Self-medication Behavior Research Articles

Self-medication behavior among pregnant women user of the Instituto Nacional Materno Perinatal, Peru 2011

We aim to determine the prevalence of self prescribing behaviour during pregnancy and its characteristics. For this purpose, we designed a cross sectional study and interviewed 400 pregnant women who had their prenatal care at Instituto Nacional Materno Perinatal, Lima. We found that 10.5% of the patients (42 patients) had a self prescribing behavior during pregnancy, 64.5% think that self prescribing behavior can produce congenital malformations. The medications used were classified as type A and B according to the Food and Drug Administration (FDA). Paracetamol was used more frequently (47.6%) followed by amoxicillin (16.7%). All the women who self-prescribed have had this behavior before pregnancy. According to these results, we conclude there is a low prevalence of self-prescribing behavior during pregnancy compared to the international literature.

Ruminant self-medication against gastrointestinal nematodes: evidence, mechanism, and origins.

Gastrointestinal helminths challenge ruminants in ways that reduce their fitness. In turn, ruminants have evolved physiological and behavioral adaptations that counteract this challenge. Ruminants display anorexia and avoidance behaviors, which tend to reduce the incidence of parasitism. In addition, ruminants appear to learn to self-medicate against gastrointestinal parasites by increasing consumption of plant secondary compounds with antiparasitic actions. This selective feeding improves health and fitness. Here, we review the evidence for self-medication in ruminants, propose a hypothesis to explain self-medicative behaviors (based on post-ingestive consequences), and discuss mechanisms (e.g., enhanced neophilia, social transmission) that may underlie the ontogeny and spread of self-medicative behaviors in social groups. A better understanding of the mechanisms that underlie and trigger self-medication in parasitized animals will help scientists devise innovative and more sustainable management strategies for improving ruminant health and well-being.

The effect of education based on extended parallel process model (EPPM) on the self-medication of elderly in Zarandieh

Background: Self-medication can be defined as obtaining and consuming drugs without the prescription of a physician either and it might have serious consequences. The aim of this study was to determine the effect of education based extended parallel process model (EPPM) on the self-medication among elderly in Zarandieh. Methods: In this quasi-experimental study, 110 elderly men were selected randomly and were randomly divided into two equal groups of experimental and control groups (45 in each). Data was collected through a questionnaire consisting of extended parallel process model (EPPM) questions and a performance checklist on self-medication which was used in order to evaluate the effectiveness of the educational program. The participants in the two groups filled out the questionnaire, and then intervention was done during a month in 5 sessions, 45 minutes, and finally the data of the two groups were collected and analyzed using SPSS18. Results: Before educational program, there was no statistically significant difference between two groups regarding self-medication and extended parallel process model constructs. However after intervention, independent sample t-test showed a statistical significant difference between two groups (P<0.05) in knowledge, perceived susceptibility and severity, response efficacy, self-efficacy and practice. In addition, self-medication rate decreased significantly among the experimental group compared to controls after intervention (p<0.01) (33% V.S 13%). Conclusion: Results of this study confirmed the efficiency of extended parallel process model in prevention of self-medication behaviour among elderly individuals.

Frequency and Severity of Adverse Drug Reactions Due to Self-Medication: A Cross-Sectional Multicentre Survey in Emergency Departments

