Self-medication in Central Saudi Arabia

ىوادتلا راشتنا ىدم ديدتح ىلإ ةساردلا هذه فدهت :فادهلأا وحن ينكلهتسلما ىدل كاردلأاو تايكولسلاو فراعلما يموقتو ىتاذلا .ىتاذلا ىوادتلا ىف عيباسأ ةعبرأ ةدلم ةيعطقلما ةساردلا هذه تيرجأ :ةقيرطلا تمو ةيدوعسلا ةيبرعلا ةكلملماب ،ضايرلا ةنيدم يف م2011 ويام رهش قرشو برغو بونجو لامش نم عمتجلما تايلديص نم ددعرايتخا ةساردلا تلمشو ةساردلا ضرغل ةيئاوشع ةقيرطب ضايرلا طسوو ةيبطلا تادعلما ءارشل اورضح نيذلا ءانثتساب ينكلهتسلما لك ققحتلا تم امك ىتاذ نايبتسا مادختسا تمو ليمجتلا تارضحتسمو .نابتسلاا ةحص نم لصأ نم كلهتسم 538 ةساردلا يف ةكراشلما ىلع قفاو :جئاتنلا ةيبلاغ ناكو .ضايرلا ةنيدم يف عمتجلما تايلديص اوراز 707 ةنس 23-33 ينب مهرامعأ حوارتتو ،)73%( روكذلا نم ينبيجتسلما .تاعمالجا يجيرخ نم اوناك )42%( ينكراشلما مظعمو )35%( 149 اهنم ةيبط ةفصو نود ءاود 285 هُعَومجم ام ءارش تم دقو نكيم )51%( 155 و طقف ةيبط ةفصوب فرصت نأ بجي )49%( ،)22%( ةيويلحا تاداضلما تناكو .ةيبط ةفصو نودب فرصت نأ اًعويش رثكلأا ةيودلأا نم )19%( ةرارلحا تاضفاخو تانكسلماو ءارشل اًعويش رثكلأا بابسلأا تناكو ةيبط ةفصوب اهفرص بجي ىتلاو يعدتست لاو ًادج ةفيفط تناك ضارعلأا نأ ةيبط ةفصو نود ةيودلأا ةطيسبلا ضارملأاو )40%( تقولا ريفوتو )545%( بيبطلا ةرايز لكشب .)40%( بولطلما جلاعلاب مهتفرعم ينكراشلما دقتعي يتلا تاروصت مهيدلو ةفرعملل نورقتفي ينكراشلما ةيبلاغ نأ دجو ماع نوفرعي لا ينكراشلما نم 68% نم رثكأ .يتاذلا ىوادتلا نع ةيبلس ةيودلأا نم وأ ةيفصولا ةيودلأا نم وه هورتشا ىذلا ءاودلا ناك اذإ ام .ةيفصو ريغلا ةيبرعلا ةكلملما يف عئاش ةيلؤسم نود ىتاذلا ىوادتلا ةسرامم :ةتمالخا يعو ينستح ىلع ةيلبقتسلما تاساردلا زكرت نأ يغبنيو ةيدوعسلا .ةيودلأل ميلسلا مادختسلااو ىتاذلا ىوادتلا لوح ينكلهتسلما Objectives: To determine the prevalence of selfmedication and assess the knowledge, attitudes, and perception of consumers toward self-medication. Methods: This cross-sectional survey was conducted over 4 weeks in May 2011 in Riyadh city, Kingdom of Saudi Arabia. Community pharmacies within 5 areas of the city (North, South, West, East, and Middle) were randomly selected for the study. All consumers were approached to participate in the study, with the exception of those buying cosmetic and medicinal equipments. A validated self-administered questionnaire was used to collect the data. Results: A total of 538 out of 707 consumers attending community pharmacies in Riyadh city, agreed to participate in the study. Most responders were male (73%), 23-33 years old (35%), and college graduates (42%). A total of 285 medications were bought without a prescription. Of these, 149 (49%) medications should be dispensed by prescription only, and 155 (51%) were over the counter medications. The most common prescription medications dispensed without prescriptions were antibiotics (22%) and analgesics/antipyretics (19%). The most common reasons for buying medications without a prescription were that the symptoms were too minor to visit a doctor (54%), time saving (40%), and minor illnesses for which the participants knew the required treatment (40%). Overall, most participants had poor knowledge, and negative perceptions regarding selfmedication. More than 68% of participants did not know whether the medicine they bought is a prescription-only or over the counter medication. Conclusion: Irresponsible self-medication is common in Saudi Arabia. Future studies should focus on improving the consumers’ awareness of self-medication and the proper use of medications. Saudi Med J 2015; Vol. 36 (3): 328-334 doi: 10.15537/smj.2015.3.10523 From the Department of Clinical Pharmacy (Aljadhey), Medication Safety Research Chair (Assiri, Mahmoud, Al-Aqeel), College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia, and the College of Pharmacy and Regenstrief Institute (Murray), Purdue University, Indianapolis City, USA. Received 15th October 2014. Accepted 28th January 2015. Address correspondence and re-print request to: Dr. Hisham Aljadhey, Vice Dean for Academic Affairs, Director of Medication Safety Research Chair, Department of Clinical Pharmacy, College of Pharmacy, King Saud University, PO Box 2475, Riyadh 11451, Kingdom of Saudi Arabia. E-mail: [email protected] 328 Saudi Med J 2015; Vol. 36 (3) www.smj.org.sa OPEN ACCESS 329 www.smj.org.sa Saudi Med J 2015; Vol. 36 (3) Self-medication in Central Saudi Arabia ... Aljadhey et al M individuals practice self-care to maintain good health and to manage minor illnesses. The World Health Organization (WHO) has defined self-medication as ‘the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms’.1 The US Food and Drug Authority has defined Over the Counter (OTC) medication as “drugs that are safe and effective for use by the general public without seeking treatment by a health professional”.2 Self-medication with OTC medications is called responsible self-medication, and is an acceptable practice worldwide, whereas buying prescription medications