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EVALUATION OF SELF-MEDICATION AMONG PHARMACY STUDENTS

Article  in  American Journal of Pharmacology and Toxicology · April 2012

DOI: 10.3844/ajptsp.2012.135.140

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American Journal of Pharmacology and Toxicology, 2012, 7 (4), 135-140
ISSN: 1557-4962
©2012 Science Publication
doi:10.3844/ajptsp.2012.135.140 Published Online 7 (4) 2012 (http://www.thescipub.com/ajpt.toc)

EVALUATION OF SELF-MEDICATION
AMONG PHARMACY STUDENTS
Suleiman Ibrahim Sharif,
Osama Hussein Mohamed Ibrahim, Laila Mouslli and Riham Waisi
Department of Pharmacy Practice and Pharmacotherapeutics,
College of Pharmacy, University of Sharjah, 27272, United Arab Emirates, Sharjah

Received 2012-12-01, Revised 2012-12-05; Accepted 2012-12-15

ABSTRACT
To determine the incidence of self-medication among Sharjah university students and the impact of medical
knowledge on such practice. A pre-validated questionnaire was distributed to 200 pharmacy students during
May, 2012. Data were analyzed using SPSS and results expressed as counts and percentages. The overall
response rate was 85% with 98% of respondents being Arabs. Females comprised about 91% of students
and the mean age (SD) was 19.5(2.4). Practicing self-medication in the past year was high as145 (86%)
used drugs without medical consultation. Most respondents (128, 76%) obtained their medication from
pharmacies and used the medication for one week (106, 63%). Antibiotics were used by 54(32%) of
students despite the fact that slightly more than 50% of students were aware of the possibility of emergence
of bacterial resistance and were also aware of the concept of rational drug use in general. Main reasons for
self-medication were non-serious health problem, illness is minor, seeking quick relief and to avoid long
waiting hours at clinics. Reasons against self-medication include risks of adverse effects, using the wrong
medication, drug interaction, misdiagnosis and drug abuse and dependence. Medical consultation is mainly
sought in case of presence of severe pain, worsening of symptoms, or persistence of the latter for more than
a week. Headache or mild pain, eye and ear symptoms, gastric problems, cold, fever and allergy were the
commonest symptoms for self-medication. Knowledge of responsible self medication is inadequate but the
practice is high and common among pharmacy students. Interventions to promote responsible self-
medication among university students are required.

Keywords: United Arab Emirates, Pharmacy Students, Self-Medication

1. INTRODUCTION Therefore responsible self-medication can be defined as

the appropriate use of OTC drugs to conditions for which
Self medication is the medically unsolicited use of they are necessary (Annonymus, 2007), a practice that
prescription and/or Over-The Counter (OTC) drugs. The requires a certain level of knowledge by those who use
practice is becoming a form of self care (Hughes et al., such drugs (Aljinovic-Vucic et al., 2005). The WHO
2001) and is a global trend that is encouraged when it (1995) stressed that rational self medication helps in the
deals with minor illness (Porteous et al., 2005). Self- prevention and treatment of minor pathological
medication is not restricted to OTC drugs, it also conditions at an affordable cost. However, the practice is
encompasses use of prescription drugs like antibiotics not without undesirable and sometimes serious
(Abasaeed et al., 2009; Sarhroodi et al., 2010). drawbacks. As in addition to the possibility of serious
Particularly in countries where there are no strict adverse effects, drug interactions, poly pharmacy and
regulations and prescription drugs are freely dispensed. drug abuse and dependence, the emergence of resistant
Corresponding Author: Suleiman Ibrahim Sharif, Department of Pharmacy Practice and Pharmacotherapeutics,
College of Pharmacy, University of Sharjah, 27272, United Arab Emirates, Sharjah

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 Suleiman Ibrahim Sharif et al. / American Journal of Pharmacology and Toxicology 7 (4) (2012) 135-140