BackgroundLittle is known about the relation of adverse drug reactions (ADRs) to self-use of medications.ObjectiveThe aim of this study was to determine the frequency and severity of ADRs related to self-medication (ADR-SM) among emergency department (ED) patients and to describe their main characteristics.MethodsA prospective, cross-sectional, observational study was conducted over a period of 8 weeks (1 March to 20 April 2010), in the ED of 11 French academic hospitals. Adult patients presenting to the ED during randomization periods were included, with the exception of cases of self-drug poisoning, inability to complete self-medication questionnaire, or refusal. Clinical outcomes were assessed as well as history of self-medication behaviours and all drugs taken. All doubtful files and those related to ADR-SM were systematically reviewed by an expert committee.ResultsA total of 3,027 of 4,661 patients presenting to the ED met the inclusion criteria. Of these, 84.4 % declared a self-medication behaviour, 63.7 % took at least one non-prescribed drug during the previous 2 weeks and 59.9 % took a prescribed medication. A total of 296 patients experienced an ADR (9.78 %), of which 52 (1.72 %) were related to self-medication. Those ADRs related to self-medication included prescribed drugs (n = 19), non-prescribed drugs (n = 17), treatment discontinuation (n = 14), and interactions between non-prescribed and prescribed drugs (n = 2). The ADRs attributed to non-prescribed drugs represented 1 % of all patients taking non-prescribed drugs (n = 1,927). ADR severity was significantly lower for those related to self-medication (p = .032).ConclusionSelf-medication is frequent; its potential toxicity should not be neglected, taking into account the rate of adverse drug reactions in about 1 % of ED patient.Electronic supplementary materialThe online version of this article (doi:10.1007/s40264-013-0114-y) contains supplementary material, which is available to authorized users.

Dynamics of macronutrient self‐medication and illness‐induced anorexia in virally infected insects

Some animals change their feeding behaviour when infected with parasites, seeking out substances that enhance their ability to overcome infection. This ‘self-medication’ is typically considered to involve the consumption of toxins, minerals or secondary compounds. However, recent studies have shown that macronutrients can influence the immune response and that pathogen-challenged individuals can self-medicate by choosing a diet rich in protein and low in carbohydrates. Infected individuals might also reduce food intake when infected (i.e. illness-induced anorexia).Here, we examine macronutrient self-medication and illness-induced anorexia in caterpillars of the African armyworm (Spodoptera exempta) by asking how individuals change their feeding decisions over the time course of infection with a baculovirus. We measured self-medication behaviour across several full-sib families to evaluate the plasticity of diet choice and underlying genetic variation.Larvae restricted to diets high in protein (P) and low in carbohydrate (C) were more likely to survive a virus challenge than those restricted to diets with a low P: C ratio. When allowed free choice, virus-challenged individuals chose a higher protein diet than controls.Individuals challenged with either a lethal or sublethal dose of virus increased the P: C ratio of their chosen diets. This was mostly due to a sharp decline in carbohydrate intake, rather than an increased intake of protein, reducing overall food intake, consistent with an illness-induced anorexic response. Over time the P: C ratio of the diet decreased until it matched that of controls.Our study provides the clearest evidence yet for dietary self-medication using macronutrients and shows that the temporal dynamics of feeding behaviour depends on the severity and stage of the infection. The strikingly similar behaviour shown by different families suggests that self-medication is phenotypically plastic and not a consequence of genetically based differences in diet choice between families.

Leaf Surface Roughness Elicits Leaf Swallowing Behavior in Captive Chimpanzees (Pan troglodytes) and Bonobos (P. paniscus), but not in Gorillas (Gorilla gorilla) or Orangutans (Pongo abelii)

Researchers have described apparently self-medicative behaviors for a variety of nonhuman species including birds and primates. Wild chimpanzees, bonobos, and gorillas have been observed to swallow rough leaves without chewing, a behavior proposed to be self-medicative and to aid control of intestinal parasites. Researchers have hypothesized that the presence of hairs on the leaf surface elicits the behavior. We investigated the acquisition and the underlying mechanisms of leaf swallowing. We provided 42 captive great apes (24 chimpanzees, six bonobos, six gorillas, and six orangutans) with both rough-surfaced and hairless plants. None of the subjects had previously been observed to engage in leaf swallowing behavior and were therefore assumed naive. Two chimpanzees and one bonobo swallowed rough-surfaced leaves spontaneously without chewing them. In a social setup six more chimpanzees acquired the behavior. None of the gorillas or orangutans showed leaf swallowing. Because this behavior occurred in naive individuals, we conclude that it is part of the behavioral repertoire of chimpanzees and bonobos. Social learning is thus not strictly required for the acquisition of leaf swallowing, but it may still facilitate its expression. The fact that apes always chewed leaves of hairless control plants before swallowing, i.e., normal feeding behavior, indicates that the surface structure of leaves is indeed a determinant for initiating leaf swallowing in apes where it occurs.

