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Original Article
7 (
1
); 19-23
doi:
10.53553/JCH.v07i01.005

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

MBBS Student, Community Medicine, North Bengal Medical college and Hospital, Darjeeling, West Bengal, India
Associate Professor, Community Medicine, North Bengal Medical college and Hospital, Darjeeling, West Bengal, India
Corresponding Author: Dr. Romy Biswas, Associate Professor, Community Medicine, North Bengal Medical College and Hospital, Darleeling, West Bengal, India. Email: docbromi@rediffmail.com
Licence
This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0

How to cite this article: Dey V, Biswas R. Practice of self-medication among the adult population in the Municipal Corporation area of Siliguri, West Bengal, India. J Comprehensive Health.2019;7(1):19-23.

Abstract

Background:

Self-medication is a major public health concern which has increased at the community level, It may lead to delay in diagnosis as well as care seeking. Present study was undertaken to find out the prevalence and pattern of self medication practices among adult population in an urban area of Siliguri Municipal Corporation area of West Bengal.

Methods:

A cross-sectional study was conducted among 110 adults in urban areas of Siliguri Municipal Corporation area by purposive sampling.

Results:

The prevalence of self-medication among urban adults was found to be 47,2%. More than 50% of the study subjects had symptoms like fever and headache for resorting medication by him. Common drugs were antipyretic or paracetamol (65.4%), antacid (50%), anti-inflammatory (44,2%) or anti-allergic (42.3%). Significant association was found between occupational status (engaged in unskilled work) and self-medication.

Conclusion:

Self-medication practices are a dual sword to manage time, relieve overburdened medical practice and increased resistance of pathogens due to delayed diagnosis etc, Health educational activities should be initiated to encourage common people In order to utilize health care services from government facilities which are now made at a subsidized cost.

Keywords

Drugs
magnitude
self-medication
habit

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 population11,12.

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 India4-9. 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.

Fig 1:
Pie diagram showing number of persons
Table 1. Pattern of Self-Medication among the study population(n=52)
Episodes of self-medication No. (%)
Once only 26 50.0
Twice 20 38.5
Thrice or more 6 11.5
Outcome of self-medication
Cured 28 53.8
Improved 20 38.5
Worsened 4 7.7
*Drugs used for Self-Medication
Paracetamol 34 65.4
Antacid 26 50.0
Anti-inflam matory 23 44.2
Anti-allergic 22 42.3
Cough and cold remedies 16 30.8
Antibiotics 11 21.1
Vitamins 10 19.2
Others 9 17.3
*Common ailments for resorting Self-Medication
Fever 28 53.8
Headache 26 50.0
Cough/Cold 16 30.8
Acidity/Heartburn 14 26.9
Diarrhea 11 21.1
Sleep disorder 7 13.4
Nausea 7 13.4

*Multiple responses

Table 2: Association of self-medication with socio-demographic factors
Socio-demographic factors Practicing Self- Medication No. (%) Not Practicing Self- Medication No. (%) X2 DF and P
Category of age
<30 years 17(47.2) 19(52.8) .332, df-2
30-60 years 28(49.1) 29(50.9) .847
= 60 yea rs 7(41.2) 10(58.8)
Gender
Male 20(38.5) 32(61.5) 3.072, df-1
Female 32(55.2) 26(44.8) .080
Educational status
Illiterate 6(50) 6(50) .755, df-3
Primary & middle 10(43.5) 13(56.5) .860
Highersecondary 20(44.4) 25(55.6)
Graduate & above 16(53.3) 14(46.7)
Occupational status
Job and business 16(32.0) 34(68.0) 8.801, df-3
Unskilled worker 6(60.0) 4(40.0) .032
Student and unemployed 10(55.6) 8(44.4)
Homemaker 20(62.5) 12(37.5)
Type of family
Nuclear 39(52.7) 35(47.3) 2.675,df-1
Joint 13(36.1) 23(63.9) .102
Family Income
< Rs.10,000 3(25.0) 9(75.0) 2.881, df-2
Rs.10,000-30,000 36(51.4) 34(48.6) .237
= Rs.30,000 13(46.4) 15(53.6)
Add iction
Present 15(40.5) 22(59.5) 1.014.df-1
Absent 37(50.7) 36(49.3) .314

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

Discussion:

Prevalence of self-medication

A cross-sectional, descriptive study was conducted among urban population of Siliguri Municipal Corporation. The study was aimed to find out the prevalence and pattern of self- medication among adult study subjects. It also tried to elicit various factors associated with self-medication. Self- medication can be defined as the consumption of medicines by people on their own initiative. Easy avail-ability of a wide range of drugs and inadequate and inequitable health services result in increased pro-portions of drugs to be used as self-medication in developing countries like India3. Present study reported prevalence of self-medication among urban adults is to about 47.2%. This finding is similar to a study conducted in rural Meghalaya by Marak A. et al13. A community-based, cross-sectional study in rural areas by Ahmed et al. had found that 50% of respondents practiced self-medication14.

But prevalence of self-medication in urban Pondicherry was found to be as low as 11.9%. A study among undergraduate medical students in a medical college of West Bengal found the prevalence of self-medication to be 57.1%. It was found to be 55.9% in an urban slum community of Mumbai15.

Pattern of self-medication

More than 50% of the study subjects had symptoms like fever and headache for resorting medication by him. Other symptoms were cough and cold, acidity or diarrhea or sleep disorder. Headache, fever, respiratory illnesses were the common symptoms in Mumbai study15. Vague pain, cold; heart burn and headache were the presenting symptoms in a study among undergraduate medical students16. Similar findings were observed in a study in New Delhi18. Common drugs were antipyretic or paracetamol (65.4%), antacid (50%), anti-inflammatory (44.2%) or anti-allergic (42.3%). Paracetamol and cough syrups were the most commonly used class of drugs in a study by Gupta et al16. A study by Banerjee I. et al, among undergraduate medical students revealed that common cold and diarrhea were presenting symptoms and antibiotics were most commonly taken17. Similar findings were noted in a study done in Ahmadabad, India20 and by Adhikary et al18 and even in Rajasthan among urban population19. Sedatives and antibiotics werecommonly used in the study of Saudi Arabia18. Analgesics were most common followed by antipyretics and analgesics in a study conducted in Karachi21.

Associated factors

Age category, gender, educational status, occupational status, type of family, family income and addiction were associated with the practice of self-medication. Practice of self-medication is found to be more in the age group of 30-60 years. But in study in Meghalaya it was commoner in younger age groups13. It is almost equal in less than 30 years age group. But in study conducted by M. Jain in Rajasthan showed a different pattern where it was common in younger age groups". Females are seen to be more dependent on self- medication and this is similar in study by Gupta et al16. Participants having education of graduate and above had used self-medication more compared to those having education less than secondary and illiterate persons in present study. This is in accordance with the finding of study conducted in Delhi by Varun Kumar et al22. Higher prevalence among productive age group may be due to more access of information to them.

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.

Sources of support:

Nil

Acknowledgement:

The authors gratefully acknowledge the financial grant from ICMR- STS for the conduction of the research project. Thanks to all the concerned authorities for their active cooperation and support.

Conflict of interest:

Nil

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