ABSTRACT
Introduction:
Billions of people worldwide rely on self-medication, a key component of self-care endorsed by the World Health Organization. While self-medication, particularly with over-the-counter (OTC) medications, is generally considered safe, misuse—especially involving prescription medications—poses risks. This study explores the practice of self-medication among adult patients attending primary healthcare centers of NGHA in Riyadh, Saudi Arabia.
Methods:
A cross-sectional study was conducted in Riyadh, Saudi Arabia, from November 2022 to January 2023, involving 387 participants from four primary healthcare centers. Non-probability convenience sampling was used, with data collected through a well-structured questionnaire that assessed sociodemographic factors, self-medication habits, and awareness levels.
Results:
The majority of participants were female (60.20%), aged 25–35 years (38.50%), and married (65.10%). Chronic diseases were reported by 28.30% of participants. Self-medication was prevalent among 82.30%, primarily for pain relief (55.50%). Painkillers were the most commonly used (65.60%). Factors influencing self-medication included long waiting times (51.10%) and reliance on previous prescriptions (44.10%). Participants generally exhibited good knowledge, though this varied by gender and education level.
Conclusion:
This study reveals a high prevalence of self-medication, particularly among females, with a focus on pain management and influenced by extended waiting times. While participants demonstrated overall good knowledge, there are specific areas, particularly related to medication details, that require improvement. The findings highlight the need for targeted public health education to address the potential risks associated with self-medication.
Keywords: Over-the-counter drugs, NGHA, Riyadh, Saudi Arabia, self-medication
Introduction
Many people worldwide rely on self-medication to manage a variety of medical conditions each year.[1,2] As an essential aspect of self-care, self-medication helps in preventing and treating illnesses.[3] According to the World Health Organization (WHO), self-medication is defined as the use of medication by individuals to treat self-diagnosed diseases or symptoms.[4] This practice is widespread globally, particularly in underdeveloped countries, with prevalence rates ranging from 38.5% to 92% in different regions.[1,5,6,7]
Self-medication can effectively address minor illnesses and conditions that do not require a physician’s intervention.[8,9] It also helps to alleviate the burden on healthcare systems with limited resources.[6,8,9] Typically, over-the-counter (OTC) medications are utilized for self-medication, and these are generally safe and effective for public use without medical consultation, as endorsed by WHO guidelines.[4,8]
Self-medication practice arises due to various factors. Some of the important reasons include limited or no access to healthcare facilities, prior good experience, minor or mild illness, emergency conditions, inexpensiveness, suggestions by friends, and sufficient knowledge of drugs.[10]
However, the drawbacks of self-medication practice can undermine its effectiveness. While OTC medications are usually safe, the misuse of prescription drugs without proper medical guidance poses significant risks.[11] A notable concern is the misuse of oral opioids for pain management, with studies indicating that many individuals who abuse opioids started with these medications, including some available over the counter.[12] Such misuse can lead to severe side effects, including drug toxicity, adverse drug reactions, and food-to-drug interactions.[5]
Despite numerous studies on self-medication, few have focused on the general population. Most research has targeted specific demographic groups, such as college students, pregnant women, or the misuse of antibiotics.[13,14,15] Additionally, there is a significant shortage of studies evaluating the general population’s knowledge of self-medication practices, particularly in Saudi Arabia. A 2015 study conducted in Saudi Arabia indicated that a substantial proportion of participants lacked adequate knowledge about self-medication.[11] Following that study, there have been limited investigations into whether there has been any improvement in knowledge levels over time. This gap in research highlights the urgent need for a comprehensive assessment of public awareness and understanding of self-medication, including its potential risks and benefits.
By addressing this gap, the current study aims to provide valuable insights into the self-medication practices of adult patients attending primary healthcare centers at NGHA in Riyadh. The findings will not only enhance the understanding of self-medication within this specific context but will also inform the development of targeted interventions to promote safe and responsible self-medication practices in Saudi Arabia.
Methods
Study setting and participants
This cross-sectional study was conducted at four major primary healthcare centers in Riyadh, Saudi Arabia, from November 2022 to January 2023. Patients in the waiting areas of these clinics were invited to participate in the study.
A non-probability convenience sampling technique was employed. The sample size was determined based on a 95% confidence interval and a 5% margin of error, resulting in an estimated sample size of 387 participants. All participants met the inclusion criteria, which required them to be 18 years or older and of either gender. Exclusion criteria included individuals who were mentally incompetent, minors, and those who declined to participate.
