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Australasian

Medical Journal [AMJ 2012, 5, 4, 217220]



Selfmedication patterns among medical students in South India


Sanjeev Badiger1, Rashmi Kundapur 1, Animesh Jain2, Ashwini Kumar2, Sanjay Pattanshetty3,
Nimmy Thakolkaran4 , Nitasha Bhat4, Nowshin Ullal4
1. Department of Community Medicine, K.S. Hegde Medical Academy, Nitte University, Mangalore, India
2. Department of Community Medicine, Kasturba Medical College, Mangalore Manipal University, India
3. Department of Public Health, Manipal University, Karnataka, India
4. K.S. Hegde Medical Academy, Nitte University, Deralakatte, Karnataka, India

RESEARCH

Please cite this paper as : Badiger S, Kundapur R, Jain A,


KumarA,PatanashettyS,ThakolkaranN,Bhat,UllalN.Self
medicationpatternsamongmedicalstudentsinSouthIndia.
AMJ
2012,
5,
4,
217220.
http//dx.doi.org/10.4066/AMJ.2012.1007.

CorrespondingAuthor:

DrSanjeevBadiger

AssociateProfessor

DepartmentofCommunityMedicine,

K.S.HegdeMedicalAcademy,

Mangalore,India

Email:s_badiger@yahoo.com

Abstract

Background
Selfmedication results in wastage of resources, increases
resistanceofpathogensandgenerallycausesserioushealth
hazardssuchasadversedrugreactions,prolongedsuffering
and drug dependence. This study was undertaken to
determine the reasons for selfmedication and the pattern
ofselfmedicationamongmedicalstudents.
Method
Thiscrosssectionaldescriptivestudywas conductedatthe
K.S.Hegde Medical Academy, Mangalore. The participants
were medical students from first to final year. Medical
studentswereselectedthroughconveniencesampling.The
data was collected using a pretested semistructured
questionnaire.ThedatawasanalysedusingSPSSversion16
andtheresultsexpressedasproportions.
Results
Atotalof200students,121(60.5%)femaleand79(39.5%)
male, were included in the study. Of the medical students
surveyed, selfmedication was reported among 92%. The
respondentswhousedselfmedicationfoundittobetime
saving in providing relief from minor ailments. The most
common ailments for which selfmedication were used
were: the common cold (69%), fever (63%) and headache

(60%). The students consulted their textbooks (39%) and


seniors or classmates (38%) for the medications.
Antipyretics (71%), analgesics (65%), antihistamines (37%)
and antibiotics (34%) were the most common self
medicateddrugs.Oftherespondents,33%wereunawareof
the adverse effects of the medication and 5% had
experienced adverse reactions. The majority (64%) of
students advised medications to others, more often to
familyandfriends.
Conclusion
The prevalence of selfmedication among medical students
is high, facilitated by the easy availability of drugs and
informationfromtextbooksorseniors.Asignificantnumber
of students are unaware of the adverse effects of the
medicationthattheythemselvestakeandsuggesttoothers.
Therefore, potentialproblems of selfmedication should be
emphasisedtothestudents.
KeyWords
Selfmedication,Medicalstudents

Whatthisstudyadds:
1.Thepatternofselfmedicationamongmedicalstudents.
2.Factorsinfluencingselfmedication.
3.Potentialadverseeffectsofselfmedication.

Background
Selfmedicationcanbedefinedasobtainingandconsuming
drugs without the advice of a physician for diagnosis,
prescription or surveillance oftreatment.1,2 Selfmedication
differs from selfcare in that it involves drugs that may do
good or cause harm.3 In several studies it has been found
that inappropriate selfmedication causes wastage of
resources, increases resistance of pathogens and generally
causes serious health hazards such as adverse drug
reactions,prolongedsufferinganddrugdependence.36

Therearemanyreasonsfortheincreasedlikelihoodofself
medication among medical students.3 These students have
easyaccesstoinformationfromdrugindices,literature,and
other medical students to selfdiagnose and selfmedicate.

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Australasian Medical Journal [AMJ 2012, 5, 4, 217220]



In addition, they have easy access to the medication itself


through physician samples provided by pharmaceutical
representatives, and The White Coatguarantees trouble
freeaccesstodrugsavailableinpharmacies.

There is a paucity of studies on selfmedication among


medical students.3 The present study was undertaken to
identifythereasonsfor,andthepatternsof,selfmedication
amongmedicalstudents.

