Self-medication Practices of the Rural Community People: A Cross-Sectional Study

Abstract

Background:

Self-medication is the practice of taking medicines without a physician’s advice, and it has become more common in developing nations. The root cause could be anything from a shortage of physicians to financial factors. However, most people are not aware of the ill effects and drug reactions brought on by self-medication. This research aimed to find out the prevalence, frequency, common complaints, primary sources, and regular medicines utilized for self-medication, which are the goal of this study.

Materials and Methods:

A cross-sectional study was conducted among the rural community people in Keezhur, Chengalpattu District, Tamil Nadu, India. A group of 253 participants were selected using a random sampling technique. A self-structured questionnaire was used to collect the data. The gathered information was coded and examined.

Results:

Self-medication was common in 60.5% of people, and 46.6% of them frequently utilize analgesics. The most frequent condition for which people used self-medication was headache (30.4%). The practice was significantly correlated with the younger age group and the level of education.

Conclusion:

Self-medication is harmful to one’s health and is widespread in the research group’s region. To reduce the practice of self-medication, general people should get sufficient health education.

INTRODUCTION

Self-medication is the practice of taking medicines without a physician’s advice.[1,2] Self-medication with over-the-counter medications has grown in popularity throughout the world.[3] Self-medication is used for minor ailments because it frequently offers an affordable, quick, and convenient treatment, without which any country’s healthcare system would be overwhelmed.[3,4] Self-medication may reduce patients’ wait hours for doctor’s appointments and could reduce medical expenses using scarce medical protection for minor illnesses. However, inopportune self-medication practices can result in health risks such as incorrect self-diagnosis, the incorrect treatment being adopted, extensive and continued usage, harmful side effects, adverse drug reactions, the inability to swiftly seek the right medical advice, and polypharmacy.[5-7] Most people are ignorant of the negative consequences and pharmacological reactions. When people self-medicate, the risks of fatalities are increased.[8] Reasons for self-medication could be a modern lifestyle, the easy availability of medication, a busy work schedule, a lack of time to seek doctor appointments, or waiting for a longer period for consultation.[4,9]

Self-medication is found all over the world. In India, the prevalence of self-medication practice varied from 9% to 90%.[10] The media and the Internet are the main sources of growing self-medication practices prohibited by the Drugs and Magic Remedies Act of 1954.[11,12] The ability to practice self-medication may also be influenced by other elements, including a positive outlook and sense of confidence regarding the medication and the severity of the sickness.[13] Many factors, including education level, familial and societal influences, drug availability, and marketing exposure, might impact someone’s decision to choose self-medication.[13] People’s perception of the nature and frequency of illness may also influence the choice of self-medication.[14,15]

This research study’s objectives were to determine the prevalence of self-medication practice among rural communities, common complaints of self-medication practice, the regular medicines utilized for self-medication, and the relationship between demographic variables and self-medication practice.

MATERIALS AND METHODS

Research design and setting

Community-based cross-sectional research was completed in July 2022. The Institutional Human Ethics Committee at Chettinad Academy of Research and Education provided their approval for the study with the proposal number (IHEC-I/0605/22). The study was carried out in Keezhur Village, Chengalpattu District, Tamil Nadu, India. The community is situated 55 kilometers from Chengalpattu and 40 kilometers from Kelambakkam. According to the 2020 census, Keezhur Village has about 1305 citizens. Keezhur Village has a total area of 214.51 hectares.

Sample size

There were 800 adults living in the community. Of that, 391 were women and 409 were men among the adult community (members under 18 years of age were excluded). The sample size formula is as follows:

n = Z²Xp(1-q)/E2/1 + Z2Xp (1-q)/E2/N

where n is the sample size, Z is the significant level of the normally distributed at the appropriate confidence level, Z = 1.96 for a 95% confidence interval, Z² is 3.84, p is the sample proportion (0.6), E is the margin of error (0.05), and N is the population size (800). The estimated sample size was 253.

Participants

The study participants in the age group of 18 to 69 years living in the locality of Keezhur Village were selected. A simple random technique was applied using the lottery method for the selection of two of four wards. The first ward had six streets, and the second ward had 10 streets. A total of 14 streets of 16 were selected by the lottery method. From that point, five of every 13 houses on the street were selected, giving a total of about 182 houses. From each house, roughly four adults were selected. This process was repeated until the desired sample size of 253 was achieved. Ninety-seven subjects were obtained from ward 1 and 156 subjects from ward 2.

Questionnaire development and data collection

A self-structured questionnaire in English was developed after a thorough examination of the literature. The content of the questionnaire was verified by the expert team. It was translated into Tamil (the regional language) by the investigator, and the tool was verified by a Tamil language expert. The study questionnaire consisted of two parts—socio-demographic and self-medication practices. The data were collected over two months in the village of Keezhur. The research aim was explained, and informed written consent was obtained before gathering the data. Age, gender, education, occupation, income, consumption of self-medication, condition of the drug consumers, reasons, common problems, and knowledge source materials were collected. Data were collected from each participant through the questionnaire, followed by a booklet given about risk, awareness of self-medication practices, and adverse events. The questionnaire was read to those who were unable to read because of impaired vision or illiteracy.

Statistical analysis

Statistical analysis was carried out with Statistical Package for the Social Sciences (SPSS) V26. The gathered information was summarized and coded. The continuous data were reported as the mean standard deviation, whereas the descriptive analysis was expressed as a percentage. The relationship between demographic factors and self-medication practices was examined by the Chi-square test with a probability value of 0.05. Findings were presented in the bar graphs and frequency distributions.

