Prevalence of using non prescribed medications in economically deprived rural population of Pakistan

A remarkably high response rate of 100 % was obtained, due to proper explanation of
research proposal and assurance of maintaining full confidentiality of the data they
provided. Three fifty participants (50 %) were recruited from each hospital. The mean
age of the subjects was 48.5?±?6.3, consisting of 441 (63 %) males and 259 (37 %)
females. Besides, 217 (31) participants were matriculated (grade 10),182 (26) had
secondary school degree (intermediate), 77 (11 %) participants were graduated,49 (7 %)
had qualification of post graduation and 175 (25 %) OPD patients had no formal education.
Regarding occupation, 329 (47 %) were employed,77 (11 %) were retired, 161 (23 %)
were un-employed and 133 (19 %) were students. When questioned about monthly income,
147 (21 %) earned 5000 PKR, 210 (30 %) responded in the range of 5000–10,000PKR,
182 (26 %) subjects responded 10,000–20,000 PKR, 95 (13.5 %) responded 20,000–50,000PKR,
66 (9.5 %) responded for 50,000PKR. Further,429 (61.3 %) participants were married,
122 (17.5 %) were single,56 (8.0 %) were widow and 92 (13.2 %) were divorced. For
the subdivision of chronic illness, 365 (52.2 %) were not having any chronic disease
where as 77 (11 %) responded diabetes and 133 (19.0) claimed cardiovascular diseases.

According to the survey, 595 (85 %) subjects practiced self medication. The most common
reason evaluated for self medication was cost of consultation (90.3 %), availability
of transport (81.0 %), advice from friend/family (78.0 %), convenience (62.0 %) and
previous experience (67.0). The prevalent symptoms that led rural dwellers to indulge
in self medication were headaches (81.0 %), flu/cough (79.0 %), fever (68.0 %) and
pain elsewhere in body (63.0 %). As a result paracetamol as a painkiller (93.0 %),
acetylsalicylic acid as an anti pyretic (69.0 %), anti biotic (52.0 %) and anti allergic
(51.0 %) were the commonest drug used without prescription of a health care physician.
Besides, 90 % (535) never read the instructions that are placed with medicine and
only 9 % (54) read about side effects and contraindications. Moreover, 35 % (208)
of the subjects practicing self medication adjusted dosage of medicine consulting
pharmacist and 22 % (131) adjusted according to previous experiences.

Furthermore, for the most prevalent self medicated drug, paracetamol (pain killers)
were used with the frequency of every few months by 216 (39 %) subjects, 172 (42 %)
subjects also used acetylsalicylic acid (anti pyretic) within every few months. However,
anti allergics were used by 136 (45 %) participants with with the frequency of 2–3
times in a year whereas same frequency was recorded for usage of antibiotics by 151
(49 %) participants. Alarmingly, only 196 (33 %) self medicated OPD patients were
aware of the fact that their practice can lead to harmful effects and only 150 (25.2 %)
subjects among them appreciated that they should consult a medical physician before
starting a new medicine.

Further analysis was performed to assess the significant difference associated with
demographical features with regards to prevalence of self medication. There was no
significant difference between self medication practiced by male and females (p?=?0.32; 41 % vs 44 %) and subjects having a chronic disease with participants having
no disease (p?=?0.48; 42 % vs 43 %). However, a significant difference was obtained between participants
earning less than 50,000 PKR and greater than this amount (p?=?0.029; 61 % vs 24 %) and for the self medicated patients having education less
than graduation with the participants having education of graduation or above it (p?=?0.03; 63 % vs 22 %) (Tables 1, 2, 3 and 4).

Table 1. Illustrates demographic features of study participants

Table 2. Illustrates factors and symptomatology that leads to self medication among study participants

Table 3. Illustrates attitudes of study participants towards self medication

Table 4. Depicts frequencies of most common self medicated drugs