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ORIGINAL ARTICLE
Year : 2012 | Volume : 58 | Issue : 2 | Page : 127-131

Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal
I Banerjee1, T Bhadury2,
1 Department of Pharmacology, Murshidabad Medical College, Behrampore, India
2 Department of Medicine, AMRI Hospitals Limited, Kolkata, West Bengal, India
Correspondence Address:
I Banerjee
Department of Pharmacology, Murshidabad Medical College, Behrampore
India

Abstract
Background: Self-medication is a w idely prevalent practice in India. It assumes a special significance among medical students as they are the
future medical practitioners. Aim: To assess the pattern of self-medication practice among undergraduate medical students. Settings and
Design: Tertiary care medical college in W est Bengal, India. Material and Methods: A cross-sectional questionnaire-based study w as conducted
among the undergraduate medical students. Results: Out of 500 students of the institute, 482 consented for the study and filled in the
supplied questionnaire. Fourteen incomplete questionnaires w ere excluded and the remaining 468 analyzed. It w as found that 267 (57.05%)
respondents practiced self-medication. The principal morbidities for seeking self-medication included cough and common cold as reported by 94
students (35.21%) follow ed by diarrhea (68 students) (25.47%), fever (42 students) (15.73%), headache (40 students) (14.98%) and pain
abdomen due to heartburn/ peptic ulcer (23 students) (8.61%). Drugs/ drug groups commonly used for self-medication included antibiotics
(31.09%) follow ed by analgesics (23.21%), antipyretics (17.98%), antiulcer agents (8.99%), cough suppressant (7.87%), multivitamins (6.37%)
and antihelminthics (4.49%). Among reasons for seeking self-medication, 126 students (47.19%) felt that their illness w as mild w hile 76
(28.46%) preferred as it is time-saving. About 42 students (15.73%) cited cost-effectiveness as the primary reason w hile 23 (8.62%) preferred
because of urgency. Conclusion: Our study show s that self-medication is w idely practiced among students of the institute. In this situation,
faculties should create aw areness and educate their students regarding advantages and disadvantages of self-medication.

How to cite this article:

Banerjee I, Bhadury T. Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal.J Postgrad Med 2012;58:127131

How to cite this URL:

Banerjee I, Bhadury T. Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal. J Postgrad Med [serial online]
2012 [cited 2016 Jun 9 ];58:127-131
Available from: http://www.jpgmonline.com/text.asp?2012/58/2/127/97175

Full Text
Introduction

W illiam Osler once commented, "The desire to take medicine is perhaps the greatest feature w hich distinguishes man from animals". This desire
is perhaps the key factor for the practice of self-medication w hich can be defined as obtaining and consuming drugs w ithout the advice of a
physician either for diagnosis, prescription or surveillance of treatment. [1]
Self-medication is w idely practiced w orldw ide and often considered as a component of self-care. [2] How ever, unlike other components of selfcare, self-medication has the potential to do good as w ell as cause harm since it involves the use of drugs. The W orld Health Organization
(W HO) has appropriately pointed out that responsible self-medication can help prevent and treat diseases that do not require medical
consultation and provides a cheaper alternative for treating common illnesses. [3] The practice of self-medication must be based on authentic
medical information otherw ise irrational use of drugs can cause w astage of resources, increased resistance of pathogens, and can lead to
serious health hazards such as adverse drug reaction and prolonged morbidity. [2] In developing countries like India, self-medication is a
common practice as it provides a low -cost alternative for people w ho cannot afford the high cost of clinical service and also as many drugs are
dispensed over the counter w ithout prescription from a registered medical practitioner. [4]
Self-medication assumes a special significance among the medical students as they are the future medical practitioners and have a potential
role in counseling the patients about the advantages and disadvantages of self-medication. Medical students also differ from the general
population because they are w ell-exposed to the know ledge about diseases and drugs. A literature search w as conducted w hich consisted of a
Medical Literature Analysis and Retrieval System Online (MEDLINE) database search (accessed on 16.4.2010) and a W orld W ide W eb search
(Search engine: Google, accessed on 16.4.2010) using the follow ing keyw ords: Self-medication, medical students, study. The search revealed
that few studies have been conducted to ascertain the self-medication practice among medical students. [5],[6],[7],[8],[9],[10],[11],[12] In
these studies, the prevalence of self-medication practice w as found to vary among medical students of different countries. Headache, common
cold and cough, fever, abdominal pain have been mentioned as the primary morbidities for seeking self-medication. The drugs predominantly
used included analgesics, antibiotics, antipyretics. The reasons for seeking self-medication as mentioned in the majority of the literature are mild

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nature of illness, prior experience of treating similar illness, economic considerations. How ever, since the majority of these studies w ere
conducted outside India, [5],[6],[8],[9],[10],[12] the pattern of self-medication among medical students of India remained unexplored.
Our study w as conducted against this backdrop w ith the aim to assess the pattern of self-medication practice among the undergraduate
medical students.

