Self-Medication (PSBH Project 2010)

2010

PROBLEM SOLVING FOR BETTER HEALTH

PROJECT REPORT

“PREVALENCE OF SELF‐MEDICATION IN GENERAL POPULATION”

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Taking this opportunity, we would like to thank everyone without whom we couldn’t have moved ahead in our project which is indeed the first step towards our coming closer to the community.

We would like to thank our project head, Dr. RAKESH SHAH and our facilitator Dr. V.MURUGAN, for not only the faith they had in us but also weaning us with their ideas and knowledge. We appreciate the support and encouragement they provided us during the entire course of our project.

We express our sincere thanks to Dr. D.V.BALA, Head of the Department, Department of Community Medicine, Smt. N.H.L. Municipal Medical College, who introduced us to the whole concept of PSBH, making our journey in this field more interesting and worthwhile as well as giving us an opportunity to work one as a TEAM!

We also thank all the staff members, especially the residents of the P.S.M. Department, for their help in making this project a successful one.

Finally, we take this opportunity to extend our deep appreciation to our family and friends, for their cooperation and help in the completion of our project.

Index

D Introduction

G Aims And Objectives

I Materials And Methods

L Review Of Literature

DL Methods Of Control & Awareness

EG Benefits Of Self Medication

EK Results And Observations

FL Conclusion

GE Bibliography

GG Questionnaire

INTRODUCTION

PSBH PROBLEM SOLVING FOR BETTER HEALTH

Self-Medication is medication of oneself especially

without the advice of a physician.

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Introduction

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Introduction WHAT I S SELF MEDICAT ION?

Self‐medication, the ability of the patient to administer his or her own medication, can be useful in the rehabilitation setting in reducing the incidence of poly‐pharmacy, medication abuse, and inappropriate medication usage.

Self‐Medication, according to the WEBSTER’s ENGLISH DICTIONARY, is medication of oneself especially without the advice of a physician. Use of non prescribing drugs without consultation of a physician is termed self‐treatment.

Self medication has always been a part of normal practice in human life from the ancient times. Such hollow practice is supposed to be a baseless and doubtful attitude. It has never been appreciated, for the fact that, it may induce severe effects on human body. There is a fundamental difference between medical prescribing and self‐medication. A qualified doctor is well trained about the symptoms and their causes, so he basically concentrates on symptoms as well as its causes. It would be difficult for an unqualified prescriber to investigate the basic causes. Essentiality must be given to the causes and secondly to the symptoms. Advertisement on Television, newspapers and other pharmaceutical publications have improved the rate of self‐medication. Self‐medication may treat the symptoms but not its causes. It may cause complexities if some internal disease is growing inside. It may be concluded that self‐medication or prescribing of an unqualified doctor can induce severe effects on human body.

It has been observed that a large number of people, when they fall sick, do not consult the physician. They either consult a chemist and

Introduction

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obtain a medicine from his self, or may consult a neighbor who may be having some tablets left over from his previous illness, and readily spares them. If you have a fever, cold, cough, constipation or indigestion, your friends or even total strangers volunteer advice on medicines to take like expert physicians. Almost everyone you meet has an excellent remedy for whatever ails you have. In short, this is what is meant to be self‐medication. May be most of the times nothing untoward happens on following such advice, but it can be dangerous.

AIMS AND OBJECTIVES


“I Keep Six Honest Serving Men; They Taught Me All

I Know. Their Names Are What, Why, When, How, Where And Who.”

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AIMS AND OBJECTIVES

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AIMS AND OBJECTIVES

1. To find out the prevalence of self medication in general population.

2. To find out the knowledge regarding dose & duration of drugs.

3. To find out the knowledge regarding side effects of the drugs consumed.

MATERIALS AND METHOD


“One Of The First Duties Of The Physician Is To Educate

The Masses When Not To Take Medicines.” -WILLIAM OSLER

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MATERIALS AND METHODS

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MATERIALS AND METHODS • Study Design: Cross‐Sectional.

• Subjects: 156 residents of Ahmedabad City.

• Inclusion Criteria: None

• Exclusion Criteria: Medical & Para‐medical workers.

RESOURCES • Manpower

o Volunteers: Five

o Teachers: Two

• Materials

MATERIALS AMOUNT COST (Rs.)

Pen 4 20

Printouts 50 50

Laptop 1 -

Photocopies 200 150

Travel Charges - 300

Final report 7 500

Total (approx) - 1030

MATTERIALS AND METHODS

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REVIEW OF LITERATURE


According To Paracelsus, The Alchemist-Physician Of The 16th

Century, “All Drugs Are Poisons.”

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e today are a crazy pill‐popping generation. It is rightly said that the desire to take medicines, is one feature that distinguishes man from animals. Recent advances in drug research have provided many synthetic medicines for the treatment of disease,

leading to a drug explosion. Today over 7000 drugs and drug combinations are available. Many of them have been released for general use, and are sold directly to the public as over‐the‐counter (OTC) remedies. A large number of potent drugs are thus available to the individual for self‐medication. There is an obvious difference between drugs and other commodities of life.

