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Prevalence, pattern and perceptions of self-medication in medical students

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DOI: 10.5455/2319-2003.ijbcp2013060

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 Print ISSN: 2319-2003 | Online ISSN: 2279-0780

IJBCP International Journal of Basic & Clinical Pharmacology

doi: 10.5455/2319-2003.ijbcp20130608
Research Article

Prevalence, pattern and perceptions of self-medication

in medical students
Rushi N. Pandya1, Kunal S. Jhaveri2, Falgun I. Vyas3, Varsha J. Patel4*

1
Resident, Department of
ABSTRACT
Pharmacology, Smt. NHL Muni.
Medical College, Ahmedabad,
Background: The use of self-medication is highly prevalent in the
Gujarat, India
2 community more so amongst the medical students. Self-medication can be
Medical Advisor, AstraZeneca,
defined as the use of drugs to treat self-diagnosed disorders or symptoms, or
Bengaluru, India
3 the intermittent or continued use of a prescribed drug for chronic or
Medical Advisor, Intas
recurrent disease or symptoms.
Pharmaceutical, Ahmedabad, India
4 Aims and Objectives: To study the prevalence and pattern of use of self-
Professor & Head, Department of
medication among medical students from first year to internship.
Pharmacology, Smt. NHL Muni.
Methods: This cross sectional study was carried out among under graduate
Medical College, Ahmedabad,
medical students including interns of Smt. NHL Municipal Medical
Gujarat, India
College, Ahmedabad during the period of March 2010 to May 2010.
Results: Out of 747 students and interns enrolled, 685 responded (91.7%).
Received: 23 April 2013
Out of 685 respondents 564 (82.3%) reported self-medication within one
Accepted: 5 May 2013
year of recall period. Most common conditions/symptoms for self-
medication in students were fever (72.7%), headache (69.1%), upper
*Correspondence to:
respiratory tract infections (64.1%) followed by others like body-ache,
Dr. Varsha J. Patel,
abdominal pain, diarrhoea etc. Over the counter drugs (84.2%) was the most
Email: drvarsha4@rediffmail.com
common category of drugs used by all the students except first year students
who used prescription only drugs more frequently (48.5%). Herbal and
© 2013 Pandya RN et al. This is an
Ayurvedic drugs were also used as self-medication (17.8%); most
open-access article distributed under
frequently by the first year students (22.7%).
the terms of the Creative Commons
Conclusion: The pattern of self-medication practice changes with time and
Attribution License, which permits
advancement of knowledge.
unrestricted use, distribution, and
reproduction in any medium, provided
Keywords: Self-medication, Medical students, OTC drugs, Survey
the original work is properly cited.

INTRODUCTION The practice of self-medication among doctors develops

during their training period as obvious from some studies
Self-medication can be defined as the use of drugs to of self-medication among medical students. These studies
treat self-diagnosed disorders or symptoms, or the have reported high prevalence ranging from 57.7% to
intermittent or continued use of a prescribed drug for 76%.8,9 Self-medication is also reported to be quite
chronic or recurrent disease or symptoms. In practice, popular among Indian medical students.10 However
it also includes use of the medication of family there is a paucity of studies of the prevalence and pattern
members, especially where the treatment of children or of self medication among medical students from India.
the elderly is involved. 1 Use of self-medication is This questionnaire based study was planned to find
highly prevalent in both urban and rural community out the prevalence and pattern of self-medication in
varying from 32.5% to 81.5%. 2-4 Self-prescribing undergraduate medical students and their perceptions
among doctors is reported to be prevalent. In a study about self-medication.
of self medication in young Norwegian doctors, 56%
of hospital physicians and the general practitioners METHODS
reported self-medication during the previous year. 5 A
quarter of the primary healthcare professionals in This cross sectional study was carried out among under
Brazil self-medicated themselves. 6 Self-medication graduate medical students including interns of Smt. NHL
with antibiotics was reported by 53% of doctors in a Municipal Medical College, Ahmedabad during the
study from Karnataka state of India. 7 period of March 2010 to May 2010. The study began