Using an e-health intervention to enhance patient visits for hypertension: The nurse practitioner perspective

This article reports the findings from interviews with 11 nurse practitioners (NPs) who provided an in-office, e-health intervention as part of a randomized clinical trial aimed at improving medication adherence and reducing adverse self-medication behaviors in older adults with hypertension. The NPs’ perspective of their experience with training for the research protocol, recruitment of patient participants, implementing the e-health intervention, and patient response was elicited through open-ended questions in individual face-to-face tape recorded interviews.

A normal psychology of everyday pain

Proposed is a psychology of pain that focusses on normal psychological reactions to pain. A normal psychology of pain seeks to explain what normal people (those who would not meet any criteria for any psychological disorder) do when faced with pain. Herein, we focus on everyday pain defined as pain that is clinically unimportant that arises from normal everyday activity. Pain functions to interrupt current concerns and promote problem solving typically in the form of escape, pain management, or request for assistance. A model of analgesic problem solving is described. Focussing on pain as an interruption leads us to think about the purpose of analgesics in repairing attention and returning function. New endpoints for analgesic performance are offered. Similarly, a focus on pain as a motivation for analgesia demands that we understand how people self-medicate its relative success, and what influences patterns of self-medication. Finally, the problem of pain in children and adolescents, including self-medication in youth, is discussed. Although there is limited small-scale research on young people and their knowledge about analgesics, very little is known about their beliefs, attitudes to analgesics and their self-medication behaviour. Adolescents in most societies are left largely unguided. There is little child-specific communication about how to manage pain. Most children rely on parental knowledge, although increasingly the internet is becoming a source of advice for young people learning about analgesics.

Zoopharmacognosy, the self-medication behavior of animals

Animals can give good indications on new sources of medicines. Field researchers have observed different species of animals seeking and using substances in such a way as to enhance their own health. This behavior was called as animal self-medication, or zoopharmacognosy. This article presents a brief review on the subject and calls attention for future field studies, especially considering Brazilian faunistic diversity.

Differential roles of thought suppression and dispositional mindfulness in posttraumatic stress symptoms and craving

Exposure to traumatic events often results in severe distress which may elicit self-medication behaviors. Yet, some individuals exposed to trauma do not develop post-traumatic stress symptoms and comorbid addictive impulses. In the wake of traumatic events, psychological processes like thought suppression and mindfulness may modulate post-traumatic stress and craving for substances. We examined the differential roles of mindfulness and suppression in comorbid post-traumatic stress and craving among a sample of 125 persons with extensive trauma histories and psychiatric symptoms in residential treatment for substance dependence. Results indicated that thought suppression, rather than extent of trauma history, significantly predicted post-traumatic stress symptom severity while dispositional mindfulness significantly predicted both post-traumatic stress symptoms and craving. In multiple regression models, mindfulness and thought suppression combined explained nearly half of the variance in post-traumatic stress symptoms and one-quarter of the variance in substance craving. Moreover, multivariate path analysis indicated that prior traumatic experience was associated with greater thought suppression, which in turn was correlated with increased post-traumatic stress symptoms and drug craving, whereas dispositional mindfulness was associated with decreased suppression, post-traumatic stress, and craving. The maladaptive strategy of thought suppression appears to be linked with adverse psychological consequences of traumatic life events. In contrast, dispositional mindfulness appears to be a protective factor that buffers individuals from experiencing more severe post-traumatic stress symptoms and craving.