Data collection method
The data collection process was carried out using a well-structured self-administered questionnaire that included a mix of open- and closed-ended questions. Initially prepared in English, the questionnaire was then translated into Arabic by a team of experts to ensure accuracy and reliability. A pilot study of 30 patients was done before the definitive data collection to confirm the validity and reliability of the questionnaire. The participants were informed about the purpose of the study, and their verbal and written consent was obtained before conducting the questionnaire.
The questionnaire comprised three sections: participant profiles, self-medication habits, and awareness levels. The participant profile section collected demographic data, such as gender, age, education level, occupation, employment, income, marital status, and chronic diseases. The self-medication habits section included inquiries about the practice of self-medication, types of medication used, conditions for which the medication was used, reasons for engaging in self-medication, and sources of knowledge about the medication used. The awareness status section consisted of twelve questions associated with side effects, time intervals, and the timing for discontinuing medication.
Statistical analysis
Statistical analysis was performed using SPSS (IBM Version 26). Categorical data were presented as frequencies and percentages. The Chi-square test was employed to examine the association between self-medication practices and sociodemographic variables. The Chi-square test results included frequencies, percentages, and P values. A P value of < 0.05 was considered indicative of statistical significance.
Ethical considerations
The study received ethical approval from the King Abdullah International Medical Research Center, Ministry of the National Guard, Kingdom of Saudi Arabia. Prior to participation, individuals were thoroughly informed about the voluntary nature of the study and the measures taken to ensure their privacy, anonymity, and the confidentiality of their data. Furthermore, the research adhered to the ethical principles outlined in the Declaration of Helsinki.
Results
Sociodemographic data and chronic diseases which the participants suffer from
This study on self-medication included 387 participants. The majority were female, comprising 233 participants (60.20%). The largest age group was 25–35 years, with 149 participants (38.50%). In terms of marital status, more than half of the participants were married, totaling 252 (65.10%). University education was the most common level of education among participants, with 190 individuals (49.10%) [Table 1].
Table 1.
Association between practicing self-medication and sociodemographic data
| Parameter | Category | No | Yes | P | ||
|---|---|---|---|---|---|---|
|
|
|
|||||
| n | % | n | % | |||
| Gender | Male | 37 | 24.30% | 115 | 75.70% | 0.006* |
| Female | 31 | 13.30% | 202 | 86.70% | ||
| Age | 18-25 | 14 | 16.90% | 69 | 83.10% | 0.478 |
| 26-35 | 23 | 15.40% | 126 | 84.60% | ||
| 36-55 | 24 | 18.80% | 104 | 81.30% | ||
| >55 | 7 | 28.00% | 18 | 72.00% | ||
| Marital status | Single | 20 | 15.00% | 113 | 85.00% | 0.327 |
| Married | 48 | 19.00% | 204 | 81.00% | ||
| Pregnancy | No | 25 | 13.70% | 158 | 86.30% | 0.690 |
| Yes | 6 | 11.50% | 46 | 88.50% | ||
| Level of education | Illiterate | 2 | 14.30% | 12 | 85.70% | 0.143 |
| Elementary school | 8 | 40.00% | 12 | 60.00% | ||
| Middle school | 4 | 20.00% | 16 | 80.00% | ||
| High school | 24 | 18.60% | 105 | 81.40% | ||
| University | 28 | 14.70% | 162 | 85.30% | ||
| Higher degrees | 2 | 16.70% | 10 | 83.30% | ||
| Occupation | Student | 11 | 20.80% | 42 | 79.20% | 0.189 |
| Unemployed | 6 | 11.80% | 45 | 88.20% | ||
| Employee | 29 | 17.90% | 133 | 82.10% | ||
| Retired | 7 | 35.00% | 13 | 65.00% | ||
| Housewife | 15 | 15.20% | 84 | 84.80% | ||
| Monthly Income | <4000 | 27 | 16.60% | 136 | 83.40% | 0.970 |
| 4000-10000 | 25 | 18.70% | 109 | 81.30% | ||
| 10000-15000 | 11 | 18.00% | 50 | 82.00% | ||
| >15000 | 5 | 18.50% | 22 | 81.50% | ||
Practicing of self-medication and the reasons for it
In the past six months, over half of the participants engaged in self-medication, totaling 317 individuals (82.30%). The primary reason for self-medication was pain, including body, tooth, head, and ear pain, reported by 166 participants (55.50%) as seen in [Figure 1]. Among those who practiced self-medication, the most commonly used medication was painkillers, with 202 participants (65.60%) reporting their use [Figure 2]. A significant number of participants engaged in self-medication due to long waiting times in clinics, accounting for 158 individuals (51.10%). Additionally, 139 participants (44.10%) reported that their knowledge about the medication came from previous prescriptions [Table 2] [Figures 3 and 4].
Figure 1.
