Self-medication Behavior Research Articles

GAMBARAN TINGKAT PENGETAHUAN SWAMEDIKASI ANALGESIK PADA MASYARAKAT DESA TANJUNGSARI, PETANAHAN, KABUPATEN KEBUMEN

According to WHO, self-medication is the selection and using of drugs without a doctor's prescription by people to to treat common health issues at home . The most widely self-medicated substances are over-the-counter drugs, suplement and herbal medicine. A study in United States and the United Kingdom found that self-medication was the main effort to solve health issues. This is confirmed by the results of several studies that found about 40-72% people in several countries practicing self-medication. In Indonesia, according to Basic Health Research (Riskesdas 2013) found that 103,860 (35.2%) households use self medication. Several studies have found that differences in age, marital status, education , occupation, have closely related with self-medication behavior. This is the descriptive-observational study with 64 respondent The result show that many people do not understand how to practicing right self medication such as side effect drugs used in self medication, safe analgesic medication for pregnancy.Keyword : analgesic, self-medication

Age-related pharmacodynamics in a bumblebee-microsporidian system mirror similar patterns in vertebrates.

Immune systems provide a key defence against diseases. However, they are not a panacea and so both vertebrates and invertebrates co-opt naturally occurring bioactive compounds to treat themselves against parasites and pathogens. In vertebrates, this co-option is complex, with pharmacodynamics leading to differential effects of treatment at different life stages, which may reflect age-linked differences in the immune system. However, our understanding of pharmacodynamics in invertebrates is almost non-existent. Critically, this knowledge may elucidate broad parallels across animals in regard to the requirement for the co-option of bioactive compounds to ameliorate disease. Here, we used biochanin A, an isoflavone found in the pollen of red clover (Trifolium pratense), to therapeutically treat Nosema bombi (Microsporidia) infection in bumblebee (Bombus terrestris) larvae and adults, and thus examine age-linked pharmacodynamics in an invertebrate. Therapeutic treatment of larvae with biochanin A did not reduce the infection intensity of N. bombi in adults. In contrast, therapeutic treatment of adults did reduce the infection intensity of N. bombi This transition in parasite resistance to bioactive compounds mirrors the age-linked pharmacodynamics of vertebrates. Understanding how different life-history stages respond to therapeutic compounds will provide novel insights into the evolution of foraging and self-medication behaviour in natural systems more broadly.

HUBUNGAN STATUS EKONOMI KELUARGA DENGAN PERILAKU PENGOBATAN SENDIRI (SELF-MEDICATION)

Background: Health degree is an important component of health development. One of the indicators is morbidity rate. Based on National Health Survey in 2008, the number of morbidity rate is 33.24% where 65.59% of population applied self-medication to treat their health problems. Many factors influence people to use self-medication. Family economic status is suspected to be one of them.
 Objective: This study aimed to identify the correlation between family economic status and self-medication behavior.
 Methods: A quantitative cross sectional design study with retrospective approach was applied. Cluster random sampling technique was employed to 71 respondents. The Kendall Tau test was performed to analyze the data. The probability risk factors of self-medication was identified using odds ratio.
 Results: The family economic status were gained with 81.7% in high category and 15.5% in low category. The result of self-medication behavior showed 69% of the respondents often did self-medication, 15.5% rarely, and 15.5% never. The Kendall Tau correlation was 0,515 (p<0.05) and the odds ratio was 8,941.
 Conclusion: There is a moderate correlation between family economic status and self-medication behavior where the family with high economic status is more likely implement self-medication 8,941 times more than the one with low economic status.
 Keywords: Economic Status, Family, Behavior, Self-Medication

Prevalence Of Self-Medication With Antibiotics Among Residents In United Arab Emirates.

