ASSESSING THE KNOWLEDGE, ATTITUDE, AND PRACTICES OF SELF-MEDICATION AMONG ADULTS OF 25-60 YEARS

CHAPTER ONE
INTRODUCTION

This chapter presents the background of the study, statement of the problem, general and specific objectives, research questions, significance of the study, scope of study and operational definitions.

1.1 Background of the study

Since time immemorial, people depend on local practitioners, traditional physicians or dais to acquire medicines, but with the advanced technology, vast knowledge being freely available and easy accessibility, there is a growing concept of self-medication (Balamurugan and Ganesh, 2011). WHO defines self-medication as the use of medication by a patient on his own initiative or on the advice of a pharmacist or a lay person instead of consulting a medical practitioner? It involves acquiring medicines without a prescription, resubmitting old prescriptions to purchase medicines, sharing medicines with relatives or members of one’s own social circle or using leftover medicines stored at home (Porteouset al., 2005).

According to ShaliniS. Lynch 2019, at one time drugs were available without prescription. Before food and drugs administration (FDA) existed just about anything could be put in bottle and sold as sure fire cure. Alcohol, Cocaine, Marijuana and Opium were included in some over the counter (OTC)products without notification to users.

The food, drugs and cosmetics (FD&CT) act, enacted in 1938, gave the FDA some authorities to issue regulation, but the act did not provide clear guidelines as to which drugs could be sold by prescriptions only and which could be sold over the counter.

An amendment to the FD&C acts in 1951 attempted to clarify the difference between OTC and prescriptions drugs and to deals with issues of drugs safety. Prescription drugs were defined as compounds that could be habit forming, toxic or unsafe for use except under a doctor supervision anything else could be sold over the counter.

As noted by an amendment to the FD&C act of 1962, OTC drugs were required to be both effective and safe. However, determining effectiveness and safety can be difficult. What is effective for one person might not be for another and any drugs might cause unwanted effects (also called adverse effects) of OTC drugs until 2007 when a new law became effective reports serious adverse events associated with OTC drugs.

Medicines available for self-medication are often called nonprescription or over the counter drugs (OTC) which are available without prescription in pharmacies (Loyola, 2004). Self- medication with OTC drugs following knowledge regarding the indication of drug, dosage, adverse effect, interactions, precautions, duration of use and when to seek professional advice is termed as responsible self-medication.

In developing countries like India, not only OTC drugs, but even prescription drugs are easily accessible without prescription in pharmacy outlets (Pereira et al,2008). These practices make irrational use of medicines which promotes unwanted effects such as adverse drug reactions, resistance to pathogens, drug interactions, wastage of resources, delay in seeking professional

advice and increased morbidity (Hansen et al., 2006). Under dosage of self-medicated drugs may not treat the symptoms completely & over dosage may cause collateral damage to other organs.

Many studies have established that the practice of self-medication is rampant in most communities (Ali et al., 2016). This may be due to accessibility and basic knowledge regarding medicines, which may favour self-medication practices. Also, the youth are vastly influenced by the technology and can get information about most drugs from pompous advertisements as well as have access to them through websites, resulting in the hazards of irrational self-medication practices (Venkataraman et al., 2017).

4.4: Measures to eradicate the practice of self-medication           

Study Shows that 68 respondents consider the prevention of the supply of drugs without prescription as a measure to eradicate the practice of self-medication making 25%, 40 respondents consider enforcing strict rules regarding the misleading advertisement as a measure to eradicate the practice of self-medication making 14.7%, 25 respondents consider the availability of health care as a measure to eradicate the practice of self-medication making 9.2%.,  34 respondents consider making health facilities easily available as a measure to eradicate  self- medication making12.5%, 66 respondents consider subsidizing the prices  of drugs as another measure to eradicate the practice of self-medication making 24.3%, 6 respondents consider government policy as a measure of eradicating self-medication making 2.2%, 33 respondents consider the holding of seminars as a measure to eradicate  the use of self-medication making  12.1%

Therefore, the highest number of despondence consider preventing the supply of drugs without prescription as a measure to eradicate the practice of self-medication. This is shown on the table above.

In Pakistan, over-the-counter medications are easily accessible to everyone without a prescription, a phenomenon seen in many economically deprived countries (Chang et al., 2003). Over the years, implications of self-medication especially with antibiotics have gained increasing recognition globally and likewise in Pakistan (Nalini, 2010).

In Pakistan, few studies have investigated the phenomenon of self-medication. Very few surveys carried out to assess antibiotic self-medication practices in Pakistan reported prevalence as high as 35.2%-42% among students and between 6.3 to 51.3% in (Zafaret et al., 2008). The available studies did not include Pakistani students abroad, who differed from the general population and students in Pakistan in many aspects. Being abroad, they expose to different conditions related to health and diseases and different health care system, so they might be expected to behave differently.

Relatively fewer studies have been conducted in low income countries such as Cameroon. A study conducted in Yaounde, Cameroon by Ngambouk. (2020) revealed that most chemist supply a variety of medicines for self-medication. To participants, it helps them break the hegemony of professionals and enable people to help themselves. As a vehicle of individualization, medicines empower individuals by providing them with the means to solve their problems without the knowledge, social control and interference of experts (Van, 2005). This implies that community knowledge and personal experience are often the basis of popular medical knowledge, rather than professional consultation or formal training, and that most people treat most minor ailments by themselves (Porten et al., 2009).

Hence, the pattern of this practice in the Muea community largely remains uncharted and unaccounted for. With this objective, the present cross-sectional study was done to assess the knowledge, attitude, and practices towards self-medication practices among the inhabitants of the community.

1.2 Problem Statement

There has been increasing complaints on adverse effects of drugs taken by patients without the approval of medical practitioners. This results from the high number of drug sellers in remote areas who do not have medical training, low government regulation of the drug commercialization sector, high cost of hospital bills as well as inherent drive towards low-cost medications.

Despite the beneficial effects of over-the-counter medications from mild illness, it might be risky in that the health consequences of this practice are numerous depending on the type of medications and varying sensitivity of each individual to them.

For example, some of the repercussions of one health stemming from this practice include increased resistance to certain types of medications and decreased efficacy of treatment due to improper use, delay of proper diagnosis, severe medications side effects, toxicity, dangerous drugs interaction, drugs dependency, hypersensitivity to certain drugs, resistance to withdrawal symptoms, such as drugs over dose or extreme dependence (Bennadi et al (2014). Therefore I was triggered to assess the knowledge, attitude and practice of over the counter medication in Muea community

1.3 Objectives Of The Study

1.3.1 General Objective

To assess the knowledge, attitude and practices of self-medication among adult of 25-60 years in Muea community.

1.3.2 Specific Objectives

1. To assess the knowledge of self-medication among adults of 25-60 years in the Muea community.
2. To assess the attitude of adults 25-60 years in the Muea community towards self-medication.
3. To determine different measures to eradicate the use of self-medication among adults of 25-60 years in the Muea community