Distribution of percentages showing the medical conditions for which participants sought self-medication in the past six months
Figure 2.
This chart represents the types of medications individuals self-administered
Table 2.
Practicing of self-medication and the reasons for it (n=387)
| Parameter | Category | n | % |
|---|---|---|---|
| Did you practice self-medication during the last 6 months?* | No | 68 | 17.70% |
| Yes | 317 | 82.30% | |
| If yes, for which condition have you taken self-medication in the last 6 months? | Flu | 115 | 38.50% |
| Pain (body, tooth, head, ear, etc.) | 166 | 55.50% | |
| Fever | 86 | 28.80% | |
| Diarrhea | 32 | 10.70% | |
| Eye problems | 65 | 21.70% | |
| Menstrual problems | 60 | 20.10% | |
| Gastrointestinal disorders (acidity, colon, heartburn) | 73 | 24.40% | |
| Cough | 61 | 20.40% | |
| Allergy (dust, animals) | 49 | 16.40% | |
| Skin problems (rash) | 46 | 15.40% | |
| Chronic diseases (diabetes, hypertension) | 19 | 6.40% | |
| Joint disease/joint pain | 49 | 16.40% | |
| Vomiting/nausea | 33 | 11.00% | |
| Burns | 30 | 10.00% | |
| Hair problems (hair fall, dandruff) | 59 | 19.70% | |
| Hematological disorders (anemia) | 23 | 7.70% | |
| Asthma | 21 | 7.00% | |
| Constipation | 32 | 10.70% | |
| During the previous 6 months, which of the medications did you use? | Flu medication | 117 | 38.00% |
| Painkillers | 202 | 65.60% | |
| Anti-fever | 132 | 42.90% | |
| Anti-allergic | 26 | 8.40% | |
| Cough syrups | 40 | 13.00% | |
| Sedatives | 35 | 11.40% | |
| Anti-inflammatory | 20 | 6.50% | |
| Vitamins | 111 | 36.00% | |
| Herbal remedies | 60 | 19.50% | |
| Eye drops | 79 | 25.60% | |
| Food supplements | 53 | 17.20% | |
| Burn creams | 31 | 10.10% | |
| Skin creams (differin, acretin) | 52 | 16.90% | |
| Nasal drops | 54 | 17.50% | |
| Anti-constipation | 20 | 6.50% | |
| Chronic diseases medication (diabetes, hypertension) | 15 | 4.90% | |
| What were your reasons for self-medication? | Time-saving | 98 | 31.70% |
| Availability (owned medication of other family members) | 92 | 29.80% | |
| Long waiting time in clinics | 158 | 51.10% | |
| Urgency | 127 | 41.10% | |
| Mildness of the disease | 130 | 42.10% | |
| Pharmacist advice | 53 | 17.20% | |
| Prior exposure to the drug/diseases | 109 | 35.30% | |
| Owned old prescription | 64 | 20.70% | |
| What was your source of knowledge about the medication that you used? | Pharmacists | 121 | 38.40% |
| Friends and family | 124 | 39.40% | |
| Previous prescription | 139 | 44.10% | |
| Internet/social media | 81 | 25.70% | |
| Healthcare provider | 33 | 10.50% | |
| Television | 7 | 2.20% | |
| Relative doctor | 1 | 0.30% | |
| Medical student | 1 | 0.30% |
*Missing 2 values
Figure 3.
The chart illustrates the reasons participants opted for self-medication
Figure 4.
This chart illustrates the distribution of information sources individuals relied on for knowledge about self-prescribed medications
Knowledge about medications
Most of the participants agreed 150 (39.90%) that medications have side effects and harmful effects. More than half of the participants strongly agreed 274 (74.50%) that taking drugs in higher doses without a prescription is dangerous. In terms of the drug information leaflet, the majority strongly agreed 234 (62.70%) that the drug information leaflet should be always read before taking OCT medication (unprescribed drug). The largest part of the participants agreed 169 (44.90%) that pharmacists are a reliable source of information regarding medical issues. Considering the consumption of medications, 164 (44.60%) of participants agreed that consuming medications rationally without doctors’ supervision and guidance is acceptable [Table 3]. In [Table 4], females strongly agreed that the interval of each medication is important 163 (65.70%) more than males (P value = 0.017). In addition, females also strongly agreed that drug-to-drug interaction when taking two different medications or more is harmful 156 (66.40%) (P value = 0.005). According to [Table 5], the participants who had a university educational level strongly agreed that drug information leaflets should be always read before taking OCT medication (unprescribed drug) 121 (51.70%) more than other educational levels (P value = 0.010). They also strongly agreed that the time interval of each dose of medication is important 129 (52.00%) more than other educational levels (P value = 0.006). Furthermore, they agreed that pharmacists are a reliable source of information regarding medical issues 93 (55.00%) (P value < 0.001).