Method
This crosssectional study was undertaken in K.S. Hegde
MedicalAcademy,Mangalore,India,withapprovalfromthe
Institutional Ethics Committee. The study population
consistedofmedicalstudentsfromfirsttofinalyear,within
the age group of 1825 years. Students were selected for
the study by a convenient sampling method. The
participants were briefed about the nature of the study,
consent was given and a pretested semistructured
questionnaire administered to them. The information
pertainingtothepatternofselfmedication,indicationsfor
selfmedication and drugs used for selfmedication were
included in the questionnaire. The investigators were
presentincasetherespondentsrequiredassistance.Forthe
purposeofthestudy,certainmedicaltermswereexplained
to the firstyear students, including dysmenorrhea,
antipyreticsandanalgesics.

The data was analysed using SPSS version 16.00 and


summarisedasproportions.

Results
A total of 200 students participated in the study, of whom
121(60.5%)werefemaleand79(39.5%)weremale.Among
these200students,45(22.5%),49(24.5%)and106(53.0%)
werestudyingintheirfirstyear,secondyearandfinalyear
respectively (Table 1). A total of 110 (90.9%) female
participants and 74 (94.7%) male participants said they
practicedselfmedication.Allthevariablesweredenotedin
multipleresponsequestions.

Table 1: Sociodemographic characteristics of study


population

No.ofstudents
%
Sociodemographicfactors
N=200
Male
79
39.5
Gender
Female
121
60.5
Agegroup
1821
153
76.5
(years)
2225
47
23.5
Firstyear
45
22.5
Yearof
Secondyear
49
24.5
study
Finalyear
106
53.0

The study found that the conditions prompting self


medication (Figure 1) were the common cold (69%), fever
(63%) and headache (60%), followed by gastrointestinal
ailments, i.e. diarrhoea (23%), gastritis (21%) and
nausea/vomiting(16%).

Table 2: Pattern of selfmedication among medical


students

Characteristics
Responses
Reasonsforselfmedication
No.ofstudents
%
(N=200)
22
11
Lackoftimetoconsultdoctor
164
82
Minorailment
Didnotwanttoconsult
12
6
faculty/peers
Finishedpharmacology,have
17
8.5
confidence
Awarenessofadverseeffects

(N=184)
124
67.4
Yes
60
32.6
No

Adversereactions(N=184)
10
5.4
Experienced
174
94.6
Notexperienced

Source(N=200)
78
39
Textbook
76
38
Senior/classmate
65
32.5
Pharmacist

The classes of drugsthat were commonly used (Figure 2)


were antipyretics (71%), analgesics (65%), antihistamines
(37%)andantibiotics(34%).Somepotentiallyharmfuldrugs
werealsoused,suchassleepingpills(2%),steroids(2%)and
stimulants(1.5%).

A significant number, 32.6% of the study group, was


unawareoftheadverseeffectsofthedrugstheytook(Table
2).Thestudyfoundthat10students(5.4%)hadexperienced
adverse reactions while on selfmedication (Table 2). Of
thosewhoexperiencedadversereactions,50%consulteda
doctor and the remaining 50% changed the medication on
theirown.

The most common sources of information for self


medication(Table2),whichweredenotedinmultiplechoice
questions, were textbooks (39%) andseniorsor classmates
(38%).

It was found that of 184 students who practiced self


medication, 117 (63.6%) suggested medication to others,
mostcommonlytofamily/friends(51.8%)andtoclassmates
orjuniors(48.2%).

218

Australasian Medical Journal [AMJ 2012, 5, 4, 217220]



Discussion
Selfmedication is becoming an increasinglyimportant area
withinhealthcare,4andthisstudyhasshownthatitiseven
more prevalent among medical students. This study has
found a prevalence of selfmedication of 92% in medical
studentsincontrastto59%inanonmedicalpopulationina
previous study.1 It is also noted that a high level of
educationandprofessionalstatusarepredictivefactorsfor
selfmedication.3 This is similar to the findings in a study
conducted by Erlend Hem and colleagues5 (90%) but is
higher than the findings (60%) in the study conducted by
HenryJamesandcolleagues.3

In our study it was found that more male students (94%)


practice selfmedication than female students (91%). This
differs from a previous study conducted among medical
students,whichshowedagreaterprevalenceamongfemale
students(45%)thanmalestudents(44%).3