BackgroundSelf-Medication with antibiotics is a human practice and attitude in which an individual uses antibiotics to treat self-diagnosed symptoms. The self-medication with antibiotics is a common practice among residents in the UAE.PurposeThe present study aimed to determine the prevalence of self-medication of antibiotics among residents in the UAE population to determine its associated risk factors and to increase awareness regarding the abuse of antibiotics.Patients and methodsThree hundred and fifteen participants from different public places in Abu Dhabi, Dubai and Sharjah,UAE received the validated questionnaire over the five-month study period. Collected data were analyzed using SPSS statistical software and the Chi-square test to assess the relationships between categorical variables.ResultsOf 315 participants, 31.7% (n=100) of the respondents reported the use of non-prescription antibiotics within a three-month study period. Self-medication with antibiotics was significantly associated with ethnicity and employment. The participants reported their previous experience with the disease (69; 21.9%), as the main reason for self-medication with antibiotics. The primary sources of antibiotics were those purchased from community pharmacies (70; 22.2%) and household (21; 6.7%).ConclusionOur study showed a high prevalence of self-medication behaviour even with the enforcement of the new legislation regarding the prohibition of selling antibiotics without a prescription. Therefore, there is a need to raise public awareness towards the safe use of antibiotics in our community.

Antibiotic use in pregnancy: knowledge, attitudes and practices among pregnant women in Cape Town, South Africa.

To establish the knowledge, attitudes and practices (KAP) regarding antibiotic use and self-medication among pregnant women. We conducted a KAP survey of 301 pregnant women hospitalized at a tertiary hospital obstetric service in Cape Town, South Africa in November and December 2017, using an interviewer-administered 12 item questionnaire. We stratified analysis of attitudes and practices by participants' mean knowledge score (K-score) group (<6 versus ≥6 out of 7 questions). Multivariate models were built to identify independent predictors of antibiotic self-medication and K-score. The mean age of pregnant women was 29 (SD 6.1) years, 44/247 (17.8%) were nulliparous, 69/247 (27.9%) were HIV-infected, 228/247 (92.3%) had completed secondary school and 78/247 (31.6%) reported a monthly household income in the lowest category of ≤50-100 US dollars (USD). The mean K-score was 6.1 (SD 1.02) out of 7 questions. Sixteen percent of the cohort reported antibiotic self-medication, with higher rates among pregnant women with K-score <6 [18/48 (37.5%) versus 32/253 (12.6%); P<0.001]. The monthly household income category of >500 USD (the highest category) was the only predictor of antibiotic self-medication behaviour [adjusted OR=6.4 (95% CI 1.2-35.2), P=0.03]. Higher antibiotic knowledge scores are associated with lower rates of antibiotic self-medication, whereas higher household income is correlated with increasing self-medication behaviours. Education of pregnant women regarding the potential dangers of antibiotic self-medication and stricter enforcement of existing South African antibiotic prescribing and dispensing regulations are needed.

Effectiveness of Educational Intervention on Reducing Self-Medication Behaviors of Patients with Diabetes Type 2: Application of BASNEF Model

Effectiveness of Educational Intervention on Reducing Self-Medication Behaviors of Patients with Diabetes Type 2: Application of BASNEF Model

From plant selection by elephants to human and veterinary pharmacopeia of mahouts in Laos

Ethnopharmacological relevanceTo what extent has animal observation contributed to the development of human pharmacopeias? We approach this question here through the study of mahouts’ knowledge regarding the responses by elephants to their health problems, and the human medicinal uses of plants and the care of domestic animals that result from their observations. Materials and methods32 mahouts were interviewed in Thongmyxay district and 28 at the Elephant Conservation Center in the province of Xayabury. Interviews focused on the elephants’ diet, health problems, plant items they consume in particular physiological or pathological contexts and the treatments that mahouts provide them. For each plant mentioned, the part of the plant consumed and mode of preparation and administration if used by mahouts were recorded. Species samples were then collected and later identified by specialists. Results114 species were recorded as being consumed by elephants during interviews with mahouts and forest outings with them to collect samples. Twenty species were identified as used by elephants in particular pathological conditions or physiological states. According to interviewed mahouts, the consumption of certain plants improves the health of the elephant. We observed clear convergences between the observations interpreted by the mahouts as self-medication behaviour from elephants and their own medicinal practices (for human and veterinary purposes). ConclusionBeyond a mere reproduction of elephant self-medication behaviours observed, the human or veterinary medicinal cares derived from these observations are the result of complex arrangements integrating all available medicinal and conceptual resources into elaborate preparations.We recommend that mahouts' knowledge about traditional medicinal care given to elephants be further compiled, as it could have a beneficial impact on veterinary health care provided in elephant resorts and elephants’ well-being.