Table 3.
Knowledge about medications (n=387)
| Parameter*(number of missing values) | Category | n | % |
|---|---|---|---|
| All medications have side effects and harmful effects* (11) | Strongly disagree | 25 | 6.60% |
| Disagree | 53 | 14.10% | |
| Agree | 150 | 39.90% | |
| Strongly agree | 148 | 39.40% | |
| It is normal to have adverse effects after taking a medication* (11) | Strongly disagree | 30 | 8.00% |
| Disagree | 60 | 16.00% | |
| Agree | 195 | 51.90% | |
| Strongly agree | 91 | 24.20% | |
| Taking drugs in higher doses without prescription is dangerous* (19) | Strongly disagree | 18 | 4.90% |
| Disagree | 11 | 3.00% | |
| Agree | 65 | 17.70% | |
| Strongly agree | 274 | 74.50% | |
| Drug information leaflet should be always read before taking over-the-counter medication (unprescribed drug)* (14) | Strongly disagree | 7 | 1.90% |
| Disagree | 21 | 5.60% | |
| Agree | 111 | 29.80% | |
| Strongly agree | 234 | 62.70% | |
| Time-interval of each dose of medication is important* (19) | Strongly disagree | 4 | 1.10% |
| Disagree | 11 | 3.00% | |
| Agree | 105 | 28.50% | |
| Strongly agree | 248 | 67.40% | |
| Drug-to-drug interaction when taking two different medications or more is harmful* (16) | Strongly disagree | 10 | 2.70% |
| Disagree | 36 | 9.70% | |
| Agree | 90 | 24.30% | |
| Strongly agree | 235 | 63.30% | |
| Medications should be prescribed by the doctor to have the appropriate treatment* (13) | Strongly disagree | 10 | 2.70% |
| Disagree | 34 | 9.10% | |
| Agree | 111 | 29.70% | |
| Strongly agree | 219 | 58.60% | |
| Pharmacists are a reliable source of information regarding medical issues* (11) | Strongly disagree | 38 | 10.10% |
| Disagree | 86 | 22.90% | |
| Agree | 169 | 44.90% | |
| Strongly agree | 83 | 22.10% | |
| Consuming medications rationally without doctors’ supervision and guidance is acceptable* (19) | Strongly disagree | 59 | 16.00% |
| Disagree | 67 | 18.20% | |
| Agree | 164 | 44.60% | |
| Strongly agree | 78 | 21.20% | |
| Taking medications without sufficient knowledge of the disease and drugs can be harmful* (15) | Strongly disagree | 33 | 8.90% |
| Disagree | 19 | 5.10% | |
| Agree | 88 | 23.70% | |
| Strongly agree | 232 | 62.40% | |
| When the complaint is relived, you can stop the medication by yourself* (14) | Strongly disagree | 89 | 23.90% |
| Disagree | 104 | 27.90% | |
| Agree | 104 | 27.90% | |
| Strongly agree | 76 | 20.40% | |
| Treating repeated headaches with painkillers is enough* (11) | Strongly disagree | 84 | 22.30% |
| Disagree | 144 | 38.30% | |
| Agree | 92 | 24.50% | |
| Strongly agree | 56 | 14.90% |
Table 4.
