Assessment of self-medication among dental students An ... - CiteSeerX

The Health Agenda, Volume 3. Issue 3. July, 2015

ORIGINAL ARTICLE Assessment of self-medication among dental students: An institution based survey in a dental college at Vadodara, Gujarat Authors: Arpan K Shah, Rajendrasinh S Rathore, Namrata P Datir Corresponding author: Dr. Arpan K Shah, Senior Lecturer Department of Oral Pathology and Microbiology Manubhai Patel Dental College Vadodara, Gujarat 390011 Mail ID: [email protected] ABSTRACT Background: With the advent of over the counter drugs, self-medication has become a common practice among the youth as an own initiative to treat undiagnosed illness. Self-medication sans knowledge can be hazardous, whereas, if done with proper knowledge, its purpose can be justified. There is evidence of lack of studies addressing the self-medication among dental students. Dental students differ from general population because they are exposed to knowledge about diseases and drugs. Objectives: The present study aimed at determining the knowledge and attitude of self-medication among students of Manubhai Patel Dental College, Vadodara. Methodology: An institution based survey was conducted during the month of January 2015. Printed copies of a pre-validated questionnaire were distributed among the students. Total 205 students participated in the study. The data obtained was tabulated and expressed as frequency and percentages. Results: Of total 215 questionnaires, 205 were completely filled; giving a response rate of 95.34%. Total 197 (96.09%) students had self-medicated them. The basic category of questions consisted of general details of the student, medications used for self-medications, ailments for which self-medication was done, frequency of self-medication, sources of the medications, advantages and disadvantages of self-medication. 174 (84.87%) students had knowledge about various OTC drugs available. Main class of drugs used for self-medication were analgesics (88.33%), main source of procuring the drugs was the pharmacy (52.82%), main advantages were time saving (94.92%), easy availability (91.88%); and major disadvantage being untreated cause (93.17%). Conclusion: It was found that higher number of senior students practiced self-medication than the junior students. Senior students were well aware of the worse effects of self-medication and details of dose, duration etc. than their junior counterparts; also the senior students frequently self-medicated themselves as compared to the junior students. Key words: Adverse drug reaction, Dental students, Over the counter drugs, Self-medication INTRODUCTION Medications are an indispensible asset in healthcare system for relief from and the treatment of innumerable illnesses. However, their proper use is justified only in safe hands causing least possible adverse reactions. Use of medications without any medical supervision can create adverse drug reactions and drug toxicity. Certain groups of medications are available ‘over the counter’ or ‘anodyne medications’, which means medications available from the pharmacy without the prescription from a general

physician.(1) These drugs have a relatively low profile of side effects if taken in appropriate dosages and frequency. These medications are freely accessible to common man. The availability of over the counter drugs gave rise to the concept of ‘self-medication’. ‘Self-medication’ is defined as ‘obtaining and consuming drugs without the advice of a physician either for diagnosis, prescription or surveillance of treatment’.(2,3) There is growing concern about the consumption of medications, since the majority of the side effects developed frequently are more serious than the original disease itself.(2) Page | 88

The Health Agenda, Online ISSN No: 2320-3749

Shah AK, Rathore RS, Datir NP: Self-medication among dental students at Vadodara, Gujarat

Various surveys are conducted worldwide to study prevalence of self-medication among general population and amongst students of medical fraternity.(4-9) Students of dental fraternity, similar to those of medical fraternity, differ from the general population because they are exposed to knowledge about diseases and drugs. However, there is lack of studies addressing the self-medication practice among dental students. Thus, the present study was undertaken to determine the knowledge, attitude and practice of self-medication among the undergraduate and post-graduate dental students of Manubhai Patel Dental College. METHODOLOGY Study was conducted as an institution based survey. The study proposal was reviewed and approved by the institutional ethics/research committee, Manubhai Patel Dental College, Vadodara. The survey was undertaken during January 2015. Students of second year BDS (Bachelor of dental surgery), third year BDS, final year BDS, internees and post-graduate students were included in the study. Students of first year BDS and students of other courses such as Dental hygienist and Dental technician were excluded as they are not exposed to the teachings of pharmacology and prescription writing. The participants were explained about the nature and purpose of study and were included in the study after obtaining informed consent. Thus, a total of 205 students participated in the survey. Printed version of a self-developed, pre-validated questionnaire, prepared in English was distributed to the participants.