The evolution of self-medication behaviour in mammals

Abstract Self-medication behaviour is the use of natural materials or chemical substances to manipulate behaviour or alter the body’s response to parasites or pathogens. Self-medication can be preventive, performed before an individual becomes infected or diseased, and/or therapeutic, performed after an individual becomes infected or diseased. We summarized all available reports of self-medication in mammals and reconstructed its evolution. We found that reports of self-medication were restricted to eutherian mammals and evolved at least four times independently. Self-medication was most commonly reported in primates. Detailed analyses of primates suggest that self-medication is a life-history trait associated with body size, absolute brain size and longevity, but we found no support for the hypothesis that self-medication evolved to reduce the costs of social living. Large, longer-lived species might thus benefit uniquely from self-medication.

Multimorbilidad crónica en mujeres con diagnóstico de fibromialgia en Chile

Objetivo: posicionar a la población diagnosticada de fibromialgia en la categoría de multimórbida y describir algunas de sus características. Lo anterior mediante el análisis de la prevalencia de comorbilidades, el uso de recursos clínicos y el uso de fármacos de la población estudiada. Materiales y métodos: estudio descriptivo, transversal con una muestra de 546 mujeres diagnosticadas de fibromialgia. Aplicación de un cuestionario autoadministrado en modalidad on line. Uso de estadística descriptiva e inferencial (bivariada) para el análisis de datos. Resultados: Un 94,7% de las pacientes estudiadas padece al menos una enfermedad diagnosticada además de la fibromialgia; 11,4% padece cinco o más afecciones. Las comorbilidades más frecuentes son trastornos de salud mental, siendo la depresión la principal (70%) seguida de colon irritable (52,8%) y cefalea (50,3%). Un 51,1% presenta alta frecuencia de consulta médica. Un 77,3% utiliza más de un tipo de fármaco. La media de uso farmacológico es de 2,8 tipos. Un 80,3% afirma haberse automedicado alguna vez, siendo en promedio 1,6 la cantidad de fármacos automedicados. Conclusiones: La población con fibromialgia es altamente multimórbida y en plena edad laboral y reproductiva, presenta alto riesgo de morbimortalidad debido a la presencia de polifarmacia y automedicación, además proyecta multimorbilidad crítica a futuro, envejecimiento patológico y alto consumo de recursos clínicos.

Geophagy among East African Chimpanzees: consumed soils provide protection from plant secondary compounds and bioavailable iron.

Geophagy, the intentional consumption of earth materials, has been recorded in humans and other animals. It has been hypothesized that geophagy is an adaptive behavior, and that clay minerals commonly found in eaten soil can provide protection from toxins and/or supplement micronutrients. To test these hypotheses, we monitored chimpanzee geophagy using camera traps in four permanent sites at the Budongo Forest Reserve, Uganda, from October 2015-October 2016. We also collected plants, and soil chimpanzees were observed eating. We analyzed 10 plant and 45 soil samples to characterize geophagic behavior and geophagic soil and determine (1) whether micronutrients are available from the soil under physiological conditions and if iron is bioavailable, (2) the concentration of phenolic compounds in plants, and (3) if consumed soils are able to adsorb these phenolics. Chimpanzees ate soil and drank clay-infused water containing 1:1 and 2:1 clay minerals and > 30% sand. Under physiological conditions, the soils released calcium, iron, and magnesium. In vitro Caco-2 experiments found that five times more iron was bioavailable from three of four soil samples found at the base of trees. Plant samples contained approximately 60μg/mg gallic acid equivalent. Soil from one site contained 10 times more 2:1 clay minerals, which were better at removing phenolics present in their diet. We suggest that geophagy may provide bioavailable iron and protection from phenolics, which have increased in plants over the last 20years. In summary, geophagy within the Sonso community is multifunctional and may be an important self-medicative behavior.

