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Indian Journal of Pharmacology, Vol. 43, No. 3, May-June, 2011, pp. 275-277 Research Article Pre and post-interventional pattern of self medication in three common illnesses in staff of a tertiary hospital S Bang1, Smita Sontakke2, Vijay Thawani3 1 Undergraduate Student, Government Medical College, Nagpur, Maharashtra, India Correspondence Address: Vijay Thawani, Department of Pharmacology, VCSG GMSRI, Srinagar, Pauri Garhwal, Uttarakhand , India, vijaythawani@rediffmail.com Date of Submission: 05-Apr-2009 Code Number: ph11074 DOI: 10.4103/0253-7613.81517 Abstract Objective: To find the pattern of self medication in three common illnesses (diarrhea, sore throat, common cold) in nonmedical staff of a tertiary care teaching hospital and to study the effect of IEC.Materials and Methods: This was a cross sectional study carried out in 100 randomly selected nonmedical staff members. Participants were interviewed by a semi structured questionnaire to obtain information about practice of self medication in the three illnesses. In the second phase participants were educated about proper self medication using Information, Education, and Communication (IEC) intervention. In post test the same information was obtained from the participants using the same questionnaire. Pre and post intervention data was compared to see whether intervention has resulted in any change in the pattern of self medication. Results: For all the three diseases the use of medicines including anti microbials did not decrease significantly after intervention. During post test significantly more number of participants were aware about warning symptoms of the disease and precautions to be taken in children and pregnant women. Even during pre intervention many participants were aware about non-pharmacological measures to be adopted in the treatment of these diseases which increased after intervention, though not significantly. Conclusion: It is possible to improve self medication practices for the treatment of common illnesses if appropriate IEC intervention is adopted. This requires that all related stakeholders should intensify efforts to educate the general public and ensure appropriate use of OTC medicines. Keywords: Self medication, IEC intervention, semi-structured questionnaire Introduction Self medication is the treatment of common health problems with medicines approved as safe and effective for use without medical supervision. Medicines for self medication are called nonprescription medicines or "over the counter" (OTC) medicines. Self medication has a rightful place in healthcare as it saves money and time that otherwise is spent on visiting a doctor. Self medication with prescription medicines is common in developing countries where pharmacies freely supply even prescription medicines without a prescription due to lack of strict implementation of regulations and monitoring by drug regulatory authorities. People stock leftover medicines in their homes, reuse them, and pass them to friends and relatives who need them. [1] These practices also exist in countries where dispensing of medicines is regulated strictly. [2] Optimal therapy with OTC medicines requires that consumers diagnose the underlying condition correctly and use the medicine in a manner that minimizes risk. This is possible only if consumers have some basic knowledge about the medicine, its appropriate use, ADRs, precautions, and contraindications. They should know when to seek further medical attention and when not to self medicate. Thus, there is a need to provide adequate information to consumers so that they choose right medicine for a particular illness to gain benefits from self medication. Hence, this study was planned to find the pattern of self medication in three common illnesses, viz. diarrhea, sore throat, and common cold, in nonmedical staff of a tertiary care teaching hospital and to study the effect of Information, Education, and Communication (IEC) intervention on self medication. Materials and Methods This was a cross-sectional study carried out in 100 randomly selected nonmedical staff members of a tertiary care teaching hospital. Study protocol was approved by Institutional Ethics Committee. Participants were explained about the study and informed consent was taken. They were interviewed and the information obtained was entered in an open-ended, semi-structured questionnaire. Second phase of the study consisted of administration of intervention in the form of:
Results This study was carried out in 100 participants, of which 70 were men and 30 women. Of all, 34 participants were graduates or above, 26 were higher secondary qualified, and 40 were less than higher secondary qualified. All participants completed both pre- and postintervention questionnaires. Information obtained from the participants during pre- and postintervention is shown in [Table - 1]. The prevalence of self medication was found to be higher in educated (Higher secondary or above) participants (72.85% for diarrhea, 65.33% for sore throat, and 66.66% for common cold). For all the three diseases, there was no statistically significant change in the number of participants who took prescription medicines OTC and no improvement in the awareness about dose of drugs after intervention. Awareness about ADRs, warning symptoms of the disease (that indicate worsening of the disease), and precautions to be taken in children and pregnant women increased significantly after intervention. Awareness about use of nonpharmacological measures also increased after intervention, but this was not statistically significant [Table - 1]. Medicines used in the three diseases were classified as symptomatic, antimicrobials, and miscellaneous, and the number of participants taking these medicines in the pre- and postintervention phases is shown in [Table - 2]. The most common medicine used for symptomatic treatment was ORS for diarrhea, cetirizine for common cold, and povidone iodine gargles for sore throat. Use of antimicrobials was common in diarrhea and sore throat, with metronidazole being the most commonly used drug in diarrhea and erythromycin in sore throat. This did not change after intervention. Discussion Number of participants who obtained prescription medicines OTC did not change significantly as a result of intervention. It is easier for people to get OTC medicines as it saves their time and money spent on hospital visits. So, people are not concerned whether the medicine is an OTC medicine or a prescription one. But their short-term savings may be counteracted by the long-term effects in the form of problems arising out of inappropriate medicine use. [3],[4] Increased awareness of study participants about the ADRs of medicines during post-test is a significant outcome as ADRs are an important cause of discontinuation of therapy and inconvenience to the patient which can at times be serious. Another study has reported that self medication for minor illnesses was preferred by 80.49% respondents, of which only 6.34% had knowledge of correct use and 19.5% knew of side effects. [5] Most of the study participants practiced self medication but it is a matter of concern that not many were aware about the warning symptoms of the disease. Increased awareness about how long to continue self medication, what symptoms indicate worsening of the disease, and when one should see a doctor, as a result of intervention, is a significant achievement as it is very important to be able to recognize the early symptoms of any impending complication of a disease while one is practicing self medication. Even during preintervention, many participants were aware about nonpharmacological measures to be adopted in the treatment of these diseases, which further increased after intervention. This indicates that people are more interested in knowing about nonmedicine measures for the treatment of common diseases. The fact that there was no change in the use of antimicrobials in diarrhea and sore throat even after intervention is a matter of concern as antimicrobials are not required in majority of the cases and their irrational use may result in development of antimicrobial resistance, which is a major public health problem. The amount of antimicrobials consumed in a community is directly related to the amount of antimicrobial resistance found. [6],[7] Unnecessary use of antimicrobials also imposes financial burden on the patient. Ideally, use of antimicrobials should follow specific criteria; currently, they are on top of the list of self-medication medicines in countries that do not control their commercialization. [8] It appears that for changing the pattern of antimicrobial use in these illnesses, interventions merely aimed at educating consumers may not be very effective, and more vigorous interventions including strict regulation of OTC sale of antimicrobials need to be employed. The prevalence of self medication was found to be higher in well-educated participants and the positive IEC outcomes were also high in this group. Similar findings have been reported by others. [9],[10] This is an expected observation as information about medicines is easily available through the media, Internet, and Direct-to-consumer advertising. It has been observed in this study that majority of participants used a particular medicine for similar symptoms. One of the probable reasons for this maybe that all the study participants worked in the same set-up and maybe discussing their disease symptoms and medicines used. Furthermore, it has also been reported that once an illness is self-diagnosed, its treatment does not differ in the given population. [11] Hence, it appears that it is labeling of the illness that is more important. The results suggest that it is possible to improve self-medication practices if appropriate IEC intervention is adopted. Efforts to educate the general public should be intensified and appropriate use of OTC medicines should be ensured. References
Copyright 2011 - Indian Journal of Pharmacology The following images related to this document are available:Photo images[ph11074t2.jpg] [ph11074t1.jpg] |
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