Ourstudydenotedthatthemostcommonreasonsforself
medication were minor ailments (82%) and lack of time to
consultadoctor(11%),whichisinconcordancewithother
studiesthat reported the reasons as mild illness (40%) and
shortage of time to consult a doctor (32%).3 The next
common reason for selfmedication in our study among
medical students was their confidence in selfdiagnosis
(8.5%), which is unique to this study group. Misplaced
confidence can lead to inappropriate selfmedication and
can expose the participants to all the risks associated with
inappropriateuseofmedications.3

With respect to indications, results were similar to those


foundinapreviousstudy.3Wealsofoundmedicalstudents
selfmedicate for unusual reasons, i.e. sports injuries,
hangovers, exam stress and recreational drug use, which
may not be common in the general public. In the study it
was noticed that the classes of drugs that were commonly
used were antipyretics (71%), analgesics (65%),
antihistamines(37%)andantibiotics(34%).Thisissimilarto
studies done earlier, which showed antipyretics (43%),
analgesics (81%), antibiotics (6%) and antihistamines (13%)
were commonly used.3 In other studies it was found that
medical students (N=68) used more types of antibiotics
compared to the nonmedical students (N=69), which may
bebecauseoftheirknowledgeaboutantibiotics.7Wehave
found,however,that11(5.5%)ofthemedicalstudentsare
not afraid of using drugs with potentially harmful adverse
effects and potential for addiction and abuse, i.e. sleeping
pills (2%),steroids (2%) and stimulants(1.5%).These drugs
maynotbeaseasilyavailabletothegeneralpopulationas
theyaretomedicalstudents,whocanobtainthembyvirtue
of their profession, and previous studies have reported
higheruseofantimicrobialswhenthestudyparticipantwas
ahealthcareprofessional.3

Despite studying in detail about all these drug reactions,


32.6%ofthestudentswereunawareoftheadverseeffects
of the drugs they used for selfmedication. In addition to
this,5.4%ofthestudygroupreportedexperiencingadverse
effects,forwhichtheyeitherconsultedadoctororstopped
themedication.

The study group cited their source of information for self


medicationinmostcasesastextbooks(39%)andseniorsor
classmates (38%); this is similar to other studies, which
showed medical students use their academic medical
knowledge50%ofthetimetoselfmedicate.7

Conclusion
Thisdescriptivestudyhasfoundthatselfmedicationisvery
common among medical students, facilitated by the easy
availability
of drugs, and information from
textbooks/seniors. A significant number of students are
unawareoftheadverseeffectsofthemedicationthatthey
themselvestakeandsuggesttoothers.Sinceinappropriate
selfmedicationhasthepotentialtocauseseriousharm, not
only to the students themselves but also to those whom
they suggest medication, potential problems of self
medication should be emphasised to the students to
minimise this risk. Restriction of sale of drugs with
potentially harmful effects should be implemented
effectivelywithmonitoringsystemsbetweenthephysicians
and pharmacists. Steps can also be taken to educate
pharmacistsontheneedtocrosscheckwiththeprescribing
physicianwhiledispensingsuchdrugs.

The limitations of this study included the absence of a


comparativegroup,suchasstudentsfromanotherfield;the
small sample size; and the absence of interventions, like
providinginformationregardinghazardsofselfmedication.

References
1.ShankarPR,ParthaP,ShenoyN.Selfmedicationandnon
doctor prescription practices in Pokhara valley, Western
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2. Montastruc JL, Bagheri H, Geraud T, Lapeyre Mestre M.
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Therapie.
1997;52:105110.
3.JamesH,HanduSS,KhalidAJ,KhajaA,OtoomS,Sequeira
RP. Evaluation of the knowledge, attitude and practice of
selfmedication among firstyear medical students. Med
PrincPract.2006;15:270275.
4.HughesCM,McElnayJC,FlemingGF.Benefitsandrisksof
selfmedication.DrugSaf.2001;24:10271037.

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Australasian Medical Journal [AMJ 2012, 5, 4, 217220]



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The authors would like to thank the medical students for


participatinginthisstudy.

Figure1:Indicationsforselfmedication

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Figure2:Drugsusedforselfmedication

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ACKNOWLEDGEMENTS

Figures

A
nt

5.HemE,StokkeG,ReidarTyssenR,GrnvoldNT,VaglumP,
Ekeberg O. Selfprescribing among young Norwegian
doctors: a nineyear followup study of a nationwide
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6.KiyingiKS,LauwoJAK.Drugsinhome:dangerandwaste.
WorldHealthForum1993;14:381384.
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Antibiotic SelfMedication among South Iranian University
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4852