Self Medication

Self-medication with antimicrobial agents is a common form of self-care among patients globally with the prevalence and nature differing from country to country. Here we assessed the prevalence and predictors of antimicrobial self-medication in post-conflict northern Uganda. A cross-sectional study was carried out using structured interviews on 892 adult (≥18 years) participants. Information on drug name, prescriber, source, cost, quantity of drug obtained, and drug use was collected. Households were randomly selected using multistage cluster sampling method. One respondent who reported having an illness within three months in each household was recruited. In each household, information was obtained from only one adult individual. Data was analyzed using STATA at 95% level of significance. The study found that a high proportion (75.7%) of the respondents practiced antimicrobial self-medication. Fever, headache, lack of appetite and body weakness were the disease symptoms most treated through self-medication (30.3%). The commonly self-medicated antimicrobials were coartem (27.3%), amoxicillin (21.7%), metronidazole (12.3%), and cotrimoxazole (11.6%). Drug use among respondents was mainly initiated by self-prescription (46.5%) and drug shop attendants (57.6%). On average, participants obtained 13.9±8.8 (95%CI: 12.6-13.8) tablets/capsules of antimicrobial drugs from drug shops and drugs were used for an average of 3.7±2.8 days (95%CI: 3.3-3.5). Over half (68.2%) of the respondents would recommend self-medication to another sick person. A high proportion (76%) of respondents reported that antimicrobial self-medication had associated risks such as wastage of money (42.1%), drug resistance (33.2%), and masking symptoms of underlying disease (15.5%). Predictors of self-medication with antimicrobial agents included gender, drug knowledge, drug leaflets, advice from friends, previous experience, long waiting time, and distance to the health facility. Despite knowledge of associated risks, use of self-medication with antimicrobial drugs in management of disease symptoms is a common practice in post-conflict northern Uganda.

BackgroundInappropriate use of antibiotics in the community plays a role in the emergence and spread of bacteria resistant to antibiotics which threatens human health significantly. The present study was designed to determine inappropriate use of antibiotics and its associated factors among urban and rural communities of Bahir Dar city administration.MethodsA comparative cross sectional study design was conducted in urban and rural kebeles of Bahir Dar city administration from February 1 to March 28, 2014. A total of 1082 participants included in the study using a systematic random sampling technique. Data was collected using pre-tested and structured questionnaire. Data was coded and entered into SPSSS version 16 for statistical analysis. Bivariate and multivariate logistic regression model were used to identify factors associated with inappropriate use of antibiotics.ResultsInappropriate use of antibiotics was 30.9% without significant difference between urban (33.1%) and rural (29.2%) communities. From the inappropriate antibiotic use practice, self-medication was 18.0% and the remaining (12.9%) was for family member medication. Respiratory tract symptoms (74.6%), diarrhea (74.4%), and physical injury/wound (64.3%) were the three main reasons that the communities had used antibiotics inappropriately. Factors associated with inappropriate use of antibiotics were low educational status, younger age, unsatisfaction with the health care services, engagement with a job, and low knowledge on the use of antibiotic preparations of human to animals.ConclusionsInappropriate use of antibiotic exists in the study area with no significant difference between urban and rural communities. The study indicated an insight on what factors that intervention should be made to reduce inappropriate use of antibiotics in the community. Interventions that consider age groups, educational status, common health problems and their jobs together with improvement of health care services should be areas of focus to reduce inappropriate use of antibiotics.

BackgroundAs far as we are aware, no previous systematic review and synthesis of the qualitative/descriptive literature on polypharmacy in anabolic-androgenic steroid(s) (AAS) users has been published.MethodWe systematically reviewed and synthesized qualitative/descriptive literature gathered from searches in electronic databases and by inspecting reference lists of relevant literature to investigate AAS users' polypharmacy. We adhered to the recommendations of the UK Economic and Social Research Council's qualitative research synthesis manual and the PRISMA guidelines.ResultsA total of 50 studies published between 1985 and 2014 were included in the analysis. Studies originated from 10 countries although most originated from United States (n=22), followed by Sweden (n=7), England only (n=5), and the United Kingdom (n=4). It was evident that prior to their debut, AAS users often used other licit and illicit substances. The main ancillary/supplementary substances used were alcohol, and cannabis/cannabinoids followed by cocaine, growth hormone, and human chorionic gonadotropin (hCG), amphetamine/meth, clenbuterol, ephedra/ephedrine, insulin, and thyroxine. Other popular substance classes were analgesics/opioids, dietary/nutritional supplements, and diuretics. Our classification of the various substances used by AAS users resulted in 13 main groups. These non-AAS substances were used mainly to enhance the effects of AAS, combat the side effects of AAS, and for recreational or relaxation purposes, as well as sexual enhancement.ConclusionsOur findings corroborate previous suggestions of associations between AAS use and the use of other licit and illicit substances. Efforts must be intensified to combat the debilitating effects of AAS-associated polypharmacy.

Older adults are vulnerable to unsafe medication practices. This cross-sectional study estimated the prevalence and factors of polypharmacy and self-medication among 600 older adults from six Indian cities. The updated Screening Tool of Older Persons' Prescriptions and Screening Tool to Alert to Right Treatment criteria (version 3) were used. Knowledge, attitudes, and reported practices regarding self-medication were assessed. Descriptive statistics, binary logistic regression, and multivariable analysis were used. The prevalence of polypharmacy was 33.7% (95% CI 29.9-37.6%), with significant associations to multiple comorbidities [adjusted odds ratio (aOR) 2.5 (95% CI 1.1-4.1)], recent transition of care [aOR 3.3 (95% CI 1.4-5.7)], and recent hospitalization [aOR 4.6 (95% CI 2-7.7)]. The proportions of prescriptions with potentially inappropriate medications and potential prescribing omissions were 28.8% (95% CI 25.2-32.6%) and 20.3% (95% CI 17.2-23.8%), respectively. The prevalence of self-medication was 19.7% (95% CI 16.6-23.1%), associated with factors, such as staying alone [aOR 4.5 (95% CI 2.4-6.6)], multiple comorbidities [aOR 3 (95% CI 1.4-6.7)], and recent hospitalization [aOR 4.8 (95% CI 1.5-8)]. Among those who self-medicated, 65.3% lacked knowledge of self-medication, 50% did not comprehend the risks, and 40.7% reported unsafe self-medication practices. The findings emphasize interventions' necessity for promoting safe medication use in older adults.