INTRODUCTION:

Self medication is defined as the utilization of drugs to treat self-diagnosed disorders or symptoms, or the irregular or continuous use of a prescribed drug for chronic or repeated diseases or symptoms ¹. Medicines for self medication are often called Non-Prescription or Over the Counter (OTC) and are available without a doctor's prescription through pharmacies.

Self-medication is now increasingly being considered as a component of self-care². Studies done on self medication reveal that it is fairly common practice, especially in economically deprived countries. WHO has also pointed out that responsible self-medication can help to prevent and treat ailments that don't require medical consultation and provide a cheaper alternative for treating common illnesses. However, it is also recognized that responsible self-medication must be accompanied by appropriate health information³.In several studies, it has been found that inappropriate self-medication results in wastage of resources, increased resistance to pathogens and generally entails serious health hazards such as adverse drug reactions, prolonged suffering and drug dependence. On the other hand, if done appropriately, self medication can readily relieve acute medical problems, can save time spent in waiting to see a doctor and may be economical also⁴. Though several studies have been carried out among different population settings regarding self-medication, there is paucity of literature among medical students. Since they are future doctors and health prescribers of community, it is very much important to know their level of knowledge regarding different aspects of self-medication. Hence, this study was planned with the objective to assess the knowledge, attitude and prevalence pattern of self-medication in medical students and to study whether their knowledge about medicines and diseases resulted in any change in their practice level.

MATERIALS AND METHODS:

This was a questionnaire based study and the locus of study was Department of Pharmacology, Late Shree Baliram Kashyap Memorial Government Medical College Jagdalpur, Chhattisgarh.

After collecting signed Informed Consent, A prevalidated questionnaire was distributed to 181 students of M.B.B.S of

1^st, 2^nd and final year students of Late Shree Baliram Kashyap Memorial Government Medical College, Jagdalpur, Chhattisgarh.

The questionnaire consisted of specific questions regarding the knowledge about self medication, indications for self medication, treatment modalities, dose and duration of therapy, adverse effects of medicines used as self medication and the knowledge about the source of information of medicines used for self medication.

RESULTS:

A total of 181 students of age group 17-26 years were selected, 111 (61.32%) females and 70 (38.68%) males were included in the study. (Table-1).

Table-1 Demographic characteristic of student participated

Characteristics	Number	Percentage
Gender
Male	70	38.68
Female	111	61.32
Age
(17-21)	80	44.2
(22-23)	51	28.18
(24-26)	50	27.62
Year of study
1^st year	89	49.18
2^nd year	40	22.1
Final year	52	28.72

Allopathic system of medicine was trusted by138 (84.15%) students for self medication (Figure-1).

On analyzing the data we found maximum reason for self medication was old prescription / previous experience of the medical student with similar symptoms 87(53.04%) (Table-2).

Figure-1 System of medicine practiced

Table -2 Source of information for self medication:

Source	Number	Percentage
Doctors (old prescription)	87	53.04
Seniors and colleagues	31	18.90
Textbook	19	11.59
Advertisement	12	7.32
Pharmacist	15	9.15

The most common ailments for which self-medication were used were: the Fever 62 (37.8%) Headache 56 (34.14%) and Common cold 38 (23.17%) (Figure-2).

Figure- 2 Indications for self medication:

Most commonly used drugs for self medication were Crocin 72 (43.90%) for Fever, Zandu Balm 64(39.02%) for Headache and Alerid 63 (38.41 %) for Common cold, whereas Strepsils 56(34.15%) and ORS 52(31.70%) were used for Sore throat and Diarrhea respectively. (Table -3).

Source of the medicine for self for self medication among medical student was pharmacy 92(56.1%), seniors and Colleagues 41(25.0%) and Casualty 31(18.90%) (Figure-3).

Table -3 Medication used for self medication

Indication	Medication	Number	Percentage
Fever	Crocin	72	43.90
	Calpol	33	20.12
	Combiflam	32	19.51
	Pacimol	14	8.54
	Dolo-650	13	7.93
Headache	Zandu Balm	64	39.02
	Disprin	44	26.83
	Saridon	23	14.02
	Brufen	18	10.98
	Nice	15	9.15
Common cold	Alerid	63	38.41
	Sinarest	37	22.57
	Vicks action-500	29	17.69
	D-cold total	21	12.80
	Anacin	9	5.49
	Avil	5	3.04
Diarrhea	ORS	52	31.70
	Norflox-TZ	26	15.85
	ORS+Norflox TZ	24	14.64
	ORS+Metrogyl	21	12.80
	Metrogyl	18	10.98
	Enteroquinol	14	8.54
	Ciplox	5	3.05
	Oflomac	4	2.44
Sore Throat	Strepsil	56	34.15
	Vicks	53	32.32
	Mox	28	17.08
	Azimax	14	8.54
	Septran	8	4.87
	Althrocin	5	3.04