Materials and Methods

Study design
This w as a cross-sectional, questionnaire-based study.
Study setting
The study w as conducted in a tertiary care district medical college and hospital in W est Bengal.
Study participants
During the study period five batches (2005-06, 2006-07, 2007-08, 2008-09 and 2009-10) of MBBS students w ere available in the institute, each
batch comprising 100 students. All the 500 students w ere considered eligible for participating in the study.
Sample size calculation
The minimum sample size (N) w as calculated using the Cochran formulae: [13] N = Z 2 pq / d 2
w here N is the sample size,
p is the prevalence of self-medication taken as 50%,
q = (1 p),
Z is the standard normal deviation (usually set at 1.96, w hich corresponds to the 95% confidence interval), and d is the desired degree of
accuracy set at 0.05 to tolerate a 5% error. Accordingly, the calculated minimum sample size N= 384, 20% non-response rate w as added to the
final sample size. Thus, N = 384 + 20/100(384) = 384 + 76.8= 460.8. For better precision, w e took an additional 40 of them. Thus, a total of 500
students studying in the institute w ere considered to be eligible to participate in the study.
Ethical issues
Prior permission w as obtained from the ethics committee of the institution for conducting the study. The purpose of the study w as explained to
the participating students and confidentiality w as ensured. Informed consent w as obtained from every student before filling the questionnaire.
Study procedure
All the undergraduate medical students w ere contacted during the scientific session of the annual college program held in the second w eek of
May 2010. Out of 500 students, 18 students w ere found absent. The purpose of the study w as explained to the remaining 482 students, all of
w hom consented to the study. After obtaining informed consent, they w ere asked to fill up a printed, semi-structured questionnaire. The
questionnaire w as designed and pretested on 50 internees (Batch 2004-05) w ho w ere not included in the study. The questionnaire contained
questions regarding demographic information, w hether the student sought self-medication in the preceding month, illness for w hich the
medication w as used, drug/ drug group used by them and the reason for not consulting a healthcare professional [Annexure 1]. For the
purpose of the study, certain operational terms w ere defined. Self-medication w as defined as the use of medicine for self-treatment w ithout
consulting a healthcare professional. A healthcare professional w as defined as a person:
W ho has obtained a bachelor of medicine and bachelor of surgery (MBBS) degree in allopathic medicine and registered w ith Medical Council of
India/ State Medical Council orPossessing Bachelor of Homoeopathic Medicine and Surgery [BHMS degree] (for homeopathic practitioners)
orPossessing Bachelor of Ayurvedic Medicine and Surgery [BAMS degree] (for ayurvedic practitioners).
[INLINE:1]
Statistical analysis
The returned questionnaires w ere checked for completeness of data. The data obtained from the completed questionnaires w ere analyzed in
the computer by using Statistical Package for Social Sciences (SPSS) program Version 10. Descriptive data w ere expressed as percentage,
frequency and meanS.D. Chi-square test w as used for testing statistical significance. A P value less than 0.05 w as considered to be
statistically significant.

Results

A total of 468 students successfully completed the questionnaire. (Flow of participants show n in [Figure 1].) The mean age of the respondents
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S.D w as 21.034.82 years. The total number of male students (372) outnumbered their female counterparts (96) (P<0.001). A total of 267
(57.05%) students reported having practiced self-medication during the preceding month w ith 200 males (53.76%) and 67 females (69.79%)
(P<0.006). It w as found that the prevalence of self-medication varied significantly among different years of students as evidenced by the fact
that 79.31% of final-year students practiced self-medication compared to 41.67% of first-year students (P<0.0001). The details of the pattern of
self-medication as practiced by the study population have been enumerated in [Table 1].{Figure 1}{Table 1}
It w as found that cough and common cold (35.21%) w as the predominant morbidity for w hich students practiced self-medication. Other causes
of morbidity prompting the students to practice self-medication included diarrhea, fever, headache, pain in the abdomen due to heartburn/
peptic ulcer. Drugs or drug groups commonly used for self-medication included antibiotics (31.09%) follow ed by analgesics, antipyretics,
antiulcer agents, cough suppressants, multivitamins, and antihelminthics. How ever, the choice of drugs varied among students of different
years [Table 2], [Figure 2]. The final-year students used antibiotics more (37.68%) than first-year students (22.5%) but the difference w as not
statistically significant (P<0.15). Among the reasons given for practicing self-medication, 126 (47.19%) respondents felt that their illness w as
mild w hile 76 (28.46%) preferred self-medication as it is time-saving. About 42 students (15.73%) reported that cost-effectiveness w as the
primary reason for self-medication w hile 23 (8.62%) preferred because of urgency.{Figure 2}{Table 2}