pathogens pose a problem when dealing with misuse of 3. RESULTS

antibiotics (Hughes et al., 2001; Sarhroodi et al., 2010).
James et al. (2006) reported numerous reasons for self The questionnaire was completed by 169 students
medication which include high cost of medical (response rate 85%). Ninety eight percent of the students
consultation, long hours of waiting at clinics, lack of were Arabs with 10% UAE nationals. The mean age ±
time, social or family support, previous experience with S.D. of the respondents was 19.5±2.4 (range 18-23). The
the condition and its drug management and lack of number of females (153, 91%) was far in excess of male
nearby health facilities and unavailability of health (16, 9%) students. Self-medication practice in the past
professionals. It has been frequently reported that in year, duration of use, source of medication and self-use
different populations, university students use self- of antibiotics are shown in Table 1. Large number of
medication very often (Sawalha, 2008; Zafar et al., 2008; students (145, 86%) practiced self-medication in the past
Klemenc-Ketis et al., 2010). Moreover, medical year and the majority (128, 76%) obtained their
knowledge has been shown to influence self-medication medications from pharmacies. About one third of
students used antibiotics for self-medication and slightly
(James et al., 2006; Sawalha, 2008; Klemenc-Ketis et al.,
more than 50% of students were aware of rational drug
2010). Self-medication among university students in the
use and the possibility of development of bacterial
United Arab Emirates has not, to our knowledge, been resistance associated with misuse of antibiotics.
previously explored. The present study was undertaken Responses on reasons for self-medication are shown in
to evaluate self-medication practice among students of Table 2. These include health problem is not serious, illness
the Sharjah-pharmacy students and assess the impact of is minor, seeking quick relief and avoidance of long waiting
knowledge about drugs and diseases on such practice. at clinics. On the other hand, reasons against self-
medication focused on risks of adverse effects, use of
2. MATERIALS AND METHODS wrong medication, drug interaction, misdiagnosis of
condition and drug abuse and dependence.
This anonymous questionnaire-based study was
carried out during May, 2012, using a pre-validated Table 1. Self- medication practice by pharmacy students in the
questionnaire consisting of both open-ended and closed- past year
ended item as modified from questionnaires used in other No. of
respondents Percentage
studies (James et al., 2006; Klemenc-Ketis et al., 2010). Did you use self-medication
The study was approved by the research and Ethics in the past year?
Committee of the Colleges of Medicine and Health Yes 145 86
Sciences, University of Sharjah, United Arab Emirates. How long the
treatment was used?
The questionnaire was first pre-validated on a sample of One week 106 63
12 students and it was in English. It was distributed to a Two weeks 21 12
One month 6 4
total of 200 students of third pharmacy at the University Longer than a month 10 8
of Sharjah. The use of prescription or OTC drugs without Where from you
medical consultation was considered self-medication and obtained self-medication?
Pharmacy 128 76
the questionnaire was explained to all students Street market 12 7
participating in the study. Students were asked to report Herbal store 13 8
self-medication in the past year. The questionnaire Relative/friend 21 12
Antibiotic obtained
contained questions covering demographic information as self-medication.
namely age, sex, nationality, college and year of study and Yes 54 32
questions focusing on self-medication. The latter included No 94 56
Duration of use.
self-medication practice, types of self-medications used, One week 42 25
duration of use, source of drugs, use of antibiotics, reasons Two weeks 15 9
for and against self-medication and reasons for seeking Awareness of
bacterial resistance.
medical consultation. The questions also addressed views Aware 89 53
of students on self-medication, health conditions requiring Not aware 80 47
self-medication and the medications used. Awareness of
rational drug use.
Descriptive statistics were calculated using SPSS Aware 90 53
program version 18. The data were summarized as Not aware 124 73
percentages and frequencies. Total number of respondents (n = 169)

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Table 2. Reasons for self-medication

No. of respondents Percentage
Health problem is not serious 122 72
Seeking quick relief 88 52
Personal convenience 48 28
Avoidance of long waiting at clinics 52 31
High cost of medical consultation 27 16
Suggestion of a relative/friend 26 15
Learning opportunity 10 6
Self need to play active role 15 9
Physician’s advice of self management 17 10
Physician prescription was not effective 7 4
I do not trust my physician 9 5
Illness is minor 88 52
Embarrassed of discussing own symptoms 11 7
Total number of respondents (n = 169)

Table 3. Reasons against self-medication and reasons for seeking professional help
No. of respondents Percentage
Reasons against self-medication
Risk of adverse effects 105 62
Risk of using wrong medication 104 62
Risk of misdiagnosis of illness 61 36
Risk of drug interaction 64 38
Risk of drug abuse and dependence 50 30
Reasons for seeking professional help
-Presence of severe pain 101 60
-Symptoms last for more than one week. 79 47
-Symptoms are worsening 103 61
-Thinking the problem is serious. 64 38
-Usual treatment is not effective. 42 25
-Side effects of usual treatment. 22 13
-In case of mental problem 10 6
Total number of respondents (n = 169)

Table 4. Student’s views on some aspects of self-medication

Approve Disapprove
No. of respondents (%)
-All medications (prescription,
OTC and herbal) have adverse effects. 70 (41) 65 (39)
-Concomitant use of drugs can be dangerous. 80 (47) 80 (47)
-Increasing drug dose can be dangerous. 124 (73) 36 (21)
-Decreasing drug dose can be dangerous. 47 (28) 53 (31)
-In case of adverse effects, physician help must be sought. 102 (60) 75 (44)
-Using medications with unknown 111 (66) 68 (40)
Substances in patients with liver and
kidney disease is dangerous.
-No drug can be used during pregnancy. 57 (34) 105 (62)
-Mild medical problems do not require drug treatment. 71 (42) 83 (49)
-Self-medication can mask signs and symptoms 80 (47) 64 (38)
of disease so the physician can over look them easily.
Total number of respondents (n = 169)

