Abstract
Purpose : To evaluate the patterns of medication use and medication appropriateness among people in different regions of Pakistan. Methods : A cross-sectional study involving 410 individuals in four provinces of Pakistan (Punjab, Sindh, Baluchistan and Khyber Pakhtunkhwa) as well as the capital city, Islamabad, via a convenient sampling method. The questionnaire used comprised three major sections: (a) medication use patterns of the population, (b) medication storage and wastage practices, and (c) development of secondary disease after medication use. The questionnaires were completed under the supervision of pharmacists trained for the purpose. Results : The majority of the study population preferred bottle caps for taking oral liquid medicines (83.9 %), and the proportion using bottle caps was highest in Punjab (55.2 %) followed by Sindh (21.8 %). A significant proportion of the population consider the use of very hot water as a reconstitution medium for suspensions (36.3 %). In many cases, suspensions were constituted by mere estimation of the vehicle used (56.1 % from Punjab, 18.9 % from Sindh, 16.1 % from KPK, 7.7 % from Baluchistan, and 1.1 % from Islamabad). Significant differences were observed in the handling of leftover drugs among respondent populations, as well as the overall diverse modes of disposal recorded (43.9 %). Doctors (46.6 %) and relatives were the main sources of instructions on medicine usage (37.6 %). A disinclination to purchase a full course of medicine was observed. Knowledge of medicine storage and measuring tools for oral liquids showed striking peculiarities among the various study populations. Conclusion : Inappropriate medication use among the general population of Pakistan requires educational interventions and awareness programs to promote rational drug use in the society. Keywords : Inappropriate, medication, population, healthcare, use
Highlights
Notwithstanding the importance of essential medicines at the healthcare level, rational use of drugs worldwide is vital, as more than 50 % of medicines are inappropriately prescribed or dispensed and 50 % of consumers use medicines inappropriately [1]
On the basis of the population responding to the respective query options; 55.2 % of the population living in the Punjab region were of the view that medicine should be taken with a bottle cap
The population of Islamabad agreed with the use of spoon as a mode of taking medicine, yielding significant results. 60.7 % of responding individuals from Punjab used boiled cooled water as a reconstitution liquid whereas 53 % used very hot water to reconstitute liquid for suspensions
Summary
Notwithstanding the importance of essential medicines at the healthcare level, rational use of drugs worldwide is vital, as more than 50 % of medicines are inappropriately prescribed or dispensed and 50 % of consumers use medicines inappropriately [1]. Self-medication, non-compliance, not sticking to prescribers' guidelines, unsafe and overuse of medicines are were followed for the study [11]. A study reported 41 % medication errors based on dosing where counseling provided by the healthcare professionals and provision of dosing tools were helpful in reducing the dosing errors [5]. One of the major factors leading to incorrect use of medicines is low literacy of patients/patients' attendants [6]. Co-morbidities, and age-related physiological changes that hamper patients' understanding of the use of the drug [7]. Among other major determinants of irrational drug use, self-prescribing of the prescription drugs such as antibiotics cannot be neglected and should be discouraged, to reduce the health and cost burden on the patient, and optimize the drug use in the community [8]. A study from Oman showed that 43 % of the population practiced selfmedication while 70 % stopped using medicine after the disappearance of symptoms [9]
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