Self-medication behaviors among Japanese consumers: sex, age, and SES differences and caregivers’ attitudes toward their children’s health management

BackgroundSince 2009, when the revised Pharmaceutical Affairs Act was enacted in Japan, self-medication practices have increased. Because the concept of self-medication was recently introduced in Japan, few studies exist on this topic. Therefore, it is necessary to explore how self-medication is practiced. This study examined Japanese consumers’ self-medication practices and attitudes toward over-the-counter (OTC) medicines based on their sex, age, and socioeconomic status (SES).MethodsThe participants were 403 adults (Mage = 41.1 years, SD = 16.22). A quota sampling method was employed based on age group, and participants completed an online questionnaire.ResultsParticipants in the 20–29 age group reported medical costs as an obstacle in seeing a doctor; in contrast, transportation was a mitigating factor for elderly people. Regarding SES, people at lower SES levels chose to rest instead of seeing a doctor or purchasing over-the-counter (OTC) medicines when sick. They also placed more value on national brand OTC medicines than private brands (likely due to advertisements). This finding suggests individuals with a low SES do not select OTC medicines based on their effects or ingredients. Regarding attitudes toward OTC medicines, Japanese participants seemed to be unaware of the potential for abuse and side effects associated with OTC medicines. Finally, in relation to caregivers’ self-medication practices for their children, the majority of participants reported taking their children to the hospital since children tend to receive free medical care. Furthermore, caregivers with a high educational background are more confident in being able to help manage their children’s health.ConclusionsOur results suggest that health and medical discrepancies among Japanese consumers pose new social problems. In Japan, universal health care is available, but the cost of receiving medical care is not completely free of charge. Thus, we hope that the government will attempt to meet the various needs of patients and support their well-being. Consumers also have to be more independent and aware of their health management, as self-medication practices will continue to play a more significant role in healthcare. More research is needed to find ways to teach Japanese consumers/patients of both the benefits and risks of over-the-counter (OTC) medicines.

Knowledge, attitude and practice of medical students towards self medication at Ain Shams University, Egypt.

Self medication is usually defined as intake of any type of drugs for treating oneself without professional supervision to relieve an illness or a condition. Self medication is an issue with serious global implications. In this study it was aimed to determine the knowledge, attitudes and behavior of self medication by the near coming physicians. A cross-sectional study was conducted on a sample of randomly selected medical students from Ain Shams University. Data was collected using self administered questionnaire. Verbal consent was ensured before applying the questionnaire. The Chi square was performed using SPSS 16 to identify associations and differences. The sample consisted of 300 students 67% females and 33% male students. Prevalence of self medication was 55%. Out of which 58.8%, 54.4%, 87.2%, 12%, 28% took antibiotic, vitamins, analgesics, sedatives, herbal products respectively without physician prescription. As regards the personal behavior towards following any prescription 14.4% always followed properly the prescription compared to 63.3% always discontinued the drug on feeling improvement, and 13.6% always repeated the prescription without seeking medical advice. Also 60% said that they increased the dose without medical advice. As regards the reported side effects 4.8%, 1.6%, 12% as a result of interaction between drugs, increase dose without medical advice and early stopping of treatment respectively. Self medication by medical students is an important issue to be avoided and need to be added to the curriculum of undergraduate students and raise the community awareness about these hazards and drawbacks.

Host behavior, environment and ability to self-medicate

Herbivores form preferences for substances that raise fitness such as nutritious foods and avoid those substances, which lower fitness such as plant secondary compounds (PSC). Nevertheless, some PSC at certain concentrations have the potential to raise fitness as they act against infective diseases such as parasitism. The objective of the present review is to assess whether parasitized farm animals are able to manifest self-medicative behaviors. The ability of herbivores to self-select these medicinal plant compounds emerges from the inherent adaptive nature of behavioral responses in living organisms. In order to manifest self-medication animals should experience discomfort caused by a certain illness and also relief associated with the mitigation of sickness brought about by the ingestion of a medicinal plant. Observational and controlled studies suggest such conditions, as well as self-medicative behaviors occur not only in wild but also in domestic herbivores. Self-medicative behaviors may allow individuals seek medicinal plant products when infected by parasites, even at times when the manager is not aware of the existence of parasitism in the flock. Self-medication may also allow for proper nutrition as animals offered choices will consume PSC-containing plants as well as nutritious and safe forages. Management programs should be geared at enhancing in herbivores the likelihood of the association medicine-relief from sickness and at favoring the transmission of self-medicative behavior across generations.

