ASSESSING THE KNOWLEDGE ON SELF MEDICATION AMONG MEDICAL STUDENTS OF BANGLADESH

ASSESSING THE KNOWLEDGE ON SELF-MEDICATION AMONG

MEDICAL STUDENTS OF BANGLADESH

Mahmudul Hasan Tushar1, Munira Tasnim Karim1, Omer Fayshal Pavel*1

1

Department of Pharmacy, East West University, Dhaka, Bangladesh.

ABSTRACT

Self medication is one of the most practiced worldwide issues and can

cause both benefit also with harmful effect at a time, when if it is not

properly mentored by experts of drugs. Bangladesh is a south Asian

developing country, where self medication is highly practiced. The aim

of the study was to examine the knowledge and practice of self

medication among the medical students in Bangladesh. The study was

done among 731 medical students of both public and private medicals

in Bangladesh. 92% of the medical students of both government and

non- government medical colleges self-medicate and they get the drugs

from local pharmacies, family, friends and neighbors. More than 60%

of the population suffered from mismanagement of self medication and more than 30% know

about the harmful effect of self medication but till they are practicing self medication.

KEYWORDS: Self medication, Medical Students, Harmful effect, Prescription, Bangladesh.

INTRODUCTION

Self medication is a pattern obtaining and consumption of drugs without the proper guideline

of physicians by diagnostic or other medical procedures.[1] Self medication is widely

practiced worldwide and can cause both benefit and harm at a time if it is not properly

mentored by experts of drugs.[2] As the result of harm self medication can bring many

unexpected and health hazardous states like adverse drug reactions, resistance of pathogens,

physical dependence, misdiagnosis, abuse of drug resources etc.[3] About the self medication

World Health Organization (WHO) has pointed out the accurate and responsible self

medication can help to prevent or treat diseases only which don’t require physicians’

consultation or can be used as over the counter drugs.[4] This self prescribing practice is

predominant in the developing countries like south Asian countries as it allows the low cost

Volume 6, Issue 10, 27-33. Research Article ISSN 2277– 7105

Article Received on 06 July 2017,

Revised on 27 July 2017, Accepted on 16 Aug. 2017

DOI: 10.20959/wjpr201710-8914

*Corresponding Author

Omer Fayshal Pavel

Department of Pharmacy,

East West University,

alternative for those people who are not financially stable enough to access the doctors for

proper consultancy.[5]

Self medication is well practiced in medical students as they have very good idea and practice

of handling different drugs and disease. Besides that they are the future councilors of drugs

and medicine thus need rapid knowledge enhancing on drugs in their academic study.[6]

Without this there is a specific culture among doctors that they don’t expect to get sick or to

be a patient of others thus self-diagnosis, self-referral or self-treatment among physicians is

highly significant.[7] Now days the most commonly accessible (Over the Counter) OTC

medications are pain-killers, cold remedies, anti-allergy medicines and vitamins. Though

these medications are considered as risk free and useful for the treatment of common health

hazards but their excessive use can also lead to serious side-effects, unfavorable reactions or

adverse drug reaction with concomitant use with other drugs.[8]

The study was done to assess knowledge of the self-medication and practice of self treatment

behavior of medical students. There have been several reports addressing the extent of

self-medication practices among university students in South Asian countries as well as developed

countries of the worlds. The current study was undertaken to describe self-medication

practices among medical college students as well as to identify potential factors that are

associated with self-medication practices and to identify reasons for self-medication practices

in Bangladesh.

METHOD AND MATERIALS

Study design

This was a cross-sectional, questionnaire-based study. There were 9 major questions, under

these questions there were 20 sub questions.

Study setting

This cross-sectional descriptive study was carried out at 9 different medical colleges of

Bangladesh situated in 3 different districts. 4 of the medical colleges are government medical

college and other 5 were private medical colleges

Study time and Population

Questionnaires were completed in January to April 2016. Approximately 900 students

them 731 people were taken as population where remaining were not included for their

ambiguous response. In the population the age range was 20 to 30 and 61% was male and

39% of the population was female. All the students from 1st to 5th year were included in the

study. Among the people 33% were form rural area and 67% were from urban area. In the

population 52% were form families earning more than 35,000 BDT monthly.

Ethical issues

Prior permission was taken from the authority of the institution for conducting the study. The

purpose of the study was explained clearly to the participating students and confidentiality

was ensured. Informed consent was obtained from population before filling the questionnaire.