Training modalities and self-medication behaviors in a sample of runners during an ultratrail

Summary Aims Training modalities, health and self-medication behaviors of athletes with high training level are not well-known. Our goal was to study these specifications during an ultramarathon race of 65 km with 3500 meters of positive altitude difference (“6000D”) and determine factors associated with better performance. Methods We conducted a transversal and descriptive survey by questionnaire. Three hundred questionnaires were distributed (random sampling) and explained by the principal investigator during the 2 days before the 2016 edition of La 6000D. Results One hundred and ninety two men and 20 women replied (mean age: 40.8 ± 10.3 years and BMI: 22.6 ± 2.1 kg/m2). Runners averaged 7 ± 6.1 years of practice. They trained specifically 12.1 ± 10.4 weeks, traveled 64.5 ± 30 km per week in 7.6 ± 5.1 hours, with an average altitude difference of 1205 ± 1172 meters. Half of the runners used food supplements before the race. Seventy-two runners (34%) had taken or planned to take drugs in the race: half of them were NSAIDs and 65.6% were not at risk of using NSAIDs. Main factors statistically associated with an improved performance were weekly training volume in the 2 months preceding the race, BMI, best marathon time, body fat percentage, weekly altitude gain, age, affiliation at a club, use of gels during the race, weekly kilometric volume, sex, use of spirulina and years of practice. Conclusion We evidence some factors that seem to be associated with an improved performance: low age, low BMI, high years of practice, high weekly hours and club membership. Contrary to popular belief among runners, performance seems not or only slightly improved by intake or medication before, during or after the race (sports cake, multi-vitamin complex, BCAA, paracetamol, NSAID, beta-2-mimetics, etc.). Some of these relationships may exist and may not be clearly perceived by athletes. However, such results can help practitioners communicate with more confidence about the risks of certain supplements and NSAIDs compared to a non-significant performance advantage.

Criollo goats limit their grass intake in the early morning suggesting a prophylactic self-medication behaviour in a heterogeneous vegetation.

The present study compared the feeding behaviour of goats in the early morning (EM = 7:00-8:30a.m.) and late morning (LM = 9:30-11:00a.m.) in response to their natural gastrointestinal nematode (GIN) infection status. Twelve female adult goats (37 ± 7.7kg live weight (LW); 5 ± 1years) with browsing experience in the tropical deciduous forest were divided into two groups (n = 6): INF group, with natural GIN infection, and non-infected (NI) group, dewormed with moxidectin (0.4mg/kg LW subcutaneous). Feeding behaviour (dry matter intake (DMI)) of two resource types (grasses vs. shrubs + herbs) was estimated by direct observation for 4weeks on two grazing moments (EM vs. LM). Environmental temperature and relative humidity at pasture level were measured twice weekly. The GIN egg counts and goats' LW were measured on days 0, 14 and 28. Temperature (mean ± standard deviation) at EM (26.2 ± 1.5°C) was lower than at LM (38.7 ± 1°C; P < 0.01). Humidity was higher on the EM (85.1 ± 2.6%) compared to LM (60.4 ± 5.6%; P < 0.01). Irrespective of the infection status, goats consumed similar amounts of grass and shrubs + herbs during EM (P > 0.05). On the other hand, the experimental groups consumed more grass than shrubs + herbs during LM (P < 0.05). The latter suggested prophylactic behaviours strategies to (a) avoid GIN infective larvae, (b) balance the protein:energy ratio of the diet and (c) avoid saturation of detoxification pathways for the secondary compounds consumed from shrubs + herbs. The constant consumption of shrubs + herbs during the study may have reduced the GIN egg count of the INF group.

