Different people act differently to treat their symptoms of disease or any illness which is common among community. For example in Malaysia, people tend to buy antihistamines either to treat common flu or itchiness developed from allergic reactions without seeking a proper medical attention from a physician. This is a form of self care which is known as self medication. Self care is a condition when individuals take care of their own health and also care to other family members and other as well (The World Self-Medication Industry, 2006). Self medication can be defined as the health activities to treat oneself with or without drugs using information obtained from past health experiences, books, advices, software, web sites, health advertising, radio or television programme (Cure, 2005).
Pharmacy students and medical students are believed to have more knowledge on diseases and medications compared to other non-pharmacy students (James, Handu, Khaja, Otoom, & Sequeira, 2006). Therefore, they always prefer to self-medicate themselves rather than consulting a physician and get a proper prescription.
Self medication has its own advantages and disadvantages. With a proper medical care and self medication practices at home, number of hospital stays can be reduced especially with chronically ill adults. Also self medication allows patient to be more confident and highly responsible towards their own health management (Yousef, Al-Bakri, Bustanji, & Wazaify, 2008). However, sometimes there may be cases of uncontrolled use of over-the-counter products that lead to overdose and interactions with other medications that used to treat other disease.
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There are numerous factors that may contribute to the development of self medication practices include difficulties to access and availability of medical care, increasing knowledge of how to deal with medications among populations and failures of health care system in certain populations (Leyva-Flores, Kageyama, & Erviti-Erice, 2001). Failure of health care systems can further explain with its improper distribution of medications and increasing cost of medical treatment (Suleman, Ketsela, & Mekonnen, 2009).
In Malaysia, the Pharmaceutical Services Division, Ministry of Health built a website named “Know Your Medicineâ€. The main purpose of the website is to educate people and create an opportunity for public to understand more about medicines. The objective of the website is also to emphasize on learning the proper use of the medicines and their rights as the consumer of medicines (Division, 2008). Included also in the portal are patient education materials like pamphlets, health articles and car stickers.
Study conducted in community pharmacies in rural Portugal shows 21.5% of customers bought drugs for self-medication (Melo, Madureira, Ferreira, Mendes, Miranda, & Martins, 2006). In Sudan, the prevalence of self-medication is alarmingly high especially with antimicrobials and antibiotics. Groups of people that commonly practise self-medication are including those educated people with intermediate income, females and people aged below 40 years old (Awad, Eltayeb, Matowe, & Thalib, 2005) .
Problem statement
Currently there are no study was reported in Malaysia context as a PubMed search on the 25th February 2010 returns in no result. It can be concluded that there may be studies done but was not published in any database. Pharmacy students in the other hand are going to be a health care professional in the future and their perception about self-medication is important.
Objectives
This study on self medication practices among undergraduate pharmacy students in two public universities and two private universities in Malaysia is important to estimate the prevalence of self-medication and to evaluate factors or conditions associated with self-medication. This study also done to investigate types of medications commonly used by the students to practise self-medication.
Significance of study
From this study, some changes on the pharmacy’s curriculum can be done to increase the knowledge about self-medication and encourage students to practice responsible self-medication in daily life.
Hypothesis
The hypothesis in this study is there is a significance difference between academic years and genders towards self-medication.
CHAPTER 2
LITERATURE REVIEW
2.1 Self care
People tend to use the words self care and self medication alternately without realizing that both words carry different meanings and concepts. From a worldwide review of consumer surveys conducted by World Self Medication Industry, self care is defined when individuals take care their own health and also care to other family members and others as well (The World Self-Medication Industry, 2006). It is our own responsibility to take care of ourselves not only to fulfil the basic needs of daily life but also other physical activities to maintain a good body and mental health.
A proper self care after being hospitalized may reduced the chances of second hospitalization especially to chronic illness patients (Shishani, 2008). For example, a diabetic patient needs a proper wound management after his left toes being amputate to avoid infections. Self care in this case is to perform a daily wound management to the patient and to control foods intake and ensure patient comply with the medications prescribed.
2.1.1 History
Self care developed accordingly with the world. Increase in technology give impact to people and raise their self awareness in obtaining a good healthy state. In a study done by R. William Soller, a term was introduced that symbolize the evolution of self care from the dark ages to the current situation. Today, self care is properly described as OTCness (Soller W. R., 1998) or the availability of safe and effective non-prescription medications through over-the-counter for responsible consumer self care (Soller W. R., 1998).