Discussion

The present study indicates that self-medication is w idely practiced (57.05%) by the undergraduate students of the institute. In studies
conducted among first-year medical students in Bahrain (2006), [5] about 44.8% of students practiced self-medication w hile in Karachi, the
percentage is 76%. [6] A study conducted among medical students in Karnataka revealed 53% students practicing self-medication. [7]
How ever, dearth of data regarding the incidence of self-medication practice in the Indian population creates difficulty in comparing the extent of
self-medication among undergraduate students of the institute in the national perspective.
In our study it w as found that the practice of self-medication w as more prevalent among females than males (P<0.006). This finding i.e. female
preponderance in seeking self-medication w as not considered in earlier studies conducted w ith a similar objective on medical students in India.
How ever, in a study conducted to assess the sex difference in self-medication practices among university students in Slovenia (2011), the
researchers failed to demonstrate any statistically significant difference betw een male (90.9%) and female (94.1%) students. [8]
It is generally expected that self-medication w ould be more prevalent in senior medical students as they are exposed to the know ledge about
drugs and disease. A notable finding in our study is that final-year students practiced self-medication more frequently than first-year students
(P value<0.001). This finding is in congruence w ith the study conducted in Slovenia (2010) by Klemenc-Ketis et al.[9] Similar results w ere also
reported in the study conducted by James et al., [10] w here medical students of Year 4 practiced self-medication more often than those of Year
2 (P value=0.02). This suggests that a higher level of medical education is associated w ith increased practice of self-medication. How ever, in the
study conducted in Nagpur by Sontakke et al., [11] the prevalence of self-medication among junior and senior medical students did not differ
significantly.
Regarding the morbidities w hich prompted the medical students to practice self-medication, cough and common cold (35.21%) w as most
common follow ed by diarrhea, fever, and headache. In studies conducted among first-year medical students in Bahrain (2006), [5] headache
w as the most common one (70.9%) follow ed by cough/common cold, stomachache, and fever. Headache (72.4%) w as also the most common
morbidity among medical students seeking medication in the study conducted in Karachi. [6] In the study conducted in Ethiopia, [12] fever and
headache w ere the most commonly reported symptoms for self-medication follow ed by cough and common cold.
The drugs w hich w ere frequently used for self-medication in our study w ere antibiotics (31.09%) follow ed by analgesics, and antipyretics. In the
study conducted in Karachi, [6] analgesics w ere the most common (88.3%) follow ed by antipyretics and antibiotics; the study in Bahrain (2006)
[5] also reported analgesics to be the most commonly used drug group (81.3%) w ith antibiotics contributing only 6% of the total share. The
reason provided by the researchers for limited use of antibiotics in medical students in Bahrain is that the governments in the countries to w hich
the study respondents belonged have strict regulatory policies about the prescription and over-the-counter (OTC) sale of antibiotics. How ever,
some studies conducted in developing countries w ith similar intent have reported a higher use of antimicrobials for self-medication, especially
w here there is increased incidence of infectious diseases and antibiotics are freely available OTC. [6],[14] This suggests that use of
antimicrobials is high w hen there is lack of implementation of proper regulatory control over the OTC sale of these drugs.
Regarding reasons w hich provoked students for self-medication, mild nature of illness w as the most common one (47.19%). The fact that those
w ith a mild illness practiced self-medication has got serious implications as many diseases may initially appear to be mild but misdiagnosis and
w rong treatment may invite serious health hazards. This finding is in congruence w ith the findings of the study conducted in Bahrain (2006) [5]
w here 45.5% of students preferred self-medication as it is time-saving w hile 25.4% preferred it due to minor nature of illness.
It is a common tendency among medical professionals to practice self-medication w hen they themselves feel sick. Although they can consult
fellow physicians, due to busy lifestyle and a complex set of reasons including ego, they hesitate in seeking medical help from professional
colleagues w hen they are ill. This particular practice how ever has its pros and cons. W hile responsible self-medication is a convenient
alternative to treat minor illness as w ell manage acute emergency, inappropriate self-medication results in deleterious results. The practice of
self-medication gets incorporated in the medical professionals right from their undergraduate days. In this situation further multicentric studies
w ith the objective of evaluating the know ledge, attitude, practices of self-medication involving a w ider section of the medical students (both
undergraduates and postgraduates) across different medical colleges in the country is urgently needed to estimate the magnitude of selfmedication in the medical fraternity. The findings of such multicentric studies could dictate the need of incorporating responsible self-education
as an intrinsic component in medical curriculum.
Limitation
The study w as based on self-reported data about self-medication in the preceding one month thus prone to recall biasMoreover, although the
students w ere encouraged to complete the questionnaire independently, mutual influence betw een the students could not be entirely ruled

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outThe results of the study w ould have been more generalized if it could involve students of other medical collegesA longer timeframe could
have been considered instead of one month as different illnesses come in cyclesData on the number of undergraduate students w ith chronic
diseases should have been included in the study.
Thus, our study show s that self-medication is w idely practiced among the medical students of the institute w ith antibiotics being the most
commonly used drug group and cough and common cold being the predominant morbidity for seeking self-medication. In this situation, faculties
of the institute should create aw areness and educate their students regarding advantages and disadvantages of self-medication. Our study
also appreciates the need of conducting further multicentric studies involving w ider sections of medical professionals to estimate the magnitude
of self-medication practice in the medical fraternity.

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