of the participant. Other personal details such as name and address were not included to avoid bias. Each participant was given appropriate instructions personally before filling the form. They were also explained about certain terms which were used in the questionnaire such as ‘self-medication’, ‘over the counter (OTC) drugs’ and ‘package insert’. They were given time of 30 minutes to fill the questionnaire. The data obtained was expressed as frequency and percentages of the total numbers. RESULTS The study population consisted of total 205 students, out of which 39 (19.03%) were males and 166 (80.97%) were females. (Table 1) It was observed that among 205 participants, 197 (96.09%) students had self-medicated themselves. (Table 1) The most common groups of medicines/drugs used for self-medication were analgesics 174 (88.33%), followed by antipyretics 117 (59.39%), cough syrup 116 (58.88%), topical creams 78 (39.59%) and allergy medications 22 (11.17%). The least common group of drugs used for self-medication was sedatives 3 (1.52%). (Table 2) Among the sources of obtaining the medicines, the most common source found was the pharmacy 108 (52.82%), followed by the stock at home 79 (40.10%), friends 20 (10.15%), and other sources 2 (1.02%) being the least. (Table 3) Regarding the drug dose and dosage form, 194 (98.47%) students were aware of the proper dose and the dosage form in which the medication was administered. 3 (1.53%) students were unaware of the dose and dosage form. (Table 4)

It was observed that 169 (85.78%) students had the knowledge of the adverse reactions of the selfThe survey form consisted both open-ended and consumed drugs, whereas 28 (14.21%) students close-ended questions. Age, gender and academic had no knowledge of the adverse drug reactions year of the curriculum were asked as general data associated with such drugs. Table 1: Frequency of self-medication practice among dental students (N=205) Gender Male Female Total

Self-medicated 36 (17.56) 161 (78.53) 197 (96.09)

Not self-medicated 3 (1.47) 5 (2.44) 8 (3.91)

Total 39 (19.03) 166 (80.97) 205 (100)

(Figures in parenthesis indicate percentages) Page | 89


Table 2: Common groups of drugs used as self-medication by dental students (N=197) Class of drugs Analgesics Antipyretics Cough syrup Topical creams Allergy medications Sedatives Others

Frequency of self-medication 174 (88.33) 117 (59.39) 116 (58.88) 78 (39.59) 22 (11.17) 3 (1.52) 1 (0.51)

(Multiple options possible, Figures in parenthesis indicate percentages)

174 (84.87%), out of 205 students had knowledge about various over the counter drugs available. However, 23 (11.21%) were not aware what the OTC drugs are. From the participants, 169 (85.78%) students read the package insert that carries extra information about the drug, 28 (14.21%) students had not read the insert. Regarding the knowledge about completion of the full dosage of drugs, 189 (95.93%) students knew the importance of course completion, whereas 8 (4.06%) students felt that course completion was not of much importance. A large number of participants, i.e. 187 (94.92%) stated that selfmedication practice is time saving. Many of them also stated easy availability and immediate relief as advantages of the self-medication practice. (Table 5) Similar to this, large number of participants i.e. 191 (93.17%) also believed that these easily available drugs give symptomatic relief but do not treat the cause of ailment. Adverse drug effects and drug toxicity/overdose were also believed as important disadvantages by many participants. (Table 6) Table 3: Various sources of over the counter drugs used by dental students (N=197) Sources of OTC drugs

N (%)

Pharmacy

108 (52.82)

Stock at home

79 (40.10)

Friends

20 (10.15)

Others

2 (1.02)

(Multiple options possible)

Table 4: Awareness about dose and dosage form of various OTC drugs among dental students (N=197) Awareness about dose and dosage form Aware Not aware

N (%) 194 (98.47) 3 (1.53)

Table 5: Advantages of self-medication perceived by dental students (N=197) Advantages of self-medication Time saving Easy availability Immediate relief

N (%) 187 (94.92) 181 (91.88) 171 (86.80)


Table 6: Disadvantages of self-medication perceived by dental students (N=205) Disadvantage of self-medication Untreated Adverse drug reactions Fatal if used in access

N (%) 191 (93.17) 182 (88.78) 173 (84.39)


DISCUSSION The study consisted of students studying from second year BDS to final year BDS, internees, and the post-graduate students. Various studies on self-medication have reported various prevalence figures, ranging from 26.2% to as high as 92%.(6,10) In our study, 96.09% students practiced selfmedication. Study by Patel et al. (2013) reported 92% medical students practiced self medication.(4) The study by Shukla et al. (2008) also reported a high number (82%) of medical students involved in self-medication practice.(7) Another study by Sujatha P et al. reported that 95% medical students had self-medicated themselves.(8) Our results were comparable to these studies. World Health Organization guidelines for the regulatory assessment of medicinal products for use in self-medication, consider self-medication as a part of self-care, when used efficiently can reduce burden of health Page | 90