W

Paracelsus (1493‐1541), the alchemist‐physician, in the 16th century observed that all drugs are poisons. The availability of potent and dangerous drugs has increased considerably since the close of the 19th century. At the same time expanding availability of medical care, exposes a large population of people to drugs, leading to a greater number of toxic reactions. This situation is further worsened in our country by the slack implementation of Drug Control. Even certain prescription drugs are available to the lay person without the physician's advice. As people vary greatly in their sensitivity to drugs, an appropriate dose for one person can be an overdose for another. Even skilled physicians sometimes fail to avoid such reactions. Thus, the lay person is ill‐advised in subjecting himself to potentially dangerous self‐medication.

Proprietary drugs which are sold over‐the‐counter include pain relievers, cough remedies, anti‐allergic medicines, laxatives, vitamins, tonics, antacids and many others. Even dangerous drugs like the antibiotics and the hormones can be procured, somehow or the other, without a valid prescription. This is an entirely different facet of drugging. It is encouraging to note that stricter 'drug control' is being gradually clamped country‐wide.

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Self‐medication usually involves common drugs which are freely available. A study carried out in the United States showed that nearly 2 billion dollars per year were spent on such remedies. It is questionable whether the benefits outweigh the potential hazards. They account for poisonings, allergy, habituation, addiction, and other adverse reactions. Above all their use often delays proper treatment of the disease.

The most misused drugs are the analgesics or pain relievers. In fact, age old, ordinary aspirin is as effective and even safer than any of the modern analgesics like fenamates, oxicams, or Cox‐2 inhibitors like rofecoxib and celecoxib. A probable factor causing lavish prescribing and selling of such drugs is vigorous promotion gimmicks by pharmaceutical firms. Today it may even be difficult to obtain simple aspirin in the market. The physicians have apparently accepted the manufacturer's claims and recommend the "modern analgesics" despite their greater cost. Similarly cough remedies, anti‐allergic medicines, laxatives, vitamins, tonics, and antacids can lead to serious side effects. Even lavish use of vitamins, especially the fat‐soluble (A, D, E, &K) can cause problems. I am reminded of the great English philosopher‐physician Sir William Osler (1849‐1919) who said, "One of the first duties of the physician is to educate the masses when not to take medicines."

Another hazard is the availability of many irrational drug combinations in the market, which expose the individual to several drugs needlessly, each of which can cause adverse effects. Very few combinations have a legitimate place in modern medicine. Yet irrational combinations abound and are being used by some professionals.

Thus, to avoid or minimize the dangers of self‐medication, firstly, the lay person should be educated about the dangers of indiscriminate use of drugs. Secondly, the physicians should be more judicious in prescribing, and must insist on drugs being supplied by the chemist only on a valid prescription. Thirdly, a proper statutory "Drug Control" must be implemented, rationally


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restricting the availability of drugs to the public. These three measures would definitely reduce the incidence of drug‐related mishaps, and help in maintaining good health of the individual and society.

COMMON S IDE EFFECTS

1) ANTIBIOTICS

The Main Classes Of Antibiotics:

• Aminoglycosides

• Cephalosporins

• Fluoroquinolones

• Macrolides

• Penicillins

• Tetracyclines

Side effects:

The most common side effects from antibiotics are diarrhea, nausea, vomiting. Fungal infections of the mouth, digestive tract and vagina can also occur with Antibiotics because they destroy the protective 'good' bacteria in the body (which help prevent overgrowth of any one organism), as well as the 'bad' ones, responsible for the infection being treated.

Some people are allergic to antibiotics, particularly penicillin. Allergic reactions cause swelling of the face, itching and a skin rash and, in severe cases, breathing difficulties. Allergic reactions require prompt treatment. Children are more likely to suffer side effects such as diarrhea and


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abdominal pain from antibiotics. In some instances, using antibiotics for ear infections increase the likelihood of getting another ear infection.

2) STIMULANTS:

Amphetamines are commonly used by students. These medications are used to increase adrenalin.

They can be very helpful in increasing a person’s energy. But you may remember the saying “speed kills”.

Side effects:

Insomnia, Tourette’s syndrome (movement disorder consisting of grimaces, ticks, an involuntary outbursts), Nervousness, Mood Lability, Tachycardia, Hypertension, Tics, Headaches, Seizures.

3) ANTI HISTAMINICS:

Common side‐effects of anti‐histaminic drugs include Sleepiness, Dry mouth, Nausea, Headache, Fatigue and Sore throat.