Knowledge about medications based on gender
| Parameter | Category | Male | Female | P | ||
|---|---|---|---|---|---|---|
|
|
|
|||||
| n | % | n | % | |||
| All medications have side effects and harmful effects | Strongly disagree | 13 | 52.00% | 12 | 48.00% | 0.295 |
| Disagree | 25 | 47.20% | 28 | 52.80% | ||
| Agree | 60 | 40.00% | 90 | 60.00% | ||
| Strongly agree | 53 | 35.80% | 95 | 64.20% | ||
| It is normal to have adverse effects after taking a medication | Strongly disagree | 13 | 43.30% | 17 | 56.70% | 0.814 |
| Disagree | 26 | 43.30% | 34 | 56.70% | ||
| Agree | 77 | 39.50% | 118 | 60.50% | ||
| Strongly agree | 33 | 36.30% | 58 | 63.70% | ||
| Taking drugs in higher doses without prescription is dangerous | Strongly disagree | 9 | 50.00% | 9 | 50.00% | 0.207 |
| Disagree | 4 | 36.40% | 7 | 63.60% | ||
| Agree | 33 | 50.80% | 32 | 49.20% | ||
| Strongly agree | 103 | 37.60% | 171 | 62.40% | ||
| Drug information leaflet should be always read before taking over-the-counter medication (unprescribed drug) | Strongly disagree | 3 | 42.90% | 4 | 57.10% | 0.082 |
| Disagree | 13 | 61.90% | 8 | 38.10% | ||
| Agree | 48 | 43.20% | 63 | 56.80% | ||
| Strongly agree | 83 | 35.50% | 151 | 64.50% | ||
| Time interval of each dose of medication is important | Strongly disagree | 2 | 50.00% | 2 | 50.00% | 0.017* |
| Disagree | 6 | 54.50% | 5 | 45.50% | ||
| Agree | 54 | 51.40% | 51 | 48.60% | ||
| Strongly agree | 85 | 34.30% | 163 | 65.70% | ||
| Drug-to-drug interaction when taking two different medications or more is harmful | Strongly disagree | 3 | 30.00% | 7 | 70.00% | 0.005* |
| Disagree | 20 | 55.60% | 16 | 44.40% | ||
| Agree | 46 | 51.10% | 44 | 48.90% | ||
| Strongly agree | 79 | 33.60% | 156 | 66.40% | ||
| Medications should be prescribed by the doctor to have the appropriate treatment | Strongly disagree | 6 | 60.00% | 4 | 40.00% | 0.327 |
| Disagree | 16 | 47.10% | 18 | 52.90% | ||
| Agree | 47 | 42.30% | 64 | 57.70% | ||
| Strongly agree | 81 | 37.00% | 138 | 63.00% | ||
| Pharmacists are a reliable source of information regarding medical issues | Strongly disagree | 14 | 36.80% | 24 | 63.20% | 0.636 |
| Disagree | 39 | 45.30% | 47 | 54.70% | ||
| Agree | 67 | 39.60% | 102 | 60.40% | ||
| Strongly agree | 30 | 36.10% | 53 | 63.90% | ||
| Consuming medications rationally without doctors’ supervision and guidance is acceptable | Strongly disagree | 30 | 50.80% | 29 | 49.20% | 0.288 |
| Disagree | 28 | 41.80% | 39 | 58.20% | ||
| Agree | 61 | 37.20% | 103 | 62.80% | ||
| Strongly agree | 29 | 37.20% | 49 | 62.80% | ||
| Taking medications without sufficient knowledge of the disease and drugs can be harmful | Strongly disagree | 13 | 39.40% | 20 | 60.60% | 0.118 |
| Disagree | 10 | 52.60% | 9 | 47.40% | ||
| Agree | 43 | 48.90% | 45 | 51.10% | ||
| Strongly agree | 83 | 35.80% | 149 | 64.20% | ||
| When the complaint is relived, you can stop the medication by yourself | Strongly disagree | 37 | 41.60% | 52 | 58.40% | 0.566 |
| Disagree | 40 | 38.50% | 64 | 61.50% | ||
| Agree | 46 | 44.20% | 58 | 55.80% | ||
| Strongly agree | 26 | 34.20% | 50 | 65.80% | ||
| Treating repeated headaches with painkillers is enough | Strongly disagree | 31 | 36.90% | 53 | 63.10% | 0.937 |
| Disagree | 57 | 39.60% | 87 | 60.40% | ||
| Agree | 38 | 41.30% | 54 | 58.70% | ||
| Strongly agree | 23 | 41.10% | 33 | 58.90% | ||
Table 5.