The Differences in Self-Medication Factors for Toddler Mothers Between Rural and Urban

Introduction: Self-medication occurs in many developing countries in the world, including Indonesia, which can cause a variety of global impacts, namely improper use that can lead to irrational use of drugs, late seeking medical advice, increasing side effects and drug interactions. Self-medication is related to the role of mothers in the household. The purpose of this study to find out the differences in factors that influence maternal behavior in self-medication oftoddler including knowledge, attitudes, income levels, and exposure to information sources between rural and urban areas. Methods: The study was conducted in 2 locations in Gemawang (rural) and Campursari (urban), WonosoboDistrict, Central Java Province. The population of quantitative analytic research with cross sectional design was 78 mothers with children in rural and 75 in urban areas. Data analysis used Kolmogorov-Smirnov because in the normality test the data used shapirowilk from the variables of knowledge, attitudes, income levels and information exposure with self-medication behavior, the result was p = 0.00 (&lt;0.05) so the data was not normally distributed. The sampling technique uses purposive sampling. Results: There were differences in knowledge, attitudes, income levels, and exposure to information about mothers oftoddler of self-medication behavior between rural and urban with a value of p=0,000. Conclusions: The behavior of mothers in self-medication of toddler between rural and urban areas has a significant difference with knowledge, behavior, attitudes, income level, and information exposure.

Practice of self-medication among medical students in a region of northern state of India

Background: Self-medication usually leads to irrational drug utilization pattern leading to various issues like economic burden, incomplete treatment and antibiotic resistance. Self-medication is a common practice in developing countries and prevalent among medical students, influencing their future decision making as medical professional. The current study was carried out to determine the prevalence of self-medication among medical students and their attitude towards the same.Methods: A cross-sectional questionnaire based study was conducted in a tertiary care teaching hospital from July 2015 to Oct 2015. Structured and validated questions were used to collect information about knowledge, attitude and practice of self-medication among undergraduate medical students. The study included total of 328 participants. Data were collected from each participant and analyzed statistically by using SPSS version 20 for count and percentages.Results: A total of 328 subjects studying at a medical school were assessed regarding their practice, attitude and perception of self-medication behavior. Out of total recruited subjects, 53% were males and 47% were females. The prevalence of self-medication among recruited subjects was 89.9%. Symptoms like fever, Headache and weakness were the most common reasons of self-medication. The most commonly used drugs were antipyretic, analgesics (81.7%), antibiotics (51.2%). Approximately 15% subjects were not aware about the completion of the course of antibiotic treatment. Subjects obtained information and procured drugs from their family members, friends and pharmacist and the reasons for this were cited as lack of time, minor ailments and quick relief. Only 32.6% students opined that self-medication should be encouraged in future.Conclusions: Current study reveals that practice of self-medication is highly prevalent among medical students without adequate knowledge of drugs used. Students should be educated regarding advantages and disadvantages of self-medication.

Healthcare-seeking behavior and its relating factors in South of Iran.

INTRODUCTION:Health systems aimed to increase health utilization. Habits and behavior about using health facilities, which is called health-seeking behavior, are different among different cultures and influenced by different factors. The present study is aimed at investigating Iranian Southern population health-seeking behavior and its influencing factors.MATERIALS AND METHODS:A sample of 397 people was selected using proportional stratified random sampling for this cross-sectional study. They were asked to fill a questionnaire about their health-seeking behaviors (seeking treatment, inattention to treatment, and self-medication) and socioeconomic factors. Data were analyzed using regression models including linear, ordinal, and logistic regressions.RESULTS:Near 80% of participants reported self-medication and most of them prefer public hospitals as their first point of contact with health system compared to others such as family physician. Using linear regression revealed seeking treatment has significant relationship with age (P = 0.037), living place (P = 0.018), and having complementary insurance (P = 0.013). Self-medication behavior has relation with age (P = 0.015), gender (P = 0.039), education years (P = 0.031), living place (P = 0.005), having complementary insurance (P = 0.001), and satisfaction with health-care providers (P = 0.003) in logistic regression. Using ordinal regression, it was found that inattention to treatment has a relation with education years (P = 0.044), living place (P = 0.042), having complementary insurance (P = 0.049), and severity of illness (P = 0.031).CONCLUSION:Southern population does not accept family physician as the first point of interaction with the health system, and they prefer to go to public hospitals directly. Moreover, self-medication is a prevalent behavior among the population and thus their acceptance of health care is low. Based on the findings, it can be suggested providing more satisfying health care, increasing insurance coverage, and informing population could lead to better utilization of health-care services.