4) OC PILLS:

Most common side effects of the birth control pills include nausea, headache, breast tenderness, weight gain, irregular bleeding, and mood changes. Scanty menstrual periods or breakthrough bleeding may occur, but are often temporary, and neither side effect is serious. Women with a history of migraines may notice an increase in migraine frequency. Contribute to increased blood pressure, blood clots, heart attack, and stroke.

http://www.medicinenet.com/script/main/art.asp?articlekey=378





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5) ANTI DIARRHEAL:

The Common Side effects Of Anti‐Diarrheal Drugs Include Severe allergic reactions, Rash, Hives, Itching, Difficulty breathing, Tightness in the chest, Swelling of the mouth, face, lips, or tongue, Constipation, Decreased urination, Red, swollen, blistered, or peeling skin, Stomach bloating, swelling, or pain

6) ANTACIDS:

They raise the risk of bone fracture, especially when used for a year or more or at high dose. Increase risk of infection with C.Difficile, a bacterium that can cause severe diarrhea. Those who experience side effects most commonly suffer from changes in bowel functions, such as diarrhea, constipation, or flatulence. Other more serious side effects include stomach or intestinal bleeding.

7) COUGH SYRUPS:

Common side‐effects include Confusion, impaired judgment, dizziness, slurred speech, nausea, vomiting, abdominal pain, irregular heartbeat, high blood pressure, dry and itchy skin and seizures.

8) CONSTIPATION DRUGS:

They lead to stomach ache, cramping, weakness, sweating, irritation of the rectal area, diarrhea.

9) ANTI EMETICS:

They lead to sedation, apnea, blood pressure, nausea, pyrexia, restlessness, stridor, wheezing.


http://sideeffects101.com/drug-side-effects/d/domperidone-apnoea.htm

http://sideeffects101.com/drug-side-effects/d/domperidone-blood-pressure-decreased.htm

http://sideeffects101.com/drug-side-effects/d/domperidone-nausea.htm

http://sideeffects101.com/drug-side-effects/d/domperidone-pyrexia.htm

http://sideeffects101.com/drug-side-effects/d/domperidone-restlessness.htm

http://sideeffects101.com/drug-side-effects/d/domperidone-stridor.htm

http://sideeffects101.com/drug-side-effects/d/domperidone-wheezing.htm


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LAWS FOR PREVENTION OF SELF MEDICATION 1 . THE DRUGS AND COSMET ICS ACT , 1940

‐This Act may be called the Drug Act, 1940

‐ It deals with prohibition of manufacture and sale of certain drugs and cosmetics

‐Any drug which by means of any statement design or device accompanying it or by any other means, purports or claims to prevent or cure any such disease or ailment, or to have any such other effect as may be prescribed

‐Any cosmetic containing any ingredient, which may render it unsafe or harmful for use under the directions, indicated or recommended;

‐Sell or stock or exhibit or offer for sale,] or distribute any drug which has been imported or manufactured in contravention of any of the provisions of this Act or any rule made there under,

‐Any drug which is not of a standard quality, or is misbranded, adulterated or spurious;

‐Penalty for manufacture, sale, etc., of drugs

a) any drug deemed to be adulterated or spurious under or which when used by any person for or in the diagnosis, treatment, mitigation, or prevention of any disease or disorder is likely to cause his death or is likely to cause such harm on his body as would amount to grievous hurt within the meaning of section 320 of the Indian Penal Code solely on


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account of such drug being adulterated or spurious or not of standard quality, as the case may be, shall be punishable with imprisonment for a term which shall not be less than five years but which may extend to a term of life and with fine which shall not be less than ten thousand rupees ;

b) Any drug —

(i) Deemed to be adulterated under, but not being a drug referred to in clause (a), or

(ii) without a valid license as required under clause , shall be punishable with imprisonment for a term which shall not be less than one year but which may extend to three years and with fine which shall not be less than five thousand rupees :

Provided that the Court may, for any adequate and special reasons to be recorded in the judgment, impose a sentence of imprisonment for a term of less than one year and of fine of less than five thousand rupees:

(c) Any drug deemed to be spurious under, but not being a drug referred to in clause (a) shall be punishable with imprisonment for a term which shall not be less than three years but which may extend to five years and with fine which shall not be less than five thousand rupees:

Provided that the Court may, for any adequate and special reasons, to be recorded in the judgment, impose a sentence of imprisonment for a term of less than three years but not less than one year,

(d) any drug, other than a drug referred to in clause (a) or clause (b) or clause (c), in contravention of any other provision of this Chapter or any rule made there under, shall be punishable with imprisonment for a term which shall not be less than one year but which may extend to two years and with fine :


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Provided that the Court may for any adequate and special reasons to be recorded in the judgment impose a sentence of imprisonment for a term of less than one year.