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Participants stated that they seek medical practice warrants in-depth further investigation as it
consultation if symptoms worsen or persist for more than could be traced back to misdiagnosis of condition or to
and in case of severe pain or thinking the problem is the use of the wrong medication. The main source for
serious (Table 3). Student’s views on some aspects of obtaining medicines was the pharmacy and only a few
self-medication are shown in Table 4. Symptoms for respondents obtained their medications from other
which self-medication was practiced include headache or sources including street market, herbal stores and
mild pain, eye and ear symptoms, gastric problems, cold, relatives or friends. This is in accordance with results of
fever and allergy. The most common types of self- earlier studies (James et al., 2006; Zafar et al., 2008;
medications used by participants include analgesics, Klemenc-Ketis et al., 2010). Alarmingly, about one third
(70%), antipyretic (67%), vitamins and minerals (67%), of the respondents obtained antibiotics for self-
herbal teas (40%), eye drops (33%) and ear drops (30%), medication without a prescription despite the fact that
anti-histamines (20%), nasal decongestants (20%), they were aware of the risk of development of bacterial
antacids (20%), laxatives (10%), anti-diarrheal(1%) and resistance. This is similar to the results reported for
anti-emetics (1%).
Jordanian (Sawair et al., 2009) and Iranian (Sarhroodi et al.,
2010) students. Such a trend is probably due to the fact
4. DISCUSSION that regardless of the strict regulations of health authorities
in UAE, antibiotics, like other most prescription drugs,
The majority of Sharjah-pharmacy students can still be obtained without a prescription.
participating in the present study were female Arabs who Results of the present study indicate that in agreement
have been exposed to courses on drugs and diseases. with previous studies (Sawalha, 2008; Zafar et al.,
Self-medication among students seems to be common 2008; Klemenc-Ketis et al., 2010; James et al., 2008;
practice for non serious health problems, to seek quick Ghosh et al., 2010), the main reasons for self-medication
relief and for minor illness. In the present study, include health problem being not serious, the illness is
prevalence of self-medication is rather high such minor, to get quick relief of the condition and to avoid
prevalence is reminiscent to the trend in Pakistani long waiting at clinics. Similarly, our results for reasons
(Mumtaz et al., 2009) but higher than that in Bahraini against self-medication were in agreement with those
(James et al., 2006) students. It is worth noting that reported for university students in other countries
Martins et al. (2002) reported prevalence rates as low as (James et al., 2006; Sontakke et al., 2011; Olayemi et al.,
26.2% in Portugal whereas higher rates (92%) were 2010). Risks of adverse effects and using wrong
observed by Abahusain et al. (2005) in Kuwait. It has medication were ranked as the main reasons deterring
been claimed that the incidence of self-medication is respondents from practicing self-medication while risks
dependent on how the question was constructed in the of misdiagnosing the condition, drug interaction and
questionnaire (Almasdy and Sharrif, 2011) where drug abuse and dependence were ranked second.
questioning current practice yield high rates (Sawalha, Surprisingly a large number (range 21-62%) of students
2008; Zafar et al., 2008; Klemenc-Ketis et al., 2010; disapproved the concepts that prescription and OTC
James et al., 2006; Verma et al., 2010; Ali et al., 2010) drugs and herbal preparation have adverse effects,
and questioning past practice yield low rates (James et al., decreasing or increasing the drug dose or concomitant
2006; Hussain and Khanum, 2008). Our results do not use of drugs may be dangerous, physician's help should
support such claims as our students were asked to report be sought in case of adverse effects, using medication
on past year self-medication practice and the incidence with unknown substance in presence of renal or liver
rate was markedly high reaching 86%. disease can be dangerous, minor problems may not
Abahusain et al. (2005) reported on differences in require drug treatment and self-medication may mask
self-medication between male and female high school symptoms of a disease. These responses by third year
students. Since in the present study 91% of the pharmacy students points at the need to stress on such
participants were females, no attempts were made to important aspects on the use of prescription drugs, OTC
study the gender-based differences, if any, on self- and herbal preparation in various relevant courses of
medication frequency. Most respondents used self- pharmacy practice and pharmacology. A very alarming
medication for one week; however, 8% of respondents observation is the use of antibiotics for self-medication
practiced self-medication for longer than a month. by one third of the participants despite their knowledge
Despite the fact that it is only reported by a small of the possibility of development of bacterial resistance.
number of respondents such a lengthy self-medication This issue requires more attention of both the academic

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and health authorities in attempts to increase awareness Almasdy, D. and A. Sharrif, 2011. Self-medication
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