The Effect of Educational Intervention Based on BASNEF Model on Self-Medication Behavior of Type 2 Diabetic Patients.

Background:Diabetes is one of the main reasons of the increase of morbidity and mortality around the world. Considering the burden of disease, self-medication can result in irrecoverable consequences. The aim of this study is to investigate the effect of educational intervention based on Beliefs, Attitudes, Subjective Norms and Enabling Factors (BASNEF) model on self-medication behaviors of type 2 diabetic patients in Fasa, Fars province, Iran, in 2017–2018.Materials and Methods:In this quasi-experimental study, 200 type 2 diabetic patients under cover of the diabetes center of Fasa were investigated (100 patients for experimental group and 100 patients for control group). A questionnaire investigating demographic information and BASNEF Model constructs (knowledge, attitude, enabling factors, subjective norms, and behavioral intention) was used for evaluating self-medication behaviors of patients before and 3 months after intervention.Results:The average age of experimental group was 53.25 ± 8.42 and the average age of control group was 54.18 ± 8.13. Three months after intervention, experimental group showed significant enhancement in knowledge, attitude, enabling factors, subjective norms, and behavioral intention and their self-medication behaviors reduced, while control group showed no significant changes in mentioned factors.Conclusion:The present study indicated the efficiency of BASNEF model on reduction of self-medication behaviors of diabetic patients. Hence, this model can act as a framework for designing and implementing educational interventions in this field.

Knowledge and behavior of Saudi female university students toward self-medication: a cross-sectional study in Riyadh, Saudi Arabia

Background: Self-medication can be defined as the use of different modalities of medications in treating self-diagnosed conditions. It also includes the use of prescribed drugs, either on an intermittent or continuous basis for treating chronic or recurrent symptoms. The present study was aimed at assessing the knowledge and behavior of Saudi female university students toward self-medication in Riyadh city, Saudi Arabia. Methodology: A cross-sectional questionnaire-based study was conducted on Princess Nora University, Riyadh, Saudi Arabia (PNU) students. The data collection included sections about sociodemographic data, behavior, and experience of self-medication, questions regarding health care system, and students influence on self-medication practices. The statistical package for social sciences (SPSS) version 22 was used for data analysis. The study assessed the common symptoms for which study participants practice self-medication, the drug categories commonly used, the sources used to acquire information about their disease. The study also analyzed their experience with self-medication and evaluated the quality of health care services. Results: The prevalence of self-medication among PNU students was found to be 82.6%. The majority of the study subjects reported using analgesics (73.5%) for headache and abdominal pain. Information was mainly accessed from internet and relatives (34.4% and 37.7%). Although 92.1% of participants found improvement of their condition, about 5.3% reported emergency admission. Most of the study participants (91%) reported the health care availability. Conclusion: Self-medication was found to be prevalent among PNU students; The College atmosphere and the educational level do not seem to influence its prevalence.

Study of the Mandrillus sphinx (Cercopithecoidea) diet behaviour from the Lekedi Park (South-East, Gabon) as a valuable approach for drugs discovery