2 . THE PHARMACY ACT , 1948

3 . THE NARCOT IC DRUGS & PSCHYCOTROPIC ACT , 1985

4 . THE DRUGS AND MAGIC REMEDIES (OBJECT IONABLE ADVERT ISEMENTS ) ACT , 1955

• An Act to control, the advertisement of drugs in certain cases, to prohibit the advertisement for certain purpose of remedies alleged to possess magic qualities and to provide for matters connected therewith. • The Act defines drugs and registered medical practitioners besides defining magic remedy. According to Act the Magic remedy includes a talisman mantra kavacha, and any other charm of any kind which is alleged and possess miraculous powers for or in the diagnosis, cure, mitigation treatment or prevention of any disease in human beings or animals or for affecting or influencing in any way the structure or any organic function of human beings or animals. • Unless prescribed by registered medical practitioners or after consultation with the Drugs and Cosmetics Act 1940, no person or company, shall take any part in the publication of any advertisement referring to any drug that is used for:

a) Miscarriage in woman.

b) Maintenance or improvement of the capacity of human beings for sexual pleasures.

http://www.medindia.net/indian_health_act/the-drugs-and-magic-remedies-act-1955.htm


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c) Correction of menstrual disorder in women.

d) The diagnosis, cure, mitigation, treatment or prevention of any disease.

• No person or company will take part in advertisement which give false impression or makes a false claim for the drug or mislead the people. Whosoever contravenes any of the provision of this Act shall be punishable with imprisonment extended to six months or with fine, or with both for first time conviction. It may extend to one year imprisonment or with fine or with both on subsequent convictions. • The schedule for diseases specified under the Act are: appendicitis, atherosclerosis, blindness, blood poisoning, Bright’s disease, cancer, cataract, deafness, diabetes, brain diseases or disorder, uterus diseases, disorder of menstrual flow, disorders of nervous system, prostatic gland disorders, dropsy, epilepsy, female disease (in general), fever (in general), Fits, Forms and structure of the female breast, gall bladder stones, kidney‐stones, bladder stones, gangrene, glaucoma, goiter, heart diseases, high or low blood pressure, hydrocele, hysteria, infantile paralysis, insanity, leprosy, leucoderma, lock jaw, loco motor ataxia, lupus, nervous debility, obesity, paralysis, plague, pleurisy, pneumonia, rheumatism, ruptures, sexual impotence, small pox, stature of person , sterility of women, trachoma, TB, tumors, typhoid fever, ulcers of GI tract, venereal diseases including, AIDS.






METHODS OF CONTROL AND AWARENESS


The MIMH program seeks to equip patients with the knowledge and tools they need to establish healthy

and informed decision-making habits from the time they start making self-medication decisions.

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1 ) MED IC INES IN MY HOME (MIMH)

Medicines in My Home (MIMH) is a new educational program about the safe and effective use of Over‐the‐Counter (OTC) medicines developed by the Food And Drug Administration (FDA) to provide practical teaching tools and information to enable adolescents and adults to make careful and correct medicine use decisions. The lesson and materials are written at a 6th to 7th grade reading level and focus on teaching patients to use the "Drug Facts" label. All program materials can be accessed through the Internet and downloaded for local presentation. Pharmacists and other health care professionals can refer patients to the Web site, where they can either use the program materials on‐line or download them. The MIMH program can also be useful to pharmacists when speaking to students or adult community groups about medicine‐related issues.

With input from Maryland's Montgomery County Public Schools health educators, the FDA originally developed MIMH as an in‐classroom lesson for 6th to 8th graders. It was piloted in 25 6th grade classes during the 2005‐2006 school year. The lesson has been successfully taught by FDA physicians, nurses, and educators and by health education teachers. Currently, most MIMH materials are directed toward teachers and students.

The MIMH Web site is located at www.fda.gov/medsinmyhome and is organized into "rooms." The Teachers' Room provides a brief introduction to the program, key concepts, and learning objectives. The Teacher's Kit contains a linked list to all lesson teaching materials including an


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animated slide presentation with slide notes, a mock Drug Facts label, a take‐home booklet and learning activity, and student assessment materials (pretest, posttest, and in‐class worksheet). It also provides links to additional on‐line resources that offer related information on the use of medicines. The Students' Room provides a doctor's visit sheet called "All About Me" that children (and adults) may use to write down important information to discuss with their health care professionals at an upcoming visit. On‐line puzzles and games are also located in the Students' Room.

The current materials available on‐line can be easily adapted for presentation to a variety of audiences. During the coming year, program development will focus on creating more interactive learning opportunities on the Web site, adapting current presentation and learning materials to adult audiences, and developing resources that support parents in teaching their children about wise medicine‐use decisions. Future developments may include an OTC medicines Jeopardy‐like game and interactive activities that familiarize Web site visitors with correct use of the Drug Facts label and provide practice with medicine‐use decisions through scenarios. Before the end of 2006, an on‐line animated slide presentation and MIMH booklet geared toward adult audiences will be posted.

The MIMH program seeks to equip patients with the knowledge and tools they need to establish healthy and informed decision‐making habits from the time they start making self‐medication decisions.

2) HEALTH EDUCAT ION

Several programs have addressed medication misuse through the use of computer technology. Personal Education Program (PEP). A randomized


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clinical trial found that adults using the Personal Education Program (PEP) software increased knowledge regarding the potential drug interactions that can result from self‐medication with OTC medications and alcohol, compared to controls and those receiving an information booklet. PEP users also reported fewer adverse self‐medication behaviors over time.