Shah AK, Rathore RS, Datir NP: Self-medication among dental students at Vadodara, Gujarat

care system. (11) Self-medication, when done judiciously can bring symptomatic relief. Analgesics (88.33%) were most commonly practised as self-medication by almost all the participants in present study. Antipyretics (59.39%) were second on the list for the most commonly used drugs as self-medications. Analgesics and antipyretics were most commonly practised as self-medication in a study conducted by Sontakke et al. (2011).(9) These observations can be explained by the fact that headache, fever, sore throat etc. are most common ailments. Similar finding had been also observed by James et al. 2008.(12) Further, males are more exposed to physical activities such as outdoor games, while females frequently seek painkillers for menstruation related pain. Thus, analgesics are the most commonly consumed group of drugs among self-remedies. Topical dermatological preparations for the treatment of conditions like acne are also common among youngsters. Being students of healthcare fraternity, our study participants were aware about the treatment regime of common allergies. In addition, common cold is one of the most common ailments, which lead the anti-histaminics to be found as a commonly involved class of drugs used as self-medications. In the present study, the major source of selfmedication was the pharmacy (52.82%). This result is similar to the study by Patel et al. which reported pharmacy as a major source of acquiring OTC drugs. (4) This is because of the lack of strict rules to obtain medicinesin developing countries like India. Most of the participants were aware about the dose and dosage form of the drugs, adverse effects. However, there were also a significant number of students who were unaware about such important aspects of self-medications.

This finding can be supported by the fact that the youngest students from the study group (second year students), receive the knowledge of pharmacology, but perhaps the practical implications of this knowledge cannot be sufficiently imbibed until they are exposed to clinical practice. In contrast to this, final year students, internees and post-graduate students were well aware of the worse effects of selfmedications and details of dose, duration etc. due to their routine patient-care exposure. Thus, it is conceivable that as the level of education and practical experience increase, the outcome of selfmedication practice is more predictable. In our study, as expected, higher number of senior students practiced self-medication than the junior students. Similar study in another medical college has reported significantly greater prevalence of self-medication in senior medical students (73.3%), excluding internees and post-graduate students) compared to their junior counterparts (52.6%).(12) Another study also reported that higher number of senior students (84.61%) practiced self-medication than junior students (96.20%).(4) Most participants believed that selfmedication had its own pros and cons. CONCLUSION This cross-sectional study shows that the number of individuals who practice self-medication is high. OTC medicines are widely used to treat common health problems, they are appreciated for their wide availability, and they are seen by many as being as effective as prescription medicine. At the same time increased rate of selfmedication practice without proper knowledge is harmful to health and can sometimes prove to be fatal. Hence, it is important to increase awareness and education regarding self-medication and OTC drugs.

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9. Sontakke SD, Bajait CS, Pimpalkhute SA, Jaiswal KM, Jaiswal SR. Comparative study of evaluation of self-medication practices in first and third year medical students. Int J Biol Med Res. 2011;2(2):561-64.

4. Patel PM, Prajapati AK, Ganguly B, Gajjar BM. Study on impact of Pharmacology teaching on knowledge, attitude and practice on selfmedication among medical students. Int J Med Sci Public Health. 2013;2(2):181-86. 5. Sawalha AF. A descriptive study of selfmedication practices among Palestinian medical and non-medical university students. Res Social Adm Pharm. 2008;2(2):164-72. 6. Hussain A, Khanum A. Self-medication among university students of Islamabad, Pakistan - A preliminary study. Southern Med Review. 2008;1(1):14-16.

10. Martins AP, Miranda AC, Mendes Z, et al. Selfmedication in a Portuguese urban population: A prevalence study. Pharmacoepidemiol Drug Saf. 2002;11(5):409-14. 11. Ethical Criteria for Medicinal Drug Promotion. World Health Organization, Geneva; 1988. 12. James H, Handu SS, Khaja KA, Sequeira RP. Influence of medical training on selfmedication by students. Int J Clin Pharmacol Ther. 2008;46(1):23-29.

Particulars of contributors: 1. Dr. Arpan K Shah, Senior Lecturer 2. Dr. Rajendrasinh S Rathore, Professor and Head 3. Dr. Namrata P Datir, Internee Department of Oral Pathology & Microbiology Manubhai Patel Dental College

Source of funding: Nil Conflict of interest: None Date of Submission: Date of Acceptance: Date of Publishing:

20 May 2015 13 June 2015 19 July 2015

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