RESULTS

Demographic variables

The respondents’ average age ranged from 18 to 39 years, with a standard deviation of 10.76 and a mean of 37.89. Among the 253 responses, men were 28.9% and women were 71.1%. 98.4% of people were Hindus. 69.6% of respondents were married, which was more than half. One-third (27.3%) of the population was illiterate.

Common complaints of seeking self-medication practices

The practice of self-medication for common health issues is as follows: for alleviating headache (30.4%) of respondents, for fever (24.5%), for respiratory disorders (17.8%), for back pain (14.2%), for gastrointestinal disorders (7.5%), for body pain (3.6%), and for skin disorders (2%).

Commonly used medicines in self-medication

Figure 1 illustrates commonly used medications for self-medication practices. Analgesics were the most commonly used form of self-medication. Thus, 46.6% of people had generally taken painkillers followed by antihistamines (13.4%), antipyretics (24.5%), antihypertensives (3.6%), antibiotics (2.4%), eye drops (2.4%), topical preparations (2.0%), antacids (1.6%), antidiabetics (1.6%), vitamin supplements (1.2%), and ear drops (1.2%).

Figure 1.

Common drugs used for self-medication practices

Association between demographic variables and self-medication practices

Age was strongly correlated with the amount of self-medication, according to a Chi-square value of 20.322 and a P value of 0.002. The reason for this can be that, as people age, they try to increase their knowledge. The level of self-medication behaviors is substantially correlated with education, as shown by the Chi-square value of 22.695 and the P value of 0.030. There is no significant relationship between the respondents’ sex, marital status, employment, income, family type, and self-medication practices. Table 1 shows the association between demographic variables and self-medication practices.

Table 1.

Association between demographic variables with self-medication practice

Demographic variables	Level of practice			DF	Chi-square	P
	Not often	Most often	Often
Age (years)
18–39	3	99	46	4	10.483	0.033*
40–59	9	60	26
60–69	2	5	2
Gender
Male	5	41	27	2	3.372	0.185
Female	9	123	48
Education status
Illiterate	10	36	23	12	22.695	0.030*
Primary	2	29	11
High school	2	7	6
Higher secondary	0	37	17
Diploma	0	15	2
Undergraduate	0	34	14
Postgraduate	0	6	2
Employment status
Unemployed	3	38	13	8	8.600	0.377
Private	1	45	22
Government	0	1	0
Contract	8	42	23
Self-employed	2	38	17
Monthly income (rupees)
Rs. 1,046–4,095	4	38	14	4	1.596	0.810
Rs. 4,096–12,695	10	118	57
More than 12,696	0	8	4
Type of family
Nuclear	14	114	47	2	4.412	0.110
Joint	0	40	38
Distance from house to the pharmacy
<15 minutes	6	36	14	4	6.701	0.153
15–30 minutes	6	119	57
30 minutes–1 hour	2	164	4

P<0.05 level is significant

DISCUSSION

The main objective of the study was to find out the prevalence of self-medication among populations in the rural community. Self-medication was prevalent in 60.5% of the rural population at Keezhur Village, Chengalpattu District, India. Similar studies conducted in Nepal showed the prevalence of 62%, and in Erode, the prevalence was 59%.[16,17] The primary causes of self-medication identified were headache (30.4%) followed by fever (24.5%). A similar study was carried out in India, which reported that headache was the most common ailment for which people self-medicated.[18,19] The present study shows that 27.7% of participants used self-medication only for minor ailments. These findings were consistent with those of a study carried out where the typical justification for self-medication was to avoid visiting a physician or other healthcare provider for a minor medical issue.[20] The current study also showed that most respondents (56.5%) resorted to the pharmacist before seeking information. One relevant study shows that 57.3% of people were self-medicated by the pharmacist.[21] In the present research, analgesics were the most widely used drug category for self-medication at 46.6%. Two researchers reported that nearly 42.2% of people used analgesics as self-medication in the community.[19,22] Demographic variables such as age and level of education were found to be significantly associated with self-medication practice (less than 0.05). An eloquent study showed that self-medication practice was revelatory to the age.[23] A meaningful study showed a significant association between education and self-medication practice.[24,25]

To reduce its prevalence, the negative effects of self-medication and their significance must be made known to the public. To make people more cognizant of the proper use of drugs and their significance in establishing a healthy lifestyle, a cause-and-effect relationship could not be established since we only included research participants who used drug outlets for self-medication. Given that it was not a multicenter study, the current one has limitations in terms of generalizability. A simple approach of sampling from nearby rural areas was used for the study. This research’s findings may not be generalizable because residents of that location have low incomes and little education.

CONCLUSION

Self-medication is a significant health concern. Since respondents were in favor of utilizing self-medication for their own needs and promoting it to others, public health education and pharmacy regulation may aid in reducing the use of self-medication. According to media reports and research publications from throughout the nation, Indians have discovered how to easily predispose themselves to the dangerous practice of self-medication. To help the public understand the benefits and drawbacks of responsible self-medication, the drug regulatory and health authorities must invest some resources in this effort. This will help change the general public’s attitudes toward self-medication practices. Second, doctors need to exercise more restraint when writing prescriptions and urge that only valid prescriptions be used to get medications from pharmacies. The public’s access to drugs must be reasonably limited by a proper legal drug control system, which must be put in place.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.