3 ) HOSP ITAL D ISCHARGE-BASED PROGRAMS

Several studies have explored strategies to improve medication compliance and reduce medication misuse among adults upon hospital discharge. Al‐Rashid and colleagues found that patient knowledge and compliance to a medication regimen was significantly better among patients receiving a 30‐minute consultation with a pharmacist prior to hospital discharge compared to those receiving standard discharge procedures. Those patients receiving the pharmacist consultation also had significantly fewer unplanned trips to the doctor and hospital admissions, and personally altered their medications less than controls.

4) HOME AND NURS ING HOME SETT INGS

A number of studies have examined the effectiveness of home‐based medication review as an early intervention strategy to prevent medication misuse among adults. The HOMER program was a large British clinical trial in which a pharmacist reviewed medications, provided education, and addressed barriers to compliance (such as inability to open pill bottle tops) with adults in their homes two and eight weeks after hospital discharge. Surprisingly, the intervention group had significantly more emergency hospital readmissions and physician home visits than controls.


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5) RECOMMENDAT IONS TO PREVENT MEDICAT ION MISUSE IN ADULTS

• Compile and disseminate a list of medications considered potentially inappropriate for use in older persons and mandate that the list be used as a screening tool.

• Provide geriatrics relevant labeling information for over‐the‐counter medications.

• Fund and encourage research on medication related problems in older persons to determine which medications are most troublesome and which patients are most at risk.

• Provide incentives to pharmaceutical manufacturers to study effects in the elderly in pre‐ and post marketing clinical trials.

• Establish mechanisms for data collection, monitoring, and analysis of medication related problems by age group.

• To improve clinicians’ knowledge regarding geriatric pharmacotherapy.

• Fund and provide education and resources for care‐givers providing medication assistance to older people.

BENEFITS OF SELF MEDICATION


There is a financial correlation between the savings to public funds and savings to individuals when an

extension in self-medication occurs.

24


25


1 ) FREED UP DOCTORS ’ T IME

A volume shift to self‐medication would also have an impact on doctors’ time. Fewer consultations on minor illnesses would free up time that could be spent on longer consultations for more serious conditions and reduce waiting time in the doctor’s surgery, thus providing a real impact on the quality of care. The model calculates freed up doctors’ time based on the total number of medical doctors per country. Given that in practice it is the general practitioners who usually deal with minor conditions, the freed up time per general practitioner is considerably more than indicated in this study. This benefit has however proved impossible to evaluate in financial terms.

ABSENCE FROM WORK CAUSED BY TREATMENT.

This item represents absence from work attributable to patients seeking treatment during working hours. Two assumptions have been made:

•50% of doctor visits are made by the active population.

•25% of these persons visit the doctor during working hour.

This means that the average number of doctor visits avoided has been divided by a factor of 8 (25% of 50%). The resulting figure has been multiplied by the treatment time, based on the average time missed from work, and by the cost to employers for each working day of missed time. It has been assumed that there is no loss of productivity to the national economy for absences lasting less than one day.


26

2 ) ABSENCE FROM WORK CAUSED BY I L LNESS

It has been assumed that people are absent from work for a shorter period of time when they practice responsible self‐medication than when they go to see a doctor as they generally return to work sooner without official endorsement from a doctor that they are ill. This item represents the average cost to the employer in lost compensation and to the national economy in lost productivity for each working day missed due to illness due to minor ailments. It has been estimated in the model that 10% of working days lost for absences lasting less than three days attributable to minor ailments could be avoided through responsible self‐medication.

3 ) TRAVEL -RELATED COSTS

Travelling to the doctor and the pharmacy involves time and transportation costs. It has been proven that patients spend less time going to the pharmacy than going to the doctor, and that travel‐related costs are also higher when going to both the doctor and the pharmacy than only to the pharmacy. As visits to the pharmacy do not need an appointment and can be made during lunch hour or after work, no loss of working time has been assumed for purchases of non‐prescription medicines.


27

4) F INANCIAL IMPL ICAT IONS OF VOLUME SH IFTS TOWARDS SELF -MEDICAT ION

There is a financial correlation between the savings to public funds and savings to individuals when an extension in self‐medication occurs.

RESULTS AND OBSERVATIONS


28



TABLE: 1 AGE WISE DISTRIBUTION

AGE FREQUENCY % 11—20 29 19 21—30 43 28 31—40 26 17 41—50 36 23 51—60 11 7 >61 11 7 TOTAL 156 100

Table 1 SHOW That 28% Of The Total People Taking Self Medication BELONGS To Age Group 21 To 30, Which Is The Maximum.

TABLE: 2 SEX WISE DISTRIBUTION

FREQUENCY % MALE 52 33 FEMALE 104 67 TOTAL 156 100

Table 2 shows that 67% of our study population comprised of females.