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 Pandya RN et al. Int J Basic Clin Pharmacol. 2013 Jun;2(3):275-280

after approval of the Institutional Ethics Committee while lowest in interns with 47 (41.6%). Fifty seven
(IEC). (10.1%) students had self medicated more than 12 times
in one year recall period.
Data were collected through structured, validated 12
questions based questionnaire which was filled up by Most common conditions/symptoms for self-medication
students after explaining about the aim of study and in students were fever (72.7%), headache (69.1%), upper
giving assurance about confidentiality of all information. respiratory tract infections (64.1%) followed by others
Data were analysed for those students who had self like bodyache, abdominal pain, diarrhoea etc (Figure 1).
medicated within one year of recall period. For majority of symptoms intern doctors resorted to self
medication, while lowest use was reported by first year
The questionnaire included questions pertaining to medical students.
demographic details, professional year of the M.B.B.S.
course (first year, second year, third year part 1, third Over the counter drugs (84.2%) was the most common
year part 2 or internship), frequency of self medication category of drugs used by all the students except first
during one year recall period, indications for self- year students who used prescription only drugs more
medication, details of type and pattern of drug usage, frequently (48.5%). Herbal and Ayurvedic drugs were
sources of drug information used, use of psychotropic also used as self medication (17.8%); most frequently by
agents as self medication, reasons for favoring self- the first year students (22.7%) (Figure 2). The most
medication and knowledge of adverse effects of drugs commonly used drugs for self-medication were
used. paracetamol (65.6%), anti infective agents (44.7%),
NSAIDS (34.7%) followed by H1 antihistaminics
Data were analysed using MS Excel 2007. (25.8%), gastrointestinal drugs (13.1%) and herbal and
Ayurvedic drugs (7.8%). Third year MBBS students were
RESULTS the most frequent users of self medication for majority of
drugs including anti-infectives which are POMs except
Out of 747 students and interns enrolled, 685 responded interns for psychotropic drugs and first year students for
(91.7%). Out of 685 respondents 564 (82.3%) reported herbal and Ayurvedic drugs (Figure 3).
self medication within one year of recall period. Table 1
shows the socio-demographic characteristics of the 685 The important sources of information for self-medication
students who responded irrespective of self-medication were relatives and physicians (48.6%), seniors and
within one year recall period. friends (45.4%) and textbook and related materials
(44.5%). The frequency of use of textbooks and related
Out of 564, 371 (65.9%) had self-medicated with printed material as major source of information
frequency of 1-5 times in last year and self-medication increased from first year (6.2%) to third year students
was highest in the second year students with 89 (74.8%), (76.3%).

Table 1: Demographic profile of medical students (n= 685).

Self Medicated in Gender

Professional Respondents Age –years
Last Year
Year –MBBS No. Male Female Mean ± S.E.
No. (%)
No. (%) No. (%)

First 139 97 (69.80) 89 (64.00) 50 (36.00) 17.88 ± 0.631

Second 160 119 (74.37) 94 (58.75) 66 (41.25) 19.28 ± 0.632

Third- Part 1 136 117 (86.00) 92 (67.60) 44 (32.40) 19.74 ± 0.599

Third- Part 2 131 118 (90.10) 97 (74.00) 34 (26.00) 21.09 ± 0.561

Interns 119 113 (95.00) 96 (80.70) 23 (19.30) 22.92 ± 0.570

Total 685 564 (82.30) 468 (68.30) 217 (31.70) 20.02 ± 0.069

International Journal of Basic & Clinical Pharmacology | May-June 2013 | Vol 2 | Issue 3 Page 276
 Pandya RN et al. Int J Basic Clin Pharmacol. 2013 Jun;2(3):275-280

100
90
% FREQUENCY OF SYMPTOMS

80
70
60
50
40
30
20
10
0
1st 2nd 3rd part-l 3rd part-ll intern doctors total
PROFESSIONAL YEAR OF MEDICAL STUDENTS

Fever Headache Body ache Cough

Diarrhoea Constipation Abdominal Pain Other symptoms

Figure 1: Conditions/symptoms for self medication.

100
% FREQUENCY OF TYPE OF THE DRUGS

80

60

40

20

0
1st 3rd part-l intern doctors

PROFESSIONAL YEAR OF MEDICAL STUDENTS

O.T.C. medicines* P.O. medicines** herbal / ayurvedic medicines others

Figure 2: Drug categories used for self medication by medical students.

