Original Research Article DOI: 10.18231/2393-9087.2017.

0036

Self-medication practices among residents of Puducherry – A cross sectional

questionnaire based survey
M. Shanmuga Priyan1, B. Maharani2,*, A. Lourdu Jafrin3, Vijay K. Chavada4, G. Sivagnanam5
1M.B.B.S Student, 2Associate Professor, 3Associate Professor & HOD, 4Associate Professor, 5Dean & Professor, 1,2,3,5Dept. of
Pharmacology, 4Dept. of Community Medicine, Indira Gandhi Medical College & Research Institute, Puducherry, India

*Corresponding Author:
Email: drkarthikrani@gmail.com

Abstract
Introduction: Improper self-medication of Over the Counter (OTC) drugs and /or drugs from earlier prescription may result in
adverse drug reactions and /or serious drug interactions with co-administered alternate system of drugs. Information on self-
medication practices, the factors influencing such practices and incidence of ADRs associated with self-medication among the
residents of Puducherry is not available.
Aim: To study the prevalence of self-medication among the residents of Puducherry and to determine the factors that influences
the pattern of self-medication.
Materials and Methods: Cross-sectional questionnaire based study, was carried out using a pretested validated questionnaire on
self-medication practices on a randomly selected population of adult residents of Puducherry.
Results: Among the 380 participants who responded by answering to the questionnaire, 34.5% were males and 65.5% were
females. Mean age of the respondents was 36.4±11.7 yrs. approximately 59.5% of the respondents self-medicated with allopathic
drugs. The frequency of self-medication by the respondents ranged from once (31.3%) to more than 5 times (11.1%) in the past
six months recall period. Statistically significant association was found between occupation and self-medication (p<0.01). The
commonest symptoms for which the respondents self-medicated were headache and fever (60.2 and 42.0% respectively). Most
common drugs consumed by self-medication were NSAIDs (63.71%) in which paracetamol contributed to 43.36% followed by
anti-histaminics (28.31%). Private pharmacy (89.8%) was the major source of drugs for self-medication followed by left over
drugs in the home (5.3%). Simpler nature of the disease was the reason given by 66.4% of the self-medicated individuals. A side
effect with self-medication was experienced by 11.9% of the respondents. Alternate system of medicine was used by 24.3%
respondents with self-medication. Pharmaceutical expiry date was always checked by 87.2% of the respondents.
Conclusion: Self-medication prevalence in the community surveyed is moderately high. Joint efforts by the health careers
including community pharmacists to educate the ill effect of self-medication among general public can help in reducing the
practice of self-medication and betterment of the society.

Keywords: Prescription drugs, expiry date, adverse drug reactions, alternate system of drugs.

Introduction hospitalization and/or mortality.(6) Literature search

Self-medication is defined as “the use of drugs to revealed incidence of 1.3% of reported ADRs are
treat self-diagnosed disorders or symptoms, or the associated with self-medication.(7) Information on self-
intermittent or continued use of a previously prescribed medication practices, the factors influencing the
drug for chronic or recurrent disease or symptoms”.(1) practices and incidence of ADRs associated with self-
World Health Organization(WHO) promotes the medication among the residents of Puducherry is not
practice of self-medication without medical available. Hence the present study was undertaken with
consultations for an effective and quick relief of the following objectives.
symptoms to reduce the burden on health care service 1. To study the prevalence of self-medication among
centers, which are often understaffed and inaccessible the residents of Puducherry.
in rural and remote areas.(2) Over the counter (OTC) 2. To determine the factors that influences the pattern of
medications are also a form of self-medication. The self-medication.
practice of self-medication is widely employed by
people all over the world.(3) In addition to allopathic Materials and methods
drugs, self-medication of alternate system of medicine Study design
with or without allopathic drugs is also prevalent The study is a community based cross-sectional
among the people. (4) Improper use of OTC drugs and questionnaire based study held at Puducherry. The
prescription only drugs by self-medication may result in study was conducted over a period of six months after
adverse drug reactions and serious drug interactions obtaining Institutional Ethics Committee clearance.
with co-administered drugs. Adverse drug reactions Puducherry comprises three communes as per revenue
(ADRs) are quite common not only with allopathic and administration purpose. One commune was
medicine, but can also occur when taken with alternate randomly selected. From the selected commune,
system of medicine due to the drug-drug interaction.(5) geographical areas catered by two primary health
ADRs are among the most common reasons for centres were randomly selected and in the last stage of
Indian Journal of Pharmacy and Pharmacology, October-December 2017;4(4);168-171 168
M. Shanmuga Priyan et al. Self-medication practices among residents of Puducherry…