29

RESULTTS AND OBSERRVATIONS

T

T

G

P

P

S

T A B L E :

TABLMedic

TABLE: 4

TableFrom

EDUCATIO

GRADUAT

PHD

PG

SCHOOL

TOTAL

3 D I S T

E 3 AND CHcines Are Gr

4 PEOPLE

e 4 AND CHA Our Study G

95%

ON FREQ

TE

T R I B U T

HART Shows raduates Wh

E PRACT

ART Shows AGroup Conta

5%

QUENCY

90

5

20

41

156 1

I O N B A

That Maximile Only 26%

TICING S

About 95% Oining 156 In

%

58

3

13

26

100

A S E D O

mum Percenta% Have Don

SELF MED

Of The Totalndividuals Se

PH.D. PO

YES

NO

TOTAL

O N E D U

age Of Peope Schooling.

DICATIO

l Study Popuelected Rand

26%

OST-GRADUAT

FREQU

U C A T I O

le Consumin.

ON

ulation Do Sedomly.

3%

13%

58%

TE GRADUA

UENCY

148

8

156

O N

ng Self

elf Medicatio

ATE SCHOO

%

8 95

8 5

6 100

on

OL

%

5

5

0

30


TABLE: 5 AGE WISE STATISTICS Age YES NO 11—20 28 1 21—30 42 1 31—40 25 1 41—50 35 1 51—60 11 0 >61 7 4 TOTAL 148 8

Table 5 reveals the fact that out of the total study of 148, 42 are young up to the age of 30 while 35 people were upto 50 yrs.

TABLE: 6 AGE AND EDUCATION WISE CONSUMPTION GRADUATE PHD PG SCHOOL 11—20 16 0 1 12 21—30 28 0 10 5 31—40 13 0 3 10 41—50 19 5 5 7 51—60 9 0 0 2 >61 5 0 1 5

Table 6 shows that 28 graduates belonging to age group 21-30 take self medicines of the total 148.maximum consumption are found amongst the graduates and second largest in those whose education is Upto School.

TABLE: 7 TYPES OF MEDICINES CONSUMED FREQUENCY % ALLOPATHY 149 90 AYURVEDIC 11 7 HOMEOPATHY 5 3 TOTAL 165 100

Table 7 shows that mostly people consume allopathic medicines without prescription. Only 3% of the study group consumed homeopathic medicines.

31


TABLE: 8 SOURCE OF DRUGS FREQUENCY % DOCTOR 100 53 PHARMACIST 35 19 MR 3 2 TV AD 26 14 NEWSPAPER 5 3 DRUG LITERATURE 6 3 OTHER 12 6 TOTAL 187 100

TABLE 8 Shows That Most of The People Get To Know About Their Medicines From The Doctor. The Pharmacists Were A Source For 19% Of People.

TABLE: 9 WHETHER THE SYMPTOMS WERE RELIEVED OR NOT

32

TABLE 9 AND CHART Shows That In 98% Of People Their Symptoms Were Relieved Even Though Self Prescribed!

98%

2%

Yes

No

SYMPTOMS RELIEVED? FREQUENCY %

YES 145 98

NO 3 2

TOTAL 148 100

RESULTTS AND OBSERRVATIONS

C

C

CHART:

CHARThe D

CHART:

CHARCons

10 AWA

RT 10 ShowsDrugs, The Re

11 AWA

RT 11 Showsumption Of

ARENESS

s That Only 3est Take The

ARENESS

s That 64% PThe Drugs!

6

S REGAR

37% Of Theem Blindly!

S REGAR

People Don’t

62%

64%

DING DO

e People Kno

DING DU

t Even Know

38%

OSE

ow How Muc

URATIO

w The Time P

36%

ch Dose To B

N

Period For Th

Yes

Be Taken For

he

No

Yes No

33


CHART: 12 KNOWLEGDE REGARDING SIDE EFFECTS

25%

75%

Yes No

CHART 12 Shows That Its An Irony That 76% Of Consumers Do Not Even Know Whether There Can Occur Any Side Effects About The Drugs They Take!

TABLE: 13 RELATION BETWEEN KNOWLEDGE ABOUT SIDE EFFECTS AND EDUCATION

EDUCATION KNOWLEDGE ABOUT SIDE EFFECTS YES NO GRADUATE 23 64 PHD 3 2 PG 2 16 SCHOOL 8 30 TOTAL 36 112

TABLE 13 Shows That 64 People Although Graduates Didn’t Know Anything About The Side Effects of Their Drugs. There is no significant association between the educational qualification of the individuals and their knowledge regarding side-effects of the drugs.

34


TABLE: 14 INCIDENCE OF SIDE EFFECT SIDE EFFECTS INCIDENCE FREQUENCY % YES 18 12 NO 130 88 148 100

TABLE 14 Reveals The Fact That Only 12% Of People Experienced Any Kind Of Side Effect Compared To The Massive 88% Who Were Fortunate Enough!

TABLE: 15 AGEWISE INCIDENCE OF SIDE EFFECTS AGE SIDE EFFECTS INCIDENCE YES NO 11—20 2 26 21—30 9 32 31—40 3 23 41—50 2 33 51—60 1 10 >61 1 6 TOTAL 18 130

TABLE 15 shows that maximum incidence of side effects had occurred between the age of 21-30. There is no significant association between the age of the individual and occurrence of the side effects.

