predictors of self-medication. Results. The overall self-medication prevalence in the past year was 81.3%. Independent risk factors for self-medication identified in the regression analysis were the final study year, housing condition, i.e., living in a leased apartment or in a student dormitory in comparison to living with parents, and cigarette consumption. The conventional drugs were the most frequently used, mostly for the symptoms of cold and pain. Final-year students had more confidence in conventional medicines than in herbal drugs and were more aware of the risks of their concomitant use. Conclusion. Self-medication is highly prevalent among students of medical sciences, especially among final-year students. Increased medical knowledge led to the higher awareness of the drug interaction risks.

Information provision and retrieval by registered salespersons from consumers during over-the-counter drug sales - a questionnaire survey

Background

In Japan, non-pharmacists who are accredited as registered salespersons can sell over-the-counter (OTC) drugs, and they play a very important role in supporting proper OTC drug use by consumers. The purpose of this study was to evaluate information provided to and information collected from consumers, and cooperation with pharmacists during OTC drug sales by registered salespersons, and to clarify their related concerns and behaviors.

Methods

A cross-sectional questionnaire-based survey of 385 registered salespersons working at 56 drugstores throughout Japan was conducted. Based on the questionnaire survey, the frequency of information provision/collection in various categories was determined for the registered salespersons. The relation between concerns of registered salespersons relating to OTC drug sales and the frequency of information provision/collection was examined. The frequency of consultation of registered salespersons with a pharmacist was calculated for registered salespersons with/without in-store pharmacists. The χ-square test or Fisher’s exact test was performed to assess the significance of differences.

Results

Two hundred and seven registered salespersons (53.7%) responded completely. A greater number of OTC drug purchasers per day was associated with a greater frequency of information provision about “side effects” and information collection about “favorite items” (alcohol, tobacco, health foods, etc.) (p < 0.05). One hundred and thirty-nine (67.2%) participants had concerns about “interactions between OTC drugs and prescription drugs”, and these concerns were related to the frequency of information provision/collection (p < 0.05). Regarding the frequency of consultation with a pharmacist, 35 of 46 participants (76.1%) working with pharmacists answered “always” or “usually”, whereas only 19 of 161 participants (11.8%) working without full-time pharmacists answered “always” or “usually”. More than half of the registered salespersons thought that cooperation with a pharmacist was necessary when they were “asked about concomitant use with prescription drugs” or “told that side effects happened.”

Conclusions

The results of this study show that experienced registered salespersons selling OTC drugs are more likely to collect information from consumers and to provide information to consumers. It appears to be important for registered salespersons to cooperate with pharmacists in order to provide and collect appropriate information about concomitant medications.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-07343-x.

Self-medication practices to prevent or manage COVID-19: A systematic review

Background

Previous studies have assessed the prevalence and characteristics of self-medication in COVID-19. However, no systematic review has summarized their findings.

Objective

We conducted a systematic review to assess the prevalence of self-medication to prevent or manage COVID-19.

Methods

We used different keywords and searched studies published in PubMed, Scopus, Web of Science, Embase, two preprint repositories, Google, and Google Scholar. We included studies that reported original data and assessed self-medication to prevent or manage COVID-19. The risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) modified for cross-sectional studies.

Results

We identified eight studies, all studies were cross-sectional, and only one detailed the question used to assess self-medication. The recall period was heterogeneous across studies. Of the eight studies, seven assessed self-medication without focusing on a specific symptom: four performed in the general population (self-medication prevalence ranged between <4% to 88.3%) and three in specific populations (range: 33.9% to 51.3%). In these seven studies, the most used medications varied widely, including antibiotics, chloroquine or hydroxychloroquine, acetaminophen, vitamins or supplements, ivermectin, and ibuprofen. The last study only assessed self-medication for fever due to COVID-19. Most studies had a risk of bias in the “representativeness of the sample” and “assessment of outcome” items of the NOS.

Conclusions

Studies that assessed self-medication for COVID-19 found heterogeneous results regarding self-medication prevalence and medications used. More well-designed and adequately reported studies are warranted to assess this topic.

Parental self-medication with antibiotics in a Tunisian pediatric center

INTRODUCTION

Self-medication of antibiotics among children is a very common problem in Tunisia. Its prevalence isn't well established. The aims of this study are to evaluate parents' knowledge concerning antibiotic use, and identify the factors associated with this problem.

PATIENTS AND METHODS

We conducted a cross-sectional study over a one year period (between August 2019 and July 2020). Data collection was performed using a questionnaire guided interview. We included parents of children consulting or hospitalized in the pediatric department of the university hospital Taher Sfar in Mahdia.

RESULTS

A total of 354 parents were included with an average age of 36.4±9.2 years. The average knowledge score was 2±1.3 points. In fact, 61.6% of the parents had poor knowledge about antibiotics. The frequency of non-prescription antibiotics use among children was 20.6%. Amoxicillin was the most used antibiotic (72.6%). Sore throat, important fever and flu-like symptoms were the main symptoms justifying non-prescription antibiotic use among our pediatric population in 60.3%, 34.2% and 23.3% of cases respectively. The main reason of self-medication was the fact that the same antibiotic was once prescribed to treat the same symptoms (58.9%). The used antibiotic came from an old prescription for the same child in 57.5% of the cases and was recommended by the pharmacist in 39.7% of the cases. After multivariate analysis, the factors associated with parental self-medication with antibiotics were: the advanced parent's age, the ability to name an antibiotic and knowledge's score>2.

CONCLUSION

Our study confirmed that parental knowledge about antibiotic use is low. In fact, the government should from one hand, organize antibiotic delivery and prohibit off the counter sells and in the other hand promote the education of the public through different procedures to stop this major health problem.

PREVALENCE OF SELF-MEDICATION FOR DYSPEPTIC SYMPTOMS IN PRIMARY CARE: A BRAZILIAN SURVEY

BACKGROUND

Dyspeptic symptoms are among the eight symptoms that most lead to the use of self-medication globally.

OBJECTIVE

The aim of the present study was to evaluate the frequency of use and profile of the population doing self-medication to control dyspeptic symptoms in a capital from South Brazil.

METHODS

Application of a survey consisting of topics regarding individual's socio-cultural data, self-reported comorbidities, use of self-medication in the 15 days prior to the interview and information on the use of this medication. Statistical analysis was performed on the data collected to determine the prevalence of self-medication for dyspeptic symptoms (SMDS) and to establish correlations with independent factors, such as gender, age, body mass index (BMI), education, family income and self-reported comorbidities.

RESULTS

A total of 719 individuals from the public health system were interviewed. Overall, 67.7% were female, 65.3% had a BMI greater than 25; 28.4% presented with self-reported hypertension, 21.4% with depression and 13.8% with diabetes. The prevalence of self-medication to control digestive symptoms in this population was 28.7% (95%CI: 25.3-32), 91.8% (n=189) due to complaints of dyspeptic origin. Proton pump inhibitors were the most used class of medication (67%), followed by antacids (15%). There was a relationship between SMDS and age >38 years (OR=1.734, 95%CI: 1.177-2.580, P=0.001), BMI >26 (OR=1.660, 95%CI: 1.166-2.362, P<0.001) and self-reported depression (OR=1.471, 95%CI: 0.983-2.201, P=0.04).

CONCLUSION

There was a higher prevalence of the use of self-medication to control dyspeptic symptoms in relation to previous data from the literature. Age >38 years, BMI >26 and self-reported depression were associated with SMDS.