without a prescription from a physician is dangerous and considered as unsafe self-medication.1 The benefits of using OTC medications include a reduction in the frequency of visits to a physician and reduced cost.3 However, misuse of OTC medications can be accompanied by adverse reactions, interactions with other medications, overdosing, and other medication related problems.3 Therefore, it is recommended that the public should be educated on the use of OTC medications to increase their knowledge and awareness and facilitate responsible self-care. The use of prescription medications is helpful to treat illnesses when they are used under the advice of physicians for appropriate diagnoses. It has been reported that selfmedication is common practice among consumers in developing countries, and prescription medications can be purchased without a prescription.4,5 In Kuwait, a self-medication prevalence of 92% has been reported among adolescents.6 A study from Bahrain reported that 44.8% of medical students have selfmedicated.7 The most commonly reported reasons for self-medication were time saving and minor illnesses. In Saudi Arabia, a recent study reported that 35% of patients attending primary care centers have some experience with self-medication.8 Factors contributing to self-medication were male gender, young age, poor health status, and dissatisfaction with health care.8 This differs from international studies reporting high levels of education and professional status as predictive factors for self-medication.9 Although there are regulations for prescription and OTC medications use, it is common to buy prescription medications without a prescription in Saudi Arabia. A study in 1992 reported that 35% of medications that were dispensed over the counter in community pharmacies in Riyadh were actually prescription only medications.5 This is a very old study, and awareness of self-medication might have changed over the past 2 decades. However, with the easy and unrestricted access to medications from community pharmacies and lack of advice from the pharmacists there is a great risk of self-medication without a healthcare provider consultation. Estimating the prevalence of selfmedication and ascertaining the reasons behind it will enable policy makers and community pharmacists to ensure safe use of medications by consumers. Previous studies on self-medication in Saudi Arabia among consumers in community pharmacies are limited. Therefore, the aims of this study were to estimate the prevalence of self-medication and assess the knowledge, attitudes, and perception toward self-medication of consumers attending community pharmacies in Riyadh, Saudi Arabia. Methods. This was a prospective cross-sectional survey conducted in Riyadh city, Kingdom of Saudi Arabia. Community pharmacies within 5 areas of the city (North, South, West, East, and Middle) were randomly selected and the study was conducted over 4 weeks in May 2011. Every third pharmacy from the 5 regions was selected. Data collectors distributed the questionnaires to consumers buying medications with or without prescriptions from the selected pharmacies at different times of the day. Training on the data collection method was provided to all data collectors. Consumers buying cosmetics and medical equipment were not approached. In cases where consumers were illiterate, their caregivers were asked to interview them and complete the questionnaire on their behalf. A selfadministered questionnaire was prepared in English after reviewing literature for similar studies.5,10,11 The questionnaire was translated into Arabic language by an experienced translator. Initially, the content validity was conducted by a group of 5 pharmacists to review the questionnaire for clarity and understanding by the public. Face validity was tested on a pilot of 5 community pharmacy customers. During the pilot study the questions were found to be clear for the respondents. In addition to questions regarding participants’ demographic characteristics, the questionnaire consisted of questions with closedand open-ended responses. In the demographic characteristics section, participants were asked to provide their age, gender, educational level, and employment status. In addition, the survey also included questions on the type of medication purchased, the indication for OTC medication use, sources of medications information, and reasons for buying medications without a prescription. Open-ended questions were used to provide in-depth information. Consumers were requested to list all medications they bought during that visit without prescription. These medications were then checked against the Saudi Food and Drug Authority (SFDA) list of human medications and subsequently classified into prescription only or