(* Over the counter medicines, ** Prescription only medicines)

Total 95 (16.8%) students used psychotropic drugs as medication frequency had increased progressively with
self-medication, out of which 13.9% of students were education level. About 70% (398) students opined in
using sedatives-hypnotics and antidepressants. Use of favor of self-medication. Most common reasons for
sedatives-hypnotics and antidepressants increased with favoring self-medication were time saving (41.2%)
seniority from 4.1% in first year to 24.5% among interns. followed by convenience (39.6%), quick relief (35.5%)
There was a significant association of self-medication and cost-effectiveness (22.8%) (Table 2).
with Out of 564 responders, 409 (72.3%) felt that self-

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 Pandya RN et al. Int J Basic Clin Pharmacol. 2013 Jun;2(3):275-280

Figure 3: Drugs used for self-medication by medical students.

Table 2: Reasons for favoring self medication. includes internship in many countries including India. It
is also known that this group starts relying on self
medication during their formative years of undergraduate
Reason No. (%) of respondents
training. Some studies have reported prevalence and
Time saving 233 (41.20) pattern of self-medication in medical students with
varying results.10,11
Convenience 224 (39.60)
Our results suggest a high prevalence (82%) of self-
Quick relief 201 (35.50) medication in our students which is somewhat higher
than reported by Zafar et al who studied self medication
Economical 129 (22.80) in medical and non medical students and found no
significant difference between the two groups9 and
Others 06 (01.10) lower than reported by Badiger et al reporting 92%
prevalence in a study of 200 students.12 The most
Out of 564 respondents, 401 (70.8%) students were aware important reason for higher trend of self medication is
of adverse reactions of drugs used for self medication, easy availability of all categories of medicines- OTC,
while 43 (7.6%) students had experienced it. prescriptions only or even schedule X drugs (Narcotics)
without prescription to consumers in India. As a result
There was significant association of self-medication with high prevalence has been reported even in urban
increased level of education (p=0.001) and examination population.2,3 The situation is much more favorable
stress. (p=0.003). There was no significant association of for medical students. Other factors favoring self
self-medication with gender. medication are acquired knowledge of medicines,
convenience and saving time due to no need of consulting
a doctor.
DISCUSSION
In spite of high prevalence, the frequency of self
The practice of self-medication is widespread all over the medication is not high with about 70% reporting 1 to 5
world especially urban and educated population. 2,3 times in one year recall period. Moreover, over the
Doctors also tend to self medicate to the extent feasible counter drugs is the most frequently used category
due to their knowledge about both diseases and drugs. meaning they exercise discretion when using POM as self
Several studies have reported prevalence of self- medication. It is also observed in this study that most of
medication varying from 25-56%.5,6 Medical students self medication is for minor common ailments like fever,
acquire knowledge of drugs and skills of drug selection headache, cough etc which is in accordance with previous
and prescribing during the undergraduate training which studies in University students.9,12 Use of drugs from

International Journal of Basic & Clinical Pharmacology | May-June 2013 | Vol 2 | Issue 3 Page 278
 Pandya RN et al. Int J Basic Clin Pharmacol. 2013 Jun;2(3):275-280

alternative medicine (herbal, Ayurvedic) was also CONCLUSION

reported, more frequently by first professional year
students. This could be due to continuation of self To conclude the practice of self medication is highly
medication practices in urban population in general in prevalent in medical students with majority restricting the
their first year of medical education. This trend decreases use to treatment of minor ailments with over the counter
with their increasing knowledge and self confidence in drugs. The pattern of self medication practice changes
modern medicines. A study from China has also reported with time and advancement of knowledge.
frequent use of Chinese herbal medicines by University
students.13 Funding: No funding sources
Competing interests: None declared
More than 90% of respondents were aware of the adverse Ethical approval: The study was approved by the
affects associated with self-medication as compared to Institutional Ethics Committee (IEC)
just above 30% in the study by Badiger et al.12
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doi:10.5455/2319-2003.ijbcp20130608
Cite this article as: Pandya RN, Jhaveri KS, Vyas FI,
Patel VJ. Prevalence, pattern and perceptions of self-
medication in medical students. Int J Basic Clin
Pharmacol 2013;2:275-80.

International Journal of Basic & Clinical Pharmacology | May-June 2013 | Vol 2 | Issue 3 Page 280

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