Knowledge about medications based on educational level
| Parameter | Category | Illiterate | Elementary school | Middle school | High school | University | Higher degrees | P | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
|
|
|
|
||||||||||
| n | % | n | % | n | % | n | % | n | % | n | % | |||
| All medications have side effects and harmful effects | Strongly disagree | 1 | 4.00% | 3 | 12.00% | 2 | 8.00% | 8 | 32.00% | 10 | 40.00% | 1 | 4.00% | 0.323 |
| Disagree | 2 | 3.80% | 2 | 3.80% | 2 | 3.80% | 21 | 39.60% | 24 | 45.30% | 2 | 3.80% | ||
| Agree | 2 | 1.30% | 6 | 4.00% | 7 | 4.70% | 51 | 34.00% | 83 | 55.30% | 1 | 0.70% | ||
| Strongly agree | 9 | 6.10% | 10 | 6.80% | 8 | 5.40% | 44 | 29.70% | 69 | 46.60% | 8 | 5.40% | ||
| It is normal to have adverse effects after taking a medication | Strongly disagree | 0 | 0.00% | 4 | 13.30% | 3 | 10.00% | 10 | 33.30% | 10 | 33.30% | 3 | 10.00% | 0.210 |
| Disagree | 3 | 5.00% | 2 | 3.30% | 2 | 3.30% | 19 | 31.70% | 33 | 55.00% | 1 | 1.70% | ||
| Agree | 5 | 2.60% | 8 | 4.10% | 9 | 4.60% | 69 | 35.40% | 99 | 50.80% | 5 | 2.60% | ||
| Strongly agree | 6 | 6.60% | 7 | 7.70% | 5 | 5.50% | 27 | 29.70% | 43 | 47.30% | 3 | 3.30% | ||
| Taking drugs in higher doses without prescription is dangerous | Strongly disagree | 0 | 0.00% | 2 | 11.10% | 2 | 11.10% | 9 | 50.00% | 5 | 27.80% | 0 | 0.00% | 0.468 |
| Disagree | 0 | 0.00% | 0 | 0.00% | 0 | 0.00% | 4 | 36.40% | 6 | 54.50% | 1 | 9.10% | ||
| Agree | 1 | 1.50% | 4 | 6.20% | 4 | 6.20% | 26 | 40.00% | 30 | 46.20% | 0 | 0.00% | ||
| Strongly agree | 12 | 4.40% | 14 | 5.10% | 13 | 4.70% | 87 | 31.80% | 137 | 50.00% | 11 | 4.00% | ||
| Drug information leaflet should be always read before taking over-the-counter medication (unprescribed drug) | Strongly disagree | 0 | 0.00% | 2 | 28.60% | 2 | 28.60% | 2 | 28.60% | 1 | 14.30% | 0 | 0.00% | 0.010* |
| Disagree | 0 | 0.00% | 2 | 9.50% | 0 | 0.00% | 6 | 28.60% | 13 | 61.90% | 0 | 0.00% | ||
| Agree | 3 | 2.70% | 5 | 4.50% | 7 | 6.30% | 48 | 43.20% | 47 | 42.30% | 1 | 0.90% | ||
| Strongly agree | 11 | 4.70% | 12 | 5.10% | 10 | 4.30% | 70 | 29.90% | 121 | 51.70% | 10 | 4.30% | ||
| Time-interval of each dose of medication is important | Strongly disagree | 0 | 0.00% | 1 | 25.00% | 2 | 50.00% | 0 | 0.00% | 1 | 25.00% | 0 | 0.00% | 0.006* |
| Disagree | 0 | 0.00% | 0 | 0.00% | 0 | 0.00% | 6 | 54.50% | 5 | 45.50% | 0 | 0.00% | ||
| Agree | 4 | 3.80% | 4 | 3.80% | 6 | 5.70% | 44 | 41.90% | 46 | 43.80% | 1 | 1.00% | ||
| Strongly agree | 10 | 4.00% | 16 | 6.50% | 11 | 4.40% | 72 | 29.00% | 129 | 52.00% | 10 | 4.00% | ||
| Drug-to-drug interaction when taking two different medications or more is harmful | Strongly disagree | 0 | 0.00% | 2 | 20.00% | 2 | 20.00% | 3 | 30.00% | 3 | 30.00% | 0 | 0.00% | 0.057 |
| Disagree | 2 | 5.60% | 3 | 8.30% | 0 | 0.00% | 17 | 47.20% | 14 | 38.90% | 0 | 0.00% | ||
| Agree | 2 | 2.20% | 4 | 4.40% | 6 | 6.70% | 37 | 41.10% | 40 | 44.40% | 1 | 1.10% | ||
| Strongly agree | 9 | 3.80% | 11 | 4.70% | 11 | 4.70% | 68 | 28.90% | 126 | 53.60% | 10 | 4.30% | ||
| Medications should be prescribed by the doctor to have the appropriate treatment | Strongly disagree | 1 | 10.00% | 2 | 20.00% | 1 | 10.00% | 2 | 20.00% | 4 | 40.00% | 0 | 0.00% | 0.319 |
| Disagree | 0 | 0.00% | 1 | 2.90% | 2 | 5.90% | 12 | 35.30% | 19 | 55.90% | 0 | 0.00% | ||
| Agree | 2 | 1.80% | 2 | 1.80% | 7 | 6.30% | 39 | 35.10% | 58 | 52.30% | 3 | 2.70% | ||