Parental involvement protects against self-medication behaviors during the high school transition

We examined how drinking patterns change as adolescents transition to high school, particularly as a function of parental involvement. Stress associated with the transition to high school may deplete psychological resources for coping with negative daily emotions in an environment when opportunities to drink are more common. A cohort of elevated-risk middle school students completed daily negative affect (sadness, worry, anger, and stress) and alcohol use assessments before and after the transition to high school, resulting in a measurement burst design. Adolescents who reported less parental involvement were at higher risk for drinking on any given day. After (but not before) the transition to high school, daily within-person fluctuations of sadness predicted an increased probability of same-day alcohol use for adolescents who reported that their parents were minimally involved in their lives. The other negative affect indicators were not predictive of use. Our results suggest that the transition to high school may represent an important intervention leverage point, particularly for adolescents who lack adequate parental support to help them cope with day-to-day changes in sadness.

A qualitative study about self-medication in the community among market vendors in Fuzhou, China

Despite government efforts to increase healthcare insurance and access in China, many individuals, regardless of insurance status, continue to engage in high levels of self-medication. To understand the factors influencing common self-medication behaviour in a community of food market vendors in Fuzhou China, a total of 30 market vendors were randomly recruited from six food markets in 2007. In-depth interviews were conducted with each participant at their market stalls by trained interviewers using a semi-structured open-ended interview protocol. Participants were asked broad questions about their health-seeking behaviours as well as their past experiences with self-medication and hospital care. ATLAS. ti was used to manage and analyse the interview data. The results showed that hospital-based healthcare services were perceived as better quality. However, self-medication was viewed as more affordable in terms of money and time. Other factors prompting self-medication, included confidence in understanding the health problem, the easy accessibility of local pharmacies and the influences of friends/peers and advertising. Three broad domains, attitude, cost and effectiveness, were all seen to determine past decisions and experiences with self-medication. Interestingly, the effective management of self-medication via pharmacy resources raised particular concern because of perceived variation in quality. In conclusion, self-medication was found to be an important and common health-seeking behaviour driven by multiple factors. A sound and comprehensive public health system should systematically attend to these behaviours and the pharmacies, where much of the behaviour occurs.

The use of herbal medicines by people with cancer: a cross-sectional survey

Background:A large proportion of cancer patients are estimated to use herbal medicines, but data to substantiate this are lacking. This study aimed to investigate the prevalence of herbal medicine use among cancer patients in the West Midlands, and determine the characteristics predicting herbal medicine use.Methods:A cross-sectional survey of oncology patients (n=1498) being followed up at a hospital in Coventry was undertaken. Recipients were asked about herbal medicine use since their cancer diagnosis, and the association between sociodemographic and cancer-related characteristics and herbal medicine use was evaluated.Results:A total of 1134 responses were received (75.7%). The prevalence of herbal medicine use was 19.7% (95% CI: 17.4–22.1; n=223). Users were more likely to be affluent, female, and aged under 50 years. Usage increased with time since cancer diagnosis (X2 for trend=4.63; P=0.031). A validation data set, derived from a survey of oncology patients in Birmingham (n=541) with differing socioeconomic characteristics showed no significant difference in estimated prevalence (16.6% 95% CI: 11.9–22.2).Conclusion:A substantial number of people with cancer are likely to be taking herbal medicines. Understanding the self-medication behaviours of these individuals is essential if health-care professionals are to support treatment adherence and avoid unwanted pharmacological interactions.

Parental involvement protects against self-medication behaviors during the high school transition

Parental involvement protects against self-medication behaviors during the high school transition

Reducing Adverse Self-Medication Behaviors in Older Adults with Hypertension: Results of an e-health Clinical Efficacy Trial.