The last decades, various research approaches have been undertaken worldwide for drug discoveries. Our study aimed to investigate medicinal plants of the Lékédi Park through a zoopharmacological and ethnopharmacological surveys on mandrills and on human population respectively from the Department of Lékoko.Data on feeding behaviour were collected on 57 mandrills, from Lékédi Park, using a 5-min focal sampling method for 17 months. The ethnopharmacological uses were carried out on the human population using semi-structured questionnaires and scientific databases. Data were evaluated statistically by using the index of Use value (UV) and informant consensus factor (Fic).The results showed that studied mandrills used about 147 plant species belonging to 48 botanical families. The Rubiaceae and Euphorbiaceae families were the most representative in the mandrill diet. Among plant organs eaten, some organs of plants such as bark or roots rich in non-nutritional compounds were occasionally used by mandrills, suggesting the involvement of a self-medication behavior in mandrill. Also, it appears that the plant selection would be mainly due to the availability, protein and sugar contents. Ethnopharmacological surveys show that among the 147 consumed by mandrills, 33% were used for medicinal purposes only, 41% as food and 11% were used as food and as medicine. The informant consensus factor values indicate that the medicinal plants are effective in treating certain diseases.Thus, the study of mandrill diets behaviour would be a potential approach for the drugs discovery against bacterial and parasitic affections.

Using machine learning to investigate self-medication purchasing in England via high street retailer loyalty card data.

The availability alongside growing awareness of medicine has led to increased self-treatment of minor ailments. Self-medication is where one ‘self’ diagnoses and prescribes over the counter medicines for treatment. The self-care movement has important policy implications, perceived to relieve the National Health Service (NHS) burden, increasing patient subsistence and freeing resources for more serious ailments. However, there has been little research exploring how self-medication behaviours vary between population groups due to a lack of available data. The aim of our study is to evaluate how high street retailer loyalty card data can help inform our understanding of how individuals self-medicate in England. Transaction level loyalty card data was acquired from a national high street retailer for England for 2012–2014. We calculated the proportion of loyalty card customers (n ~ 10 million) within Lower Super Output Areas who purchased the following medicines: ‘coughs and colds’, ‘Hayfever’, ‘pain relief’ and ‘sun preps’. Machine learning was used to explore how 50 sociodemographic and health accessibility features were associated towards explaining purchasing of each product group. Random Forests are used as a baseline and Gradient Boosting as our final model. Our results showed that pain relief was the most common medicine purchased. There was little difference in purchasing behaviours by sex other than for sun preps. The gradient boosting models demonstrated that socioeconomic status of areas, as well as air pollution, were important predictors of each medicine. Our study adds to the self-medication literature through demonstrating the usefulness of loyalty card records for producing insights about how self-medication varies at the national level. Big data offer novel insights that add to and address issues that traditional studies are unable to consider. New forms of data through data linkage may offer opportunities to improve current public health decision making surrounding at risk population groups within self-medication behaviours.

Refinements to captive chimpanzee (Pan troglodytes) care: a self-medication Paradigm.

In an effort to enhance welfare, behavioural management continually refines methods of non-human primate (NHP) care. Chimpanzees (Pan troglodytes) are one of the most cognitively complex captive NHPs and they have been observed to self-medicate in the wild. The population of captive chimpanzees in the US is aged (due to a breeding moratorium instituted in 1998) and will progressively require more medical care as they get older. To functionally simulate natural self-medication behaviour, provide chimpanzees with the opportunity to voluntarily participate in their own healthcare, and open new avenues of communication between caregivers and chimpanzees, we used a medication choice paradigm that allowed chimpanzees to choose their daily arthritis medication. We provided four arthritic, mobility-impaired chimpanzees with meloxicam or ibuprofen in blue or green Gatorade® to establish associations between the coloured drinks and the effects of the medications. We subsequently gave each chimpanzee a choice between the two medications. Behaviour was recorded using 15-min focal animal observations. Mobility was assessed using interactive mobility tests and a caregiver-rating system. One chimpanzee showed a medication preference (ibuprofen over meloxicam). The chimpanzees exhibited no significant behavioural or mobility differences over time, suggesting that ibuprofen and meloxicam may not differ significantly in their ability to alleviate arthritic symptoms. Whether or not the chimpanzees show a medication preference, the opportunity to make meaningful choices and the functional simulation of a complex behaviour, self-medication, is present when using this medication choice technique. Furthermore, the paradigm itself could have potential applications for additional medication options and treatment regimens.