sampling, responses were collected from the residents of self-medication by the respondents ranged from once
living in the area serviced by the selected Primary (70 respondents, 31.3%) to more than 5 times (25
health centre. respondents, 11.1%) in the past six months recall
period. There was a statistically significant association
Sample size between occupation and self-medication (p<0.001),
The sample size 400 was calculated as follows: whereas no significant association was found between
Required sample size = 4pq/L2where p is taken as income and education status of the participant to self-
prevalence of self-medication, p=71%(8), q= (100-71) medication (p>0.05) (Table –1). The common
=29%, L=allowable error as 7.5% of p=5.32 symptoms for which the respondents self-medicated
Sample size thus calculated was 291 and anticipating were headache and fever (60.2 and 42.0% respectively)
non-response, incomplete data collection, the sample (Table-2). Out of 226 self-medicated participants, the
size has been kept at 400. most common drugs consumed by self-medication were
Inclusion criteria NSAIDs (63.71%) in which paracetamol contributed to
1. > 18 yrs. of age 43.36% followed by antihistaminics (28.31%) (Figure-
2. Both Male and Female. 1). The various other NSAIDs consumed by self-
3. Willingness to participate in the study medication were diclofenac, aceclofenac, ibuprofen,
Exclusion criteria mefenamic acid. Some of the Fixed Drug Combinations
1. Psychiatric patients used by self-medications are Action-500, anacin,
2. <18 yrs. of age metacin, saridon, combiflam. Private pharmacy
3. Not willing to participate in the study 203(89.8%) was the major source of drugs for self-
4. Very sick and bed ridden patients medication followed by left over drugs in the home
12(5.3%).
Data collection When questioned about the reasons for self-
A pretested validated questionnaire was used for medication, disease was simple was the response given
data collection after obtaining written informed consent by 66.4% of the self-medicated individuals. (Figure-2)
from the participants. The respondents were Other reasons given by the respondents were lack of
interviewed in the local language (Tamil). trust in medical services and urgent need of drugs.
Demographic details of the participants, their response Majority of the respondents, self-medicated by their
on self-medication practices on allopathic and alternate own initiative (53.5%)(Table-3). Out of 226 self-
system of medicine, commonly self-medicated drugs, medicated respondents, 27(11.9%) said they
reasons, purpose and source of initiation for self- experienced side effect with self-medicated drugs.
medication, awareness on ADR and expiry date of Awareness on side effects of self-administered drug
pharmaceutical preparations, incidence of adverse was present only among 122(53.98%) participants.
effect associated with self-medication were recorded. Alternate system of medicine was used by 55(24.3%)
The respondents were advised to provide single or respondents who were self-medicated. Among the 55
multiple responses (if more than one option is right). respondents using alternate system of medicine,
13(5.8%) were aware of drug interaction between
Statistical analysis alternate and allopathic drugs when co-administered.
The collected data were entered in MS Excel Pharmaceutical expiry date was always checked by
master sheet and analyzed using SPSS Version 20.0. 197(87.2%) of the respondents, 24(10.6%) respondents
The descriptive statistics for categorical variables were never checked the expiry date while 5(2.2%)
explained in the form of percentages and proportions respondents at times checked the expiry date.
whereas; mean and standard deviation were used for
continuous variables. Inferential statistics using chi- Discussion
square test was applied to find any significant The study was conducted in Puducherry to estimate
association for categorical variables and p<0.05 was the prevalence and the factors that influence the pattern
considered as significant. of self-medication. Self-medication was practiced by
59.5% of individuals in the past six months recall
Results period. This was similar to the study conducted in
Responses were obtained from 380 participants. The North India and Nepal with the prevalence rate of 62%
mean age of the respondents was 38±14 yrs. Among the and 59% respectively. (9,10) But contradicts the finding
respondents 131(34.5%) were males and 249(65.5%) in the study done in coastal regions of South India
were females. Percentage of married and unmarried where the prevalence rate was 71%.(8) The study result
respondents were 292(76.8%) and 88(23.2%) had shown a higher percentage of self-medication
respectively. Out of 380 participants, 226 (59.5%) self- practice was among females than males. It was similar
medicated themselves with allopathic drugs. The mean to the study done in coastal regions of South India and
age of the self-medicated respondents was 36.4±11.7 Spain but contradicts the finding in the study done in
yrs. Male and female self-medicated respondents were North India. (8,11,9) This may be because females suffer
64(48.8%) and 162(65.1%) respectively. The frequency

Indian Journal of Pharmacy and Pharmacology, October-December 2017;4(4);168-171 169