TABLE: 16 DOCTOR CONSULTATION FOR SIDE EFFECTS

SIDE EFFECTS: CONSULTED DOCTOR? FREQUENCY % YES 7 5 NO 141 95 TOTAL 148 100

TABLE 16 Shows That Of The Total Sufferers Of Side Effects Only 5% Consulted The Doctor.

35


TABLE: 17 RELATION BETWEEN EDUCATION AND CONSULTATION TO THE DOCTOR ABOUT SIDEEFFECT:

EDUCATION SIDE EFFECTS CONSULT DOCTOR YES NO GRADUATE 5 82 PHD 0 5 PG 1 17 SCHOOL 1 37 TOTAL 7 141

TABLE 17 Shows That Most Of The Educated People Dint Consult The Doctor For The Side Effects While Only 5 Graduates Did.

TABLE: 18 EDUCATION WISE DISTRIBUTION OF REPITION OF DRUGS AFTER SIDE EFFECTS APPEARED EDUCATION AFTER SIDE EFFECTS: REPEATED THE DRUG? YES NO N/A GRADUATE 9 11 67 PHD 0 1 4 PG 1 2 15 SCHOOL 2 2 34

TABLE 18 Shows 9 People Although Graduates Repeated The Same Drug After The Side Effects Appeared.

TABLE: 19 DURATION OF CONSUMPTION OF DRUGS DRUG TAKEN TILL? FREQUENCY % AS PER DOSE 30 21 TILL SYM RELIEF 115 77 FOR LONGER DURATION 2 1 FOR PROPHYLAXIS 0 0 OTHER 1 1 TOTAL 148 100

TABLE 19 Shows That 77% Consume The Drugs Till They Get Some Relief, Then Irrespective Of The Dose They Are Stopped. The Rest Usually Consume As Per Dose.

36


TABLE: 20 RELATION BETWEEN EDUCATION AND DURATION OF CONSUMPTION OF DRUG EDUCATION DRUG TAKEN TILL? AS PER

DOSE SYMPTOMATIC

RELIEF LONGER

TIME PROPHYLAXIS OTHER

GRADUATE 18 66 2 0 1 PHD 2 3 0 0 0 PG 5 13 0 0 0 SCHOOL 7 31 0 0 0

TABLE 20 Shows That Maximum Number Of People Preferred The Drugs For Symptomatic Relief And These Included Most Of The Graduates, While Few Also Followed The Dose Regime.

TABLE: 21 WHETHER DRUG IS REFERRED TO ANYONE ELSE REFERRED TO ANYONE ELSE? FREQUENCY % YES 81 55 NO 67 45 TOTAL 148 100

TABLE 21 shows that 55% Of People Tend To Spread The Knowledge About Their Drugs To Others Even Though They Themselves Are Not Sure!

37


CHART: 22 AGE WISE DISTRIBUTION OF STUDY POPULATION.

18

27

17

23

76

2

11--20 21--30 31--40 41--50 51--60 61--70 71--80

AS SHOWN IN CHART 22 MAJORITY OF THE PEOPLE UNDER STUDY FELL IN THE AGE GROUP OF 20 TO 50 YEARS OF AGE.

38

CONCLUSION


Published studies suggest that some children start to self-medicate at 11 or 12 years of age, and that use of OTC medicine among adolescents is common.

39

CONCLUSION

40

CONCLUSION

• Our study was conducted on 156 people. 95% of the total study population takes self medication and only 5% do not.

• Majority of the population falls in the age group of 21 to 50.

• 58% of people consuming self medicines are Graduates while 26% have done only schooling.

• Mostly people consume allopathic medicines without prescription.

• 28% of people get to know about medicines from drug commercials like TV and newspaper advertisements and other sources.

• 53% of people get to know about drugs from Doctors which is a good sign.

• 98% of people had symptomatic relief when took drug on their own!

• Just 37% of the people know the right dose for the drugs, the rest take them blindly!

• 64% people don’t even know the time period for the consumption of the drugs!

• 76% of consumers were not aware about the side effects.

• The actual occurrence of side effects is a mere 12%

• Just 8% of people repeated the drug even they experienced the side effects.

• Just 21% of all take drugs as per dose.

• 77% of all take it till symptomatic relief irrespective of the actual dose or duration of the drug.

CONCLUSION

• 55% of people tend to spread the knowledge about their drugs to others even though they themselves are not sure!

• 28 Graduates belonging to age group 21‐30 take self medicinces of the total 148.maximum consumption is found amongst the graduates and second largest in those whose education is upto school.

• Maximum incidence of side effects had occurred between the age of 21‐30.

• The commonly used antibiotics we encountered during our study are Azithromycin, Norfloxacin, Tinidazole, Metronidazole.

• No significant association was found between an individual’s tendency to opt for self‐medication and his/her socio‐demographic determinants like education, age, sex, residential location.

