Abstract:

Pharmacy students are expected to be more knowledgeable regarding rational use of medications as compared to the general public. A cross-sectional study was conducted among students of pharmacy in university of uyo, Nigeria using a survey questionnaire. The duration of the study was six months. The aim was to report self-medication prevalence of prescription and non-prescription drugs among pharmacy and medical students. The prevalence of self-medication in the pharmacy college was reported at 19.61%. The prevalence of multivitamin use was reported at 30.53%, analgesics; 72.35%, antihistamines; 39.16%, and antibiotic use at 16.59%. The prevalence of anti-diarrheal medicines and antacids use among students was found to be 8.63% and 6.64%, respectively. The variable of college and study year was statistically associated with the nature of the medicines. The most common justifications given by students indulging in self-medication were ‘mild problems’ and ‘previous experience with medicines’. Our study reported that prevalence of self-medication in Pharmacy students was low, i.e., 19.61%. The figure has been reported for the first time. Students were mostly observed self-medicating with OTC drugs, however, some reported using corticosteroids and isotretenoin, which are quite dangerous if self-medicated. Students have a positive outlook towards pharmacists as drug information experts.

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CHAPTER ONE

INTRODUCTION AND LITERATURE REVIEW

Introduction

Self-medication is the medically unsolicited use of prescription and/or Over-The-Counter (OTC) drugs. The practice is becoming a form of self-care (Hughes et al., 2001) and is a global trend that is encouraged when it deals with minor illness (Porteouset al., 2005). According to Loyola et al. (2004), it involves acquiring medicines without prescription, resubmitting old prescription to purchase medicine, sharing medicines with relatives or members of one’s social circle or using leftover medicines stored at home. Although self-medication is widely practiced globally, it is more common in developing countries. Drugs that are prone to self-medication include analgesics, antimalarials, antibiotics and cough syrups, among others (Afolabi, 2000). Self-medication can potentially do well and also harm people. This is especially significant in those countries where prescription drugs are available over-the-counter due to lack of enforcement of regulations (Sontakkeet al., 2011).

Self-medication if practiced appropriately can help in the prevention and the treatment of signs and symptoms which do not require a doctor’s visit; it can also enable those patients with chronic conditions to take responsibility to control their own condition (Jain et al., 2011).  Also, rational self-care practice can decrease the pressure on the medical services, where health care personnel are inadequate (Jain et al., 2011). Furthermore, it can increase health awareness among people and allow them to build confidence and take charge to manage their own health (Hughes et al., 2011). However the practice of responsible self-medication for positive effects requires a certain level of knowledge about medications (Aljinovic-Vucicet al., 2005) as well as disease conditions. For an individual to self-medicate appropriately, WHO (2000) states that they must be able to accurately recognize symptoms, set therapeutic objectives, select appropriate medicine to be used for their medical condition, and determine appropriate dosage and dosage schedule taking into account his medical history, contraindication(s) and possible side effects of the medicine.

The increasingly high prevalence rates of self-medication may be due to socio economic factors, lifestyle, ready access to drugs, the increased potential to manage certain illnesses through self-care, and greater availability of medicinal products (World Health Organization, 1998).

The World Health Organization (1995) states that rational self-medication helps in the prevention and treatment of minor pathological conditions at an affordable cost. However, the practice is not without undesirable and sometimes serious drawbacks. In addition to the possibility of serious adverse effects, drug interactions, poly pharmacy, drug abuse and dependence, the emergence of resistant pathogens poses a problem when dealing with misuse of antibiotics.

An amplified risk of worsening of existing illness pathology as well as risk of interactions between prescription medicine and hidden active ingredients of OTC drugs are always present with self-medication (Choonaraet al., 1996). Improper practice of self-medication due to deficiency in knowledge can lead to side effects especially in physiological conditions like pregnancy and breastfeeding, and in special populations, such as children and the elderly (Shankar et al., 2002; Murray et al., 2003).

In developing countries, self-medication usually leads to inadequate drug utilization patterns and is especially worrysomer when it involves specific diseases (e.g. diarrhoea or the common cold) or prescription drugs such as antibiotics (Laporte, 1997).

Recent developments of the pharmaceutical companies contribute to a wide spread availability of OTC medicines (Hussain and Khanum, 2008).

James et al. (2006) reported numerous reasons for self-medication which include high cost of medical consultation, long hours of waiting at clinics, lack of time, social or family support, previous experience with the condition and its drug management and lack of nearby health facilities and unavailability of health professionals.

Statement of the Problem

The problem of self-medication among pharmacy and other health-related students is an issue of great concern. These populations of students, because of their access to knowledge of drugs and disease conditions, are usually inclined towards self-medication – treating ailments without professional supervision or advice.

Although self-medication is a useful tool to treat minor ailments, improper self-medication practice or medication abuse may lead to serious adverse drug reactions and possibly fatal consequences (Cicala, 2003). Despite the seriousness of the problem of self-prescription and its far reaching consequences, prevalence of this practice still remains high particularly in developing countries like Nigeria, where there is virtually unlimited access to most prescription drugs. Studies have shown that self-medication is practised widely among undergraduates generally (Eke et al., 2014; Osemene and Lamikanra, 2012; Klemenc-Ketiset al., 2010; Sawalha, 2008; Zafaret al., 2008;), and is especially common among Pharmacy undergraduates than Medical students (Bolluet al., 2014; Kumar et al., 2013; Gutemaet al., 2011).

Knowledge of medicines has been shown to influence self-medication (Klemenc-Ketiset al, 2010; Sawalha, 2008; James et al, 2006), although reports from Autaet al. (2012a) contradicts this observation. Gutemaet al.(2011) in their study showed that Pharmacy students practiced self-medication more frequently than Medical and other paramedical students, probably as a result of the compositional differences in drug-related courses taken by the different disciplines of Health Sciences. This, according to the researchers, predisposes Pharmacy students to deeper knowledge of medicines and hence more practice of self-medications as compared to Medical and other Health Sciences students (Gutemaet al., 2011). However, information on self-medication among pharmacy students in Nigeria is sparse. This study therefore sought to assess the prevalence of self-medication among undergraduate students of Pharmacy of the University of Uyo, determine factors that might predispose to this practice, as well as assess the students’ attitude towards self-medication.

Objectives and Aims of Study

The main objective of this study was to assess the prevalence of self-medication practice among undergraduate Pharmacy students of the University of Uyo, Akwa Ibom State. Specifically, this study sought to:

1.     Report self-medication prevalence of prescription and non-prescription drugs among pharmacy students

2.     Assess students’ perception and attitude towards self-medication practice;

3.     Identify common illnesses that prompt self-medication among pharmacy students;

4.     Identify classes of drugs used to self-medicate among the students;

Significance of Study

Pharmacy students possess some level of drug knowledge and may tend to utilize it towards self-medication. However, information on self-medication among this population is lacking. Depending on the results obtained from this study, therefore, adequate education and information on responsible self-medication, if necessary, can be conveyed effectively once the study objectives are accomplished.

Furthermore, issues of medication abuse and misuse can be assessed and necessary measures put in place to curb such issues which can arise from inappropriate self-medication among pharmacy students and indeed students of other disciplines. Since these students who are mostly young and single, will eventually graduate and become parents, proper education and understanding of the concept of self-medication would ultimately lead to a well-informed society with a consequent reduction in inappropriate medicines use and its attendant risks.

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