During the dark ages where it refers to years back in 1800s, self care is not really important. People do care for their health but due to lack of technology and regulations, the medications some time are not even up to the requirement. There is a case where a patent medicine label showed drug indication to treat arthritis, ringworm, diarrhoea, kidney trouble and skin disease (Soller W. R., 1998).
The renaissance of self care with over-the-counter begins in 1972 when Food and Drug Administration (FDA) define the safety and effectiveness of all marketed over-the-counter products (Soller W. R., 1998). Regulations implement by FDA is important because without a proper control, medicines produced from unrecognized company may be contaminated and cause unwanted side effects to consumers that possibly fatal.
In 1984, the changes from prescription medicines to over-the-counter recorded with Ibuprofen (Association, 1998) leaving behind other medicines. Economically, the changes from Rx to OTC also benefited the health care provider.
2.2 Self medication
Self medication is a common topic to be discussed especially among developing countries. In a search through Springer Link with the keywords self medication, 27 435 journals are related as in 23rd February 2010. Different from self care, self medication involve medicines and more specific to treat common health problems with a non-prescription medication that can be obtain through over-the-counter at any licensed pharmacy or chemist (The World Self-Medication Industry, 2006) .
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Health survey conducted in Hong Kong in 1972 showed that four-fifth of the local Chinese population kept medication at home for their own use while another 57% of the population choose to self-medicate them as response to illness (Lam, Tse, & Munro, 1989). In Amman, Jordan, 42.5% of Jordanians found to self-medicate with the most common reason is the ailments were too minor to see a doctor (Yousef, Al-Bakri, Bustanji, & Wazaify, 2008).
Two studies conducted in Palestine showed relatively high percentage of population practices self-medication. In a study done at a community pharmacy centre in the northern part of Palestine over three months period it was found that 60% of patients self-medicate and 1263 patients were purchasing one or more type of drug without prescription for one or more ailments (Sweileh, 2004). Another study done among An-Najah National University between the medical and nonmedical students showed that 98% of the surveyed students practise self-medication (Sawalha, 2008).
In Bahrain, 76.9% of the respondents had a positive attitude favouring self-medication (James, Handu, Khaja, Otoom, & Sequeira, 2006). This study was conducted among first year medical students of the Arabian Gulf University and on the day questionnaire was administered, 134 out of 153 students were present (James et al., 2006). Of 909 surveyed customers in community pharmacies in Southern Chile, 75% of them practice self-medication in response to initially treated illnesses with medications that are easily obtainable (Albarran & Zapata, 2008).
Self medication with a proper control may benefit both physicians and patients. Medicines used in self medication are called over-the-counter medicines or non prescription medicines can be found not only at licensed pharmacy but also some time they sold it in supermarket also. For example, Panadol commonly purchased and taken by most people to treat headache and as pain killers are available at supermarket, grocery shops and petrol stations.
2.2.1 Responsible self medication
As people self medicate, they are responsible to themselves regardless what the consequences are. There is a phrase called responsible self medication referred to customer who bought over-the-counter medicines and use it as instructed by health professionals (Albarran & Zapata, 2008). Self medication may or may not cause harm to consumers but a proper precaution and observation must be done. It is important to let the patient knows the effects and benefits of taking the medications.
For instance, drowsiness is a common side effect for cold medications. Patient must know the side effect so they are not going to operate any machine or do heavy tasks or else they will end up into some accidents that may cause fatal. Also self medication requires a certain level of knowledge (Aljinovic-Vucic, Trkulja, & Lackovic, 2005). Without knowing the medications, there is a tendency to overdose or misuse of medications.
Responsible self medication may reduce the health care delivery’s load as people do not need to see doctor for every common illness that occurs (Albarran & Zapata, 2008). Doctor can spend their precious time to concentrate on more critical cases.
2.2.2 World Self Medication Industry
A federation of 50 members association in the World Self Medication Industry (WSMI) are representing manufacturers and distributors of non-prescriptions medicines on all continents (The World Self-Medication Industry, 2009). Their main vision is to make responsible self medication one of the recognised key force in primary health care in World Health Organisation as well as other organisations.
They are fighting for the development of self medication all over the world and educate people about responsible self medication. To achieve their mission and vision, a lot of activities were done and currently on going especially the research part of self medication. Information exchange is one of the strategies that WSMI used besides organizing international and regional conferences and represent worldwide self medication industry at other conferences (The World Self-Medication Industry, 2009).
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