M. Shanmuga Priyan et al. Self-medication practices among residents of Puducherry…

from many acute and chronic conditions than men and respondents checked the expiry date of
this has led to more drug use.(12) Pharmaceuticals. Though Pharmaceutical laws are strict
Regarding self-medication frequency, 31.3% self- regarding the sale of expired products, it is the
medicated once and 11.1% self-medicated more than consumer responsibility to check for the expiry date at
five times in the past six months recall period. The the time of purchase. The practice was appreciably
findings were different when compared to the study good in the population surveyed.
done in coastal regions of South India in which 60% of Risks associated with self-medication are
the respondents self-medicated once.(8) Self-medication inaccurate diagnosis, inappropriate medication that
practice was high among non-skilled workers than causes side effects, masking of serious condition
students, skilled workers and retired persons. The symptoms, inaccurate dosing and sometimes accidental
predominance may be due to lack of knowledge and overdose, risk of abuse and risk of developing
awareness on side effects and other complications addiction.(19) It is high time, awareness should be
associated with self-medicated drugs. There was a created on ill effects of self-medication among general
higher percentage of self-medication practices among public. Sensitization program should be conducted to
literate respondents who have completed high- private pharmacy firms regarding the medicines that
schooling than illiterates. This finding is not at par with can be sold as over the counter and prescription
another study in which self-medication practices was medicines. Hence life-threatening complications arising
higher among illiterates.(13) Literates consider the illness because of self-medication can be reduced. Urban and
as simple and most of the time self-medicate rural health centers can disseminate the information on
themselves to avoid unnecessary hospital expenses. ill effects of self-medication through health nurses to
Based on income, middle class family self-medicate the households in the area to which they are allocated.
more when compared to other income groups which Strict laws should be enforced to completely stop the
was similar to the observations from a study done in OTC sale of prescription only medicines.
china.(14)
Headache, fever, cough and flu are the most Table 1: Sociodemographic characteristics
common reasons for self-medication among S. Parameter SM, Yes SM, No X2 P value
No n (%) n (%)
participants. Similar observations were also made in
other studies.(10,13) NSAIDs was the most common drug 1. Occupation 21.02 0.0001*
consumed by self-medication which was at par with 1.a.
Non-skilled 107(47.3) 77(50)
other studies.(9,15) The disadvantage with NSAIDs were 1.b.
Skilled 93(41.2) 43(27.9)
improper use may cause gastritis and nephrotoxicity. 1.c.
Retired 1(0.4) 13(8.4)
Consumption of antibiotics by self-medication was also 1.d. Student 25(11.1) 21(13.6)
high in our observation. Irrational use of antibiotics 2. Education 4.891 0.299≠
2.a.
may result in increased incidence of bacterial Illiterate 10(4.4) 14(9.1)
2.b. Primary
resistance. schooling 17(7.5) 9(5.8)
Our study also focused on side effects associated 2.c.
High school 85(37.6) 50(32.5)
with self-medication and co-administration of alternate 2.d.
Graduate 95(42.0) 64(41.6)
system of medicine with allopathic drugs. The later was 2.e.
Post graduate 19(8.4) 17(11.0)
followed by 24.3% of respondents which was high 3. Annual 6.805 0.078≠
when compared to the study done by Ahmad, et.al., in Income
which there was a practice of 12%.(9)Though alternate 3.a. <10000 80(35.4) 55(35.7)
3.b. 10,000-
system of medicine is mainly used for chronic ailments 30,000 99(43.8) 70(45.5)
and considered less toxic, risk of drug interaction may 3.c. 30,000-
be present with co-administration of allopathic drugs.(16) 60,000 12(5.3) 19(12.3)
3.d.
Forty-two respondents using alternate system of >60,000 8(3.5) 2(1.3)
3.e.
medicine were unaware of the drug interaction between Students 27(11.9) 8(5.2)
Total 226(100) 154(100)
co-administration of allopathic and alternate system of
medicine. Nearly 46.1% of the respondents were *- P<0.001-Significant, ≠- P>0.01 – Not significant
unaware of the side effects associated with self-
medication and 11.9% of the self-medicated individuals Table 2: Illness for which self-medicated
S. No Illness for which self-medicated n %
experienced side effects. The incidence was lower than
(17)
the study done in France which was 17.6%. 1. Cough, cold, flu 92 40.7
Awareness on side effects due to improper use of 2. Fever 95 42
medications should be created among general public to 3. Throat pain 15 6.6
4. Headache 136 60.2
prevent untoward occurrences. 5. Diarrhoea 7 3.09
Similar to various studies done on self-medication 6. Others (conjunctivitis, asthma, 70 31
practices, the source of drug was private pharmacy and constipation, ear ache, gastritis,
the participants self-medicated because of the simpler myalgia, motion sickness)
nature of the illness.(9,18) Awareness of public on expiry
date of Pharmaceuticals revealed 87.2% of the
Indian Journal of Pharmacy and Pharmacology, October-December 2017;4(4);168-171 170
M. Shanmuga Priyan et al. Self-medication practices among residents of Puducherry…

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