Study procedure

The questionnaire was distributed to all students attending randomly selected classes,

cafeteria, student halls, and common rooms. After obtaining informed consent, they were

asked to fill up a printed, questionnaire.

Statistical analysis

The data were coded, entered, and analyzed using the Microsoft Excel 2010. Descriptive

results were expressed as percentage and plotted with table, pie chart and bar diagrams. The

variables of the study are government and non-government institution, age, gender and year

of study.

RESULT

In the response of the source of medication without prescriptions the population mentioned

mainly five sources, shown in the table 1.

Table 1: Source of medication without prescription.

Source Population responded (%)

Pharmacy 70.518

Homeopath 8.639

Traditional Healer 3.239

Street Market 3.887

Relatives and friends 11.663

Neighbors 2.0518

When the population were asked the factor associated with the self medication with 8

questions they were given to choose 3 options agree, disagree or don’t know. The response is

Table 2: Factor Associated With Self Medication.

Factors Yes (%) No (%) Confused (%)

Self Medicate in the Past Year 74 18 08

Avoidance of burden my physician 26.34 32.70 40.94

No Physicians Advice 24 33 43

Active Role about Personal Health 38 19 43

Influence of Relatives, Friends and Media 18 33 49

Long Waiting Time in doctors chamber 25 31 44

Prescribed Treatment was Unsuccessful 13 44 43

They don't have Trust in Physician 17 47 36

In the study it was found that the pattern of using different medication like sedative,

painkillers, antibiotics and other non OTC drug as self medication in last month, shown is the

figure 1.

Figure 1: Use of Certain Drugs for Self medication.

And when asked in different physical hazards like weight loss, mild to moderate injury,

toothache and others what is the steps they took in last month shown in Graph 1.

From population different adverse or side effect were collected and shown in the table 3.

Table 3: Different unexpected effect after self medication.

Effect Yes (%) No (%) No response (%)

Duration of Symptoms 67 21 12

Worsening Symptoms 66 22 12

Presence of Severe Pain 62 28 10

Irregular Side Effects 43 39 18

Serious Problems 58 24 18

Psychological Problems 23 60 17

At the end of the survey the knowledge on self medication and its hazardous effect was asked

through different questions. The result is shown in the table 4.

Table 4: Knowledge on Self Medication and Its Hazardous Effect.

Questions Agree

(%)

Disagree (%)

Not Sure (%)

All drugs have side effects 33 30 37

Simultaneous use of drugs can be potentially dangerous 46 14 40

Increasing Drug Dose can be dangerous 49 41 10

Lowering drug dose can be dangerous 32 22 46

Physicians help must sought in case of side effects 50.6 8.3 40.9

Using drugs with unknown substances in patients with

liver and kidney diseases is very dangerous 60.7 7.8 31.33

No drugs can be used during pregnancy 32 28 40

Mild medical problems don’t need drug treatment 31 21 48

Self treatment can mask signs and symptoms 43 14 43

DISCUSSION

From the study it is evident that self-medication is very common among Bangladeshi medical

students. About 92% of the medical students of both government and non- government

medical colleges self-medicate in the past years which matches with the study of southern

India[9] and Students at University of Ljubljana, Slovenia.[10] It does mean the self medication

is not only an issue of Bangladesh rather a global issue that needs to get the concern of global

regulatory author with proper implementation. In the study it was found that the most

available source to get drugs for self-medication for Bangladeshi medical students is mainly

the local pharmacies and others factors like friends and neighbors are also included. It is also

evident that medical students not only influenced by friends, family rather by social

marketing of the drugs.[11] As a result some dugs are so available to get in Bangladesh like the

LIMITATION

1. The study was based on self-reported data about self-medication in four month duration.

2. Though the students were encouraged to complete the survey independently, mutual

influence between the students could not be entirely ruled out.

3. The results of the study would have been more generalized if it could involve students of

all the medical colleges in Bangladesh

CONCLUSION

This study has found that self-medication is very common among medical students,

facilitated by the easy availability of drugs, and high self-care orientation. A significant

number of students are unaware of the adverse effects of the medication that they themselves

take and suggest to others. Since inappropriate self-medication has the potential to cause

serious harm, not only to the students themselves but also to those whom they suggest

medication, potential problems of self-medication should be emphasized to the students to

minimize this risk. Restriction of sale of drugs with potentially harmful effects should be

implemented effectively with monitoring systems between the physicians and pharmacists.

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