Practice of self-medication among the adult population in the Municipal Corporation area of Siliguri, West Bengal, India

Introduction:

Self-medication is one of the most modern expressions of self-care. Self-medication is an age old practice. According to WHO “self-medication involves use of pharmaceutical or medicinal products by the consumer to treat self-recognized disorders or symptoms, the intermittent or continued use of a medication previously prescribed by a physician forchronlc or recurring disease or symptom^”1. In early days as 1950s, health was centered on medicines, doctors and health problems. But in 1980s, the public health importance of self- medication increased when more drugs were changed from prescription status to over the counter(OTC) without a prescription.² self-medication has increased due to several factors like socio-economic, lifestyle, ready and increased access to drugs, the increased potential to manage certain illness and increased knowledge and awareness about health and diseases¹. Irrational use of medicines can create many problems like increase in risk of adverse events, antibiotic resistance, and masking of symptoms which can delay correct diagnosis. This growing concern of self-medication is not restricted in developing countries only, has been adopted worldwide.

A study by Shankar PR et al shows a prevalence of 59% in Nepal⁴. According to Pushpa R et al in a study in Sri Lanka found self-medication to be 12.2% in urban sector and 7.9% in rural sector⁵. Prevalence of self-medication in urban Puducherry was found to be 11.9%. Fever (31%), headache (19%), and abdominal pain (16.7%) are most common illnesses where self-medication is being used⁶.

In West Bengal few studies have been documented related to self-medication. A study by Mandai P et al⁷ shows 39% respondents practiced self-medication and 33.4% chose their medicines on the basis of previous experiences, A study among undergraduate medical students in a tertiary care medical college of West Bengal⁸ and In homeopathic schools found the prevalence of self-medication to be 57.1% and 72.3% respectively. Rational use of medicines should be promoted by the medicine shopkeepers for the community¹⁰.

The youth is especially exposed to the media and the increased advertising of pharmaceuticals poses a largerthreattotheyoung population^11,12.

In this perspective, the present study was done to estimate the prevalence and pattern of self-medication among adult population in an urban area of Siliguri Municipal Corporation Area of West Bengal.

Materials and Methods:

The present study was community based descriptive study with cross-sectional in design done in May-June of 2017 in Siliguri Municipal Corporation area of Darjeeling district. The prevalence of self-medication varies from 30-70% in different regions of India^4-9. So 50% prevalence is chosen to get the maximum sample size. Considering this proportions the final sample size of 110 was fixed. They were selected from ward 23 in the vicinity of urban field practice area of department of community medicine of North Bengal Medical College & Hospital. They were selected by purposive sampling method and interviewed in their houses with the help ofpre-designed, pretested questionnaire and also by prescriptions review. The study variables includes socio-demographic variable like age, gender, religion, marital status education, occupation and self-medication related variables like frequency of intake, type, duration indication, cause of self-medication etc. The data collection was done by house to house visit, During home visit, the head of the family and other family members were communicated about the purpose of the study and one adult subject was chosen randomly from one household. A detail of the self- medication history wascollected for the last one month. The operational definition of self-medication used in the study was explained to each one for uniform reporting.

After collecting the data were entered in Microsoft excel datasheet 2007. Data analysis was done using the principles of descriptive statistics. Analysis of the data was done by using IBM statistical package for social sciences version 20 (SPSS 20). Ethical approval was taken from the Institutional Ethics Committee of North Bengal Medical College and Hospital. Permission was also obtained from the local Municipal Authority of Siliguri Corporation Area. Anonymity and confidentiality was ensured to each of the subject. Informed consent was also taken.

Results

In this present study, a total of 110 adult persons residing at Siliguri Municipal Corporation area were selected in a ward as study subjects. Out of them 77 persons took some medicine in the reference period. Of them 52 were self- medicated and doctor prescribed for 25 persons which is depicted in pie diagram.

50% of the population used self-medicatation for one time and 38.5% for two episodes. Out of person who took medicines of their own 7.7% replied that their symptoms worsened. Paracetamol and antacid were most common drugs ingested. Fever, headache and common cough and cold were the presentingailments.

Close

Fig 1:

Pie diagram showing number of persons

Export to PPT

Practice of self-medication and association with socio- demographlc factors were studied. Occupational status was found to be significantly associated with theself-medication.

Discussion:

Conclusion and recommendation:

The appropriateness of self-medication is still needed to be developed with the help of appropriate study design and a validated tool. The concept of self-medication is dual sword to manage time, relieve overburdened medical practice where drugs are changed over the counter without a prescription on one hand and many hazards like wrong diagnosis, prolonged morbidity and increased resistance of pathogens on the other hand. Self-medication practices cannot be considered as totally harmful. Drugs classified as “over the counter” (OTC) can be purchased without prescription and many a times might save time and money for the patients.

A study assessing the knowledge of consumers about drug use would be an ideal follow up of this study, for better planning of interventions. Health educational activities should be initiated and strengthened to encourage common people in order to utilize health care services from government facilities which are now made at a subsidized cost. List of drugs which can be dispensed acrossthe counter should be displayed like the citizen charter and strict vigilance should be done on medical stores to ensure that prescription drugscan be dispensed and not drugs for self- medication.