A randomized controlled efficacy trial targeting older adults with hypertension (age 60 and over) provided an e-health, tailored intervention with the “next generation” of the Personal Education Program (PEP-NG). Eleven primary care practices with advanced practice registered nurse (APRN) providers participated. Participants (N = 160) were randomly assigned by the PEP-NG (accessed via a wireless touchscreen tablet computer) to either control (entailing data collection and four routine APRN visits) or tailored intervention (involving PEP-NG intervention and four focused APRN visits) group. Compared to patients in the control group, patients receiving the PEP-NG e-health intervention achieved significant increases in both self-medication knowledge and self-efficacy measures, with large effect sizes. Among patients not at BP targets upon entry to the study, therapy intensification in controls (increased antihypertensive dose and/or an additional antihypertensive) was significant (p = .001) with an odds ratio of 21.27 in the control compared to the intervention group. Among patients not at BP targets on visit 1, there was a significant declining linear trend in proportion of the intervention group taking NSAIDs 21–31 days/month (p = 0.008). Satisfaction with the PEP-NG and the APRN provider relationship was high in both groups. These results suggest that the PEP-NG e-health intervention in primary care practices is effective in increasing knowledge and self-efficacy, as well as improving behavior regarding adverse self-medication practices among older adults with hypertension.

Medication storage and self-medication behaviour amongst female students in Malaysia.

The aims of this study are to determine the prevalence, attitudes and behaviours of medication storage and self-medication amongst female students at Universiti Sains Malaysia (USM). A cross-sectional survey was conducted and cluster random sampling technique was used for respondent selection. A pre-piloted questionnaire was administered to female respondents so as to collect the data. Data was analyzed using SPSS version 12 and analysis was conducted using descriptive analysis procedures. Of the 481 participants (mean age; SD was 22.1; 3.3), 93.1% (n=448) students stated that they stored medicine in their rooms, while 70.7% (n=340) stated that they stopped taking a prescribed medicine without consulting a doctor. The prevalence of self-medication was 80.9% (n=389). The most common reasons for self-medication were related to their knowledge of their ailment and its treatment (58.0%), 14.4% thought it saved time and 8.5% mentioned that medication given by provider was not effective. The most common symptoms were otorhinolaryngology problems (22.5%), followed by respiratory disease (19.6%), Gastro Intestinal Tract (GIT) disease (18.1%) and headache/fever (16.8%). Commonly used medicines were analgesics & antipyretics (30.2%), ear, nose & throat drugs (10.8%), vitamins & minerals (10.8%), GIT drugs (8.5%), anti-infections (7.3%) and herbal medicines (3.5%). Prevalence of medicine storage and self-medication practice is high among educated female students in USM. There is a need to educate the students to ensure safe practice by increasing their awareness. Strict policies need to be implemented on the unrestricted availability of medicines so as to prevent the wastage of medicines.

Complex effects of parasitoids on pharmacophagy and diet choice of a polyphagous caterpillar

This study investigates complex effects of parasitoid infection on herbivore diet choice. Specifically, we examine how immunological resistance, parasitoid infection stage, and parasitoid taxonomic identity affect the pharmacophagous behavior of the polyphagous caterpillar, Grammia incorrupta (Arctiidae). Using a combination of lab and field experiments, we test the caterpillar's pharmacophagous response to pyrrolizidine alkaloids (PAs) over the course of parasitoid infection, as well as the effect of dietary PAs on the caterpillar's immunological response. Previous work from other systems gave the prediction that dietary PAs would be detrimental to the immune response and thus less acceptable to feeding early in the infection, when encapsulation of the parasitoid is most crucial. We found that the feeding acceptability of PAs was indeed low for caterpillars with early-stage parasitoid infections; however, this was not explained by PA interference with immune function. When allowed to choose among three host plant species, individuals harboring early-stage parasitoids increased their consumption of a nutritious plant containing antioxidants. This result was driven by wasp-parasitized caterpillars, whereas fly-parasitized caterpillars increased their consumption of plants containing iridoid glycosides. Individuals in the later time phase of infection exhibited an increase in PA intake that was consistent with previously reported self-medication behavior during late-stage parasitoid infection. This study reveals the depth of complexity and the dynamic nature of herbivore host plant choice, and underscores the importance of considering multitrophic interactions when studying insect diet choice.