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      Predictors of Self-Medication Behavior: A Systematic Review

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          Abstract

          Background

          Self-medication with over the counter (OTC) and non OTC drugs may provoke serious consequences for users and societies. Recognition of its predictors therefore, is pivotal in plans to hinder the aggregating behavior. This study aimed to identify possibly all predictors of self-medication and the range of its prevalence among different populations.

          Methods

          Medline, Amed, Scopus, Medlib, SID, Pub Med, Science Direct, and super searcher of Google Scholar were scrutinized using “self-medication”, “self-prescription” and “self-treatment” key words without a time limit with special focus on Iranian studies. Authors independently assessed the title, abstract and full text of identified articles for inclusion and any disagreement was resolved with consensus.

          Results

          The range of reported self-medication in the 70 included publications was 8.5-98.0%. Having a minor illness (15 studies), health care costs (9 studies), lack of adequate time to visit a physician (11 studies), prior experience (7 studies) in using a drug and long waiting time to visit a qualified practitioner (5 studies) were most frequently reported reasons of self-medication.

          Conclusion

          The observed diversity in the reported prevalence and reasons of self-medication among different sub-groups of populations (e.g. males vs. females) and between developed and developing countries highlights the importance of explanatory behavioral chain analysis of self-medication in different population groups and countries. Even within a single country, predictors of this harmful practice could be inconsistent. Lack of sufficient quality re-search to identify precipitating factors of self-medication in developing countries is paramount.

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          Most cited references34

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          Risks of self-medication practices.

          Maria Ruiz (2010)
          Self-medication is defined as the selection and use of medicines by individuals (or a member of the individuals' family) to treat self-recognized or self-diagnosed conditions or symptoms. Several benefits have been linked to appropriate self-medication, among them: increased access to medication and relief for the patient, the active role of the patient in his or her own health care, better use of physicians and pharmacists skills and reduced (or at least optimized) burden of governments due to health expenditure linked to the treatment of minor health conditions However, self-medication is far from being a completely safe practice, in particular in the case of non-responsible self-medication. Potential risks of self-medication practices include: incorrect self-diagnosis, delays in seeking medical advice when needed, infrequent but severe adverse reactions, dangerous drug interactions, incorrect manner of administration, incorrect dosage, incorrect choice of therapy, masking of a severe disease and risk of dependence and abuse. In this short review the author analyzes recent literature on some of the most important dangers related to self-medication practices, particularly: polypharmacy and drug interactions, medications abuse or dependence, misdiagnosis and incorrect choice of treatment. The author also proposes measures that could be adopted in order to solve or improve these issues.
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            Self-medication among children and adolescents in Germany: results of the National Health Survey for Children and Adolescents (KiGGS).

            Despite the widespread use of self-medication among the child population and the potential harm it can do, up-to-date epidemiological data on self-medication are sparse worldwide. The aim was to investigate the prevalence and correlates of self-medication use among non-institutionalized children in Germany, focusing on the paediatric self-medications that are most frequently used. All cases of last-week medicine use were recorded among 17 450 children aged 0-17 years who participated in the 2003-2006 German Health Interview and Examination Survey for Children and Adolescents. Self-medication was defined as the use of medicines that had either been bought over the counter or obtained from other sources (OS). The complex sample method was used to estimate the prevalence of, and factors associated with self-medication use. During the previous week 25.2% of participants had used self-medication (17.0% used over-the-counter drugs and 9.9% other-sources drugs). Self-medication accounted for 38.5% of total medicine use and included all medication classes. These clustered among drugs acting on the respiratory system (32.1%), alimentary tract and metabolism (21.6%), skin (14.2%) and nervous system (11.3%), as well as homoeopathic preparations (8.6%). Vitamin preparations were most frequently used with a weighted user prevalence of 4.7% (5.2% vs. 4.1%, P 0.05) and analgesics 3.7% (3.0% vs. 4.4%, P < 0.001, both boys vs. girls). Overall use of aspirin among children <12 years old was 0.3%; use of CCMs was substantial (4.4%), particularly among children <6 years old. Use of self-medication was closely related to older adolescent ages of between 14 and 17 years (odds ratio 1.16; 95% confidence interval 1.00, 1.33), children with a poor health status (1.29; 1.10, 1.52), with no immigration background (1.55; 1.33, 1.80), from families with a higher household income (1.23; 1.06, 1.42) and with mothers with a higher educational level (1.37; 1.19, 1.57). Self-medication use is highly prevalent in Germany, particularly among children and adolescents from families with a higher socioeconomic status. Self-medication in younger children using such drugs as CCMs and aspirin suggested inappropriate drug use and potential risks. This should be closely monitored and warrants an education programme for parents in Germany.
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              A descriptive study of self-medication practices among Palestinian medical and nonmedical university students.

              The implications of self-medication practices are increasingly recognized around the world; however, little has been reported on the extent of self-medication practiced in Palestine. To determine the reasons, extent, and correlates of self-medication practices among university students in Palestine. A self-administered questionnaire eliciting self-medication practices was distributed to university students in a cross-sectional design. The 4 variables, sex, type of school, self-care orientation, and medication knowledge, were investigated for possible correlation with self-medication practices. Multiple logistic regression and Chi-square statistics were used in data analysis. Self-medication practices were reported by 98% of the surveyed students (n=1581). Approximately two thirds of the respondents reported a high self-care orientation and one third reported "good" medication knowledge. Multiple logistic regressions indicted that self-care orientation, medication knowledge, and sex were insignificant predictors of self-medication practices, whereas the type of school (P=.012) was a significant predictor. A significant relation between the 4 variables and the type of therapeutic class used in self-medication was observed. For example, males were more inclined to use antiallergic medications (OR=1.48) than females. Medical students were more likely to use laxatives/antidiarrheal agents (OR=1.49) than nonmedical students. Respondents with high a self-care orientation were more inclined to use headache relievers (OR=2.22) compared to those with low self-care orientation. The most commonly reported reason for self-medication practices was simplicity of the illness encountered. Self-medication practices were common among the university students studied. Sex, type of school, self-care orientation, and medication knowledge are important personal factors that are associated with the selection of certain types of therapeutic classes used in self-medication.
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                Author and article information

                Journal
                Iran J Public Health
                Iran. J. Public Health
                IJPH
                Iranian Journal of Public Health
                Tehran University of Medical Sciences
                2251-6085
                2251-6093
                February 2014
                : 43
                : 2
                : 136-146
                Affiliations
                [1]Health Education & Promotion Department, Faculty of Health, Tabriz University of Medical Sciences , Tabriz, Iran
                Author notes
                * Corresponding Author: Email: shaghaghir@ 123456tbzmed.ac.ir
                Article
                IJPH-43-136
                4450680
                26060736
                36367e65-51d2-4679-85fa-e62cd43c723c
                Copyright © Iranian Public Health Association & Tehran University of Medical Sciences

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : 05 August 2013
                : 14 December 2013
                Categories
                Review Article

                Public health
                self-medication,self-prescription,self-treatment,predictors,risk factors
                Public health
                self-medication, self-prescription, self-treatment, predictors, risk factors

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