Figure-3 Source of medicine for self medication

Of the respondents 36(21.95 %) were unaware of the adverse effects of the medication. (Table- 4)

Table- 4 Level of knowledge about medication:

Level of knowledge about medication	Number	Percentage
Content, Dose, Duration of therapy and adverse drug reaction.	52	31.70
Content and Dose	40	24.4
Do not know	36	21.95
Content, Dose and Duration of Therapy	26	15.85
Content	10	6.1

Students during self medication also experienced certain side effects 39(23.78%). They were Nausea 12(30.77 %), Drowsiness 10(25.65%), Gastrointestinal irritation 9(23.07%) and skin allergies 8(20.51%).

After facing side effects 21(53.85%) student consulted the physician, 12 (30.77%) students stopped medication while 6(15.38%) changed their medication.

DISSCUSION:

In the present study we found self-medication as the common practice amongst medical students 164(90.60%) in 1^st, 2^nd and final year medical students of the Bastar region and it is more popular among 1^st year students 83(93.25%) as compared to their 2^nd 36 (90.0%) and final year 45(86.25%) counterparts. Moreover, self-medication practice was found to be more in males 64(91.42%) than females 100(90.09%). Previous studies indicate that self-medication practice is not only common in medical students but also in other categories of students as well as in general population⁵. In general population of Jammu region it was found that 70% people practiced self-medication ⁶while it was found to be upto 87% in UP region of India ⁷.

In West Bengal, it is observed that self-medication practice is common in medical students ⁸. In Nagpur region of Maharashtra it is observed that self-medication much more (74.71% to 77.98%) ⁹. Above studies by various sources indicate different pattern of self-medication practiced among various categories. Moreover, it should be more common in senior students as observed since these students have better orientation of diseases and their management¹⁰but our findings are conflicting. It might be due to 1^st year students did not have the knowledge about disease, medication, and patients, while second year students are having the knowledge about disease, medication but superficial knowledge about patients. Meanwhile final year students having better knowledge about disease, medication and patients in comparison to their juniors hence they practiced safe medication.

An alarming percentage, 36(21.95%), of students had taken self medication without the knowledge of content, dose, duration of therapy and adverse drug reaction.

The availability of more complex drugs groups such as antibiotics without prescriptions is a source of great concern¹¹,Moreover, the practice of self medication often has many adverse effects and can lead to many problems, including the global emergence of Multi-Drug Resistant pathogens ¹², drug dependence and addiction ¹³, masking of malignant and potentially fatal diseases ¹⁴, hazard of misdiagnosis ¹⁵, problems relating to over and under dosaging ¹⁶, drug interactions ¹⁷and tragedies relating to the side effect profile of specific drugs ¹⁸.The challenge in controlling the problem of self medication is to achieve the necessary high level of consumer safety. It may be recommended that by monitoring usage of self medication, in addition to data recording and education, safe and effective use of such medicines can be promoted.

CONCLUSION:

The prevalence of self medication practices is alarmingly high in the medical students of Bastar region

Self management of acute, intermittent and long-term conditions is likely to become more extensive in future. A balance needs to be struck between safety and patient autonomy. They are referred to medicines mostly by brand names to get relief from common conditions like fever and pain. Mostly senior students have better understanding about self-medication although junior students need more training and education. Students should be educated for proper use of self-medication drugs from the beginning of their curricular activities.

We recommend that a holistic approach must be taken to prevent this problem from escalating which would involve:

(i) Awareness and Education regarding the implications of self medication.

(ii) Strategies to prevent the supply of medicines without prescription by pharmacies.

(iii) Strict rules regarding pharmaceutical advertising.

(iv) Strategies to make health care easily accessible.

Our study has also opened gateways for further research in this issue, besides showing that it is a real problem and should not be ignored.

ACKNOWLEDGEMENT:

The authors would like to thank medical students of Late Shree Baliram Kashyap Memorial Government Medical College, Jagdalpur (Bastar) Chhattisgarh for helping in this study.

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Received on 25.03.2014 Modified on 15.04.2014

Res. J. Pharmacology & P’dynamics. 6(2): April- June 2014; Page 108-111