| Strongly agree | 11 | 5.00% | 16 | 7.30% | 9 | 4.10% | 71 | 32.40% | 104 | 47.50% | 8 | 3.70% | ||
| Pharmacists are a reliable source of information regarding medical issues | Strongly disagree | 4 | 10.50% | 7 | 18.40% | 6 | 15.80% | 9 | 23.70% | 12 | 31.60% | 0 | 0.00% | <0.001* |
| Disagree | 4 | 4.70% | 4 | 4.70% | 5 | 5.80% | 34 | 39.50% | 37 | 43.00% | 2 | 2.30% | ||
| Agree | 2 | 1.20% | 5 | 3.00% | 6 | 3.60% | 56 | 33.10% | 93 | 55.00% | 7 | 4.10% | ||
| Strongly agree | 3 | 3.60% | 5 | 6.00% | 2 | 2.40% | 26 | 31.30% | 44 | 53.00% | 3 | 3.60% | ||
| Consuming medications rationally without doctors’ supervision and guidance is acceptable | Strongly disagree | 2 | 3.40% | 5 | 8.50% | 3 | 5.10% | 18 | 30.50% | 30 | 50.80% | 1 | 1.70% | 0.549 |
| Disagree | 2 | 3.00% | 3 | 4.50% | 3 | 4.50% | 24 | 35.80% | 33 | 49.30% | 2 | 3.00% | ||
| Agree | 6 | 3.70% | 6 | 3.70% | 5 | 3.00% | 65 | 39.60% | 78 | 47.60% | 4 | 2.40% | ||
| Strongly agree | 4 | 5.10% | 7 | 9.00% | 7 | 9.00% | 19 | 24.40% | 37 | 47.40% | 4 | 5.10% | ||
| Taking medications without sufficient knowledge of the disease and drugs can be harmful | Strongly disagree | 1 | 3.00% | 2 | 6.10% | 1 | 3.00% | 13 | 39.40% | 16 | 48.50% | 0 | 0.00% | 0.678 |
| Disagree | 1 | 5.30% | 2 | 10.50% | 1 | 5.30% | 9 | 47.40% | 6 | 31.60% | 0 | 0.00% | ||
| Agree | 2 | 2.30% | 4 | 4.50% | 5 | 5.70% | 37 | 42.00% | 39 | 44.30% | 1 | 1.10% | ||
| Strongly agree | 10 | 4.30% | 13 | 5.60% | 12 | 5.20% | 67 | 28.90% | 122 | 52.60% | 8 | 3.40% | ||
| When the complaint is relived, you can stop the medication by yourself | Strongly disagree | 3 | 3.40% | 7 | 7.90% | 4 | 4.50% | 25 | 28.10% | 45 | 50.60% | 5 | 5.60% | 0.175 |
| Disagree | 2 | 1.90% | 2 | 1.90% | 2 | 1.90% | 44 | 42.30% | 52 | 50.00% | 2 | 1.90% | ||
| Agree | 3 | 2.90% | 6 | 5.80% | 5 | 4.80% | 36 | 34.60% | 52 | 50.00% | 2 | 1.90% | ||
| Strongly agree | 6 | 7.90% | 6 | 7.90% | 6 | 7.90% | 19 | 25.00% | 36 | 47.40% | 3 | 3.90% | ||
| Treating repeated headaches with painkillers is enough | Strongly disagree | 1 | 1.20% | 4 | 4.80% | 2 | 2.40% | 21 | 25.00% | 49 | 58.30% | 7 | 8.30% | 0.024* |
| Disagree | 8 | 5.60% | 7 | 4.90% | 5 | 3.50% | 56 | 38.90% | 65 | 45.10% | 3 | 2.10% | ||
| Agree | 1 | 1.10% | 6 | 6.50% | 5 | 5.40% | 31 | 33.70% | 48 | 52.20% | 1 | 1.10% | ||
| Strongly agree | 4 | 7.10% | 4 | 7.10% | 6 | 10.70% | 18 | 32.10% | 23 | 41.10% | 1 | 1.80% | ||
Association between practicing self-medication and sociodemographic data
Statistical analysis revealed a significant gender difference in self-medication practices (P value = 0.006). Specifically, a higher proportion of females engaged in self-medication, with 202 females (86.70%) compared to 115 males (75.70%). Conversely, no statistically significant differences were observed with respect to age, marital status, pregnancy status, level of education, occupation, or monthly income.
Discussion
Our study revealed compelling insights into the patterns of self-medication practices. A significant majority of our participants reported engaging in self-medication within the past six months. Painkillers emerged as the most commonly used medication, with long waiting hours in clinics being the primary reason for self-medicating. Interestingly, the majority of participants sought knowledge about the medication from their previous prescriptions. Impressively, the majority of participants demonstrated a good understanding of self-medication.