TO CONCLUDE SELF-MEDICATION IS A FAIRLY

COMMON PRACTICE IN THE SOCIETY IRRESPECTIVE

TO THE INDIVIDUAL’S AGE, SEX, OCCUPATION, EDUATIONAL QUALIFICATION, RELIGION, SOCIO-ECONOMIC STATUS AND AREA OF RESIDENCE.

HOWEVER, THE KNOWLEDGE REGARDING THE DOSE, DURATION, SIDE-EFFECTS, AND APPROPRIATE

INDICATION FOR MAJORITY (ALMOST ALL) OF THE

DRUGS IS VERY POOR, WHICH IS AN IMPORTANT

FINDING.

41

BIBLIOGRAPHY


42

BIBLIOGRAPHY

43

BIBLIOGRAPHY

WEBSTER’S ENGLISH DICTIONARY

Dr. Frank S.K. Barar retired as Sr. Professor and Head, Dept. of Pharmacology, SMS Medical College, Jaipur-302004 in November 199O.

The Drugs & Cosmetic Rules 1955 vide Gazette Notification-85 (E) dt. 6.2.02.

The Drugs and Magic Remedies (Objectionable Advertisement) Rules: 1955

The Gazette of India. The Drugs and Magic Remedies (Objectionable advertisements) Act 1954. No. 21 of 1954.

Dr. Feibus, a medical officer with the FDA's Office of Nonprescription Products.

PHARMACY TIMES

WWW.ANSWERS.COM

WWW.BLOGSPOT.COM

U.S. Department of Health and Human Services

Food and Drug Administration-SAFE DRUG USE BROCHURE NOV 4, 2009

WHO AWARENESS PROGRAM

WWW.BIOINFOBANKLIBRARY.COM

OAS.BIOMEDCENTRAL.COM

WWW.BOLOJI.COM

WWW.NCBI.COM

http://www.answers.com/

http://www.blogspot.com/

http://www.bioinfobanklibrary.com/

http://www.boloji.com/

http://www.ncbi.com/

NAME: AGE: Years SEX: Male / Female

ADDRESS:

EDUCATION:

OCCUPATION:

PSBH PROJECT‐SELF MEDICATION ROLL NO:‐ 111‐115

1) HAVE YOU TAKEN ANY MEDICINES IN PAST SIX MONTHS ON YOUR OWN?

1) YES 2) NO 2) WHICH TYPE OF MEDICINES DO YOU USUALLY PREFER? 1) ALLOPATHY 2) AYURVEDIC 3) HOMOEPATHY 4) OTHER

IF OTHER: _________________________________

3) FROM WHERE DID YOU COME TO KNOW ABOUT THE DRUG THAT YOU TOOK? 1) DOCTOR 2) PHARMACIST 3) MEDICAL REPRESENTATIVE 4) TELEVISION ADVERTISEMENTS 5) NEWSPAPERS 6) DRUG LITERATURES

7) OTHERS

IF OTHER:____________________________________ 4) FOR WHAT AILMENT DO YOU COMMONLY TAKE DRUGS ON YOUR OWN AND WHICH? 1) FEVER 2) PAIN 3) HEADACHE 4) COMMON COLD 5) BACKACHE

6) COUGH 7) VOMITING 8) DIARRHEA 9) CONSTIPATION 10) WEAKNESS 11) OTHERS: A) _____________________________________

B) _____________________________________

PAGE 1

PSBH PROJECT‐SELF MEDICATION ROLL NO:‐ 111‐115

5) WERE YOUR SYMPTOMS RELIEVED ON TAKING THE DRUG?

1) YES 2) NO 6) ARE YOU AWARE ABOUT THE APPROPRIATE DOSE OF THE DRUG?

1) YES 2) NO 7) ARE YOU AWARE ABOUT THE APPROPRIATE DURATION OF TAKING THE DRUG?

1) YES 2) NO 8) ARE YOU AWARE ABOUT THE SIDE‐EFFECTS OF THE DRUG?

1) YES 2) NO 9) WERE THERE ANY SIDE EFFECTS?

1) YES 2) NO 10) IF YES, WHAT KIND OF SIDE EFFECT/S?

A)______________________________________________

B)______________________________________________

C)______________________________________________

11) DID YOU CONSULT DOCTOR FOR THE SIDE‐EFFECTS?

1) YES 2) NO 12) DID YOU REPEAT THE SAME DRUG AFTER SIDE‐EFFECTS APPEARED?

1) YES 2) NO 3) N/A 13) FOR WHAT DURATION DO YOU USUALLY TAKE THAT DRUG?

1) AS PER DOSE 2) TILL SYMPTOMATIC RELIEF

3) FOR LONGER DURATION 4) FOR PROPHYLAXIS

5) OTHER

IF OTHER: ____________________________________

14) DID YOU SUGGEST THE SAME DRUG TO ANYONE ELSE?

1) YES 2) NO

PAGE 2

Self-Medication (PSBH Project 2010)

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