Global research on self-medication reveals varying patterns. In our study, 82.30% of participants engaged in self-medication, with a predominance of females. This finding aligns with a study conducted in Saudi Arabia by Al-Ghamdi et al.,[7] which reported a self-medication rate of 81.4%, also predominantly among females. In contrast, a study in Pakistan found only 15.2% of participants engaged in self-medication, primarily males.[8] Additionally, research in India reported a self-medication prevalence of 11.9%, with higher usage among men.[16] These comparisons suggest that Saudi Arabia exhibits higher rates of self-medication, potentially due to easier access to OCT medications and healthcare system factors such as long waiting times.[7,17]
Age-related patterns in self-medication varied across studies. Our participants were predominantly aged 25 to 35, which is consistent with findings from two other studies in Saudi Arabia.[7,11] Conversely, a study in Pakistan found that individuals over 40 were more likely to self-medicate, and a research in Wuhan, China, identified the predominant age group as 41–60.[8,18] These differences may reflect cultural variations, which could explain the higher prevalence of self-medication among younger individuals in Saudi Arabia compared to other countries.
The primary reason for self-medication in our study was long waiting times in clinics. This contrasts with the study by Al-Ghamdi et al.,[7] where difficulty accessing hospitals was the main reason. This discrepancy may be due to the differing settings of the studies; ours was conducted in primary health centers of a governmental hospital in Riyadh, while the latter covered multiple regions across Saudi Arabia.
Regarding sources of information on self-medication, our study found that previous prescriptions were the most common source, followed by advice from friends and family. This finding is consistent with Lei et al.’s study along with two other studies.[18,19,20,21]
In our research, we observed that painkillers ranked as the predominantly utilized form of self-medication, followed by anti-fever and flu medication. These results align with similar studies documented in the literature.[10,22,23,24]
A study conducted in 2015 by Aljadhey et al.[11] in Saudi Arabia found that a significant number of participants had inadequate knowledge about self-medication. In contrast, our findings reveal that the majority of participants demonstrated a good overall understanding of self-medication. This increased awareness may be attributable to community-targeted health campaigns and the proliferation of educational resources available through social media platforms.
Furthermore, our study found that the most knowledgeable participants were females, which may be related to the higher prevalence of self-medication among females. Moreover, individuals with advanced academic backgrounds demonstrated a greater understanding of self-medication. This finding is consistent with similar studies conducted in Saudi Arabia and Malaysia, where researchers observed a significant correlation between the level of education and participants’ average knowledge score regarding medications.[25,26,27]
Limitations
Some limitations of our study include the relatively small number of male participants, which suggests a need for further research with a larger male sample to gain a more comprehensive understanding of self-medication practices. Additionally, the study design introduces potential limitations such as recall bias, selection bias, and the absence of a temporal sequence. Despite these limitations, the study successfully identified specific areas where participants need further guidance regarding self-medication.
Conclusion
This study aimed to assess self-medication patterns among adult patients in primary healthcare centers. Both genders exhibited high rates of self-medication, with females showing a higher statistical significance. The findings reveal that a majority of patients resort to self-medication, primarily for pain management, with painkillers being the most consumed medication. Excessive waiting times in clinics emerged as a significant driver for self-medication. Participants predominantly sought guidance from previous prescriptions, friends, family, and pharmacists, while a mere 10% relied on healthcare providers’ advice. Regarding knowledge, females displayed higher levels of knowledge. These results address the prevalence of self-medication practices and the role of multiple factors in emphasizing it. Future research should focus on examining the long-term health outcomes associated with self-medication practices, particularly assessing the risks and benefits of frequently used medications. Additional research involving a larger male sample is essential to obtain a deeper and more comprehensive understanding of self-medication practices.
Author contributions
All authors contributed to the concept, design, analysis, interpretation of data, writing, and review of the manuscript. They have reviewed and approved the final version of the manuscript.
Ethical approval
The KAIMRC IRB Committee approved the study (approval number NRC22R/506/10) All writing was executed in full compliance with the ethical principles outlined in the Declaration of Helsinki.
Informed consent
A written informed consent was acquired from all participants included in the study.
What is known about this topic
Globally, self-medication poses a significant public health concern, with billions of individuals worldwide adopting this practice.
Among the commonly utilized methods of self-treatment, over-the-counter (OTC) drugs stand out as the most frequently employed.
In Saudi Arabia, a noteworthy 81.4% of the overall population has reported resorting to self-medication, using drugs without a prescription at various points in their lives.
What this study adds
The leading motivations for self-medication comprised extended waiting times in clinics, the perceived mildness of the illness, and the urgency of relief, respectively.
Overall, the general health-related knowledge of self-medicators has improved compared to a previous study in Saudi Arabia. Females are more knowledgeable about self-medication compared to males.
Participants with a higher degree of education demonstrate an elevated level of knowledge.
The study outcomes hold significance for Saudi health policymakers aiming to educate the public on self-medication, with a focus on minimizing adverse drug reactions and drug-to-drug interactions. Particular attention should be directed towards vulnerable populations, such as children, who may inadvertently adopt this practice inappropriately.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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