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Albaraa Alsini,1 Ishraq Alkhodaidi,2 Yasir Alsini,3 Sarh Alsseeni,4 Shrooq Alkhodaidi,5 Ehsan Alsini,6 Asim Alsini,7 Hamzah Sindi,8 Khaled Alswat9 1Resident, Department of Otolaryngology Head & Neck Surgery, Alhada Armed Forces Hospital, Taif, Saudi Arabia; 2Medical Student, Faculty of Medicine, Taif University, Taif, Saudi Arabia; 3PharmD, Alhada Armed Forces Hospital, Taif, Saudi Arabia; 4PharmD Student, Taif University, Taif, Saudi Arabia; 5Resident, Department of Dermatology, King Abdulaziz Hospital, Makkah, Saudi Arabia; 6PharmD, Medical Representative in Eli Lilly and Company, Taif, Saudi Arabia; 7Medical Intern, Faculty of Medicine, Taif University, Taif, Saudi Arabia; 8Medical Student, Faculty of Medicine, Umm AlQura University, Makkah, Saudi Arabia; 9Professor of Medicine, Department of Medicine, School of Medicine, Taif University, Taif, 21944, Saudi ArabiaCorrespondence: Albaraa AlsiniDepartment of Otolaryngology Head & Neck Surgery, Alhada Armed Forces Hospital, Alhada District, Taif, Saudi ArabiaTel +966530006201Email Dr.albaraa2015@gmail.comBackground: The development of beta-blocker (BB) medications is considered one of the most critical milestones of drug research. Several trials showed possible anti-anxiety effects of BBs. Our primary goal is to investigate the prevalence of anxiety disorder and the use of BBs as anxiolytic without medical prescription among medical and pharmacological students in Saudi Arabia.Methods: A cross-sectional study was conducted at multiple universities in Saudi Arabia. Students were given a questionnaire containing 44 questions that included demographic data, school location, BB usage behavior, GPA status before and after using BBs, and a GAD-7 anxiety screening questionnaire.Results: A total of 3326 mainly female senior students participated in the study with a mean age of 21.9± 1.7 years. According to the GAD-7 score, half of the sampled students did not meet criteria indicative of anxiety disorder, and one-third were considered to have mild anxiety with a significant positive correlation between the BB usage and the GAD-7 score. A total of 6.4% of the sample reported usage of BBs. Therapeutics and Internal Medicine were the most common subjects for which BBs were used. When compared to pharmacy students, medical students were more likely to be male, smokers, diagnosed with psychiatric illness, having a higher mean GAD-7 score, report BB usage, and correctly identified common and serious BB side effects.Conclusion: The inappropriate use of BB drugs without medical advice might have short- and long-term effects, and those may be more vulnerable to have psychological issues in the future. Our findings shed light on the need to identify students who are taking BBs as being at high risk of underlying anxiety disorders.Keywords: beta-blocker, anxiety, student anxiety, self-prescription, undiagnosed anxiety

Aim: Self-medication and inappropriate beta-blocker use have been commonly reported among students. This study aimed to determine the prevalence of inappropriate self-prescription of beta-blockers among medical and dental students. Methods: We conducted a cross-sectional study using a validated self-administered questionnaire distributed via online Google document to all undergraduate medical and dental students, including interns, of King Saud University, Riyadh, Saudi Arabia. Results: Out of 1,240 emails sent, 885 students (627 [70.8%] medical students and 258 [59.2%] dental students) responded to the survey (response rate, 71.4%). Beta-blockers were used by 198 students (22.4%) during their college years, of which 147 (16.6%) used it ≤5 times. The most common reason of using beta-blockers was to relieve stress and anxiety. The most common sources of information for use were their colleagues/fellow students. Self-prescribed beta-blockers were used by 123 students (13.9%). The usual dose consumed was 20 mg in 84 students (9.5%), while 15 (1.7%) experienced side effects. Although male students used beta-blockers more than females, females used beta-blockers at significantly higher doses (>20 mg). Medical students consumed more beta-blockers than dental students did (33.7% versus 0%, P = 0.001). Students in their senior years continued self-prescription and beta-blocker use longer than their juniors. Continued use was associated with their current academic level, who prescribed the drug, their usual dose, and awareness of complications. Conclusion: Two in ten students inappropriately used beta-blockers to relieve their anxiety and stress during examinations, and most of them were self-prescribed.

Self-medication and self-prescription are actions undertaken by patients; the former, as an element of self-care that involves over-the-counter drugs, and the latter, as a violation of the Statute of Health, since it includes drugs that can only be dispensed with a medical prescription. All the drawbacks that have been attributed to self-medication are actually associated with self-prescription. La automedicacion y la autoprescripcion son acciones de los pacientes; la primera como elemento del autocuidado que involucra medicamentos de venta libre y la segunda como una violacion a la ley de salud, pues comprende medicamentos que solo pueden expenderse con receta. Todos los inconvenientes que se han atribuido a la automedicacion en realidad lo son de la autoprescripcion.

To determine the prevalence of self-medication in nursing students and their related factors, a transversal, descriptive study was performed on a sample of 378 nursing students. A total of 73.8% of the sample declared having used off-prescription drugs during the last month (2.84, 2.26–3.58). A total of 28.9% said they did this because they are familiar with the health problem and its pharmacological solution and 25% deemed that it was a mild health problem. Drugs most commonly used off-prescription were analgesics in 88.91% (3.63, 2.74–4.80) of occasions. They were mainly recommended by the students’ family (1.31, 1.03–1.65) on 58.12% of the cases. Students keep analgesics they take off-prescription in their home first aid kit (4.47, 3.28–6.08, p &lt, 0.001). Unlike other studies, 53.2% obtained off-prescription drugs from the home first aid kit (1.13, 0.89–1.43, 0.001). In addition, they gave advice and recommend drugs they have taken to other people with similar symptoms (1.97, 1.59–2.44). A total of 85.72% kept excess drugs after a treatment (6.00, 4.50–7.99). Self-medication is related to the storage of unused medicines and giving advice on the use of drugs to other people, among other things. Self-medication of drugs among nursing students is high. Thus, it appears necessary to review the training on rational the use of drugs and responsible self-medication in the discipline’s curriculum.

Self-medication for malaria is very common in Sub-Saharan Africa where this parasitosis is endemic. In order to determine the extent, characteristics and factors associated with this practice in medical area in the city of Lubumbashi, a cross-sectional descriptive study was carried out by direct interview from January 2018 to June 2018, in the internal medicine departments of 10 General Referral Hospital (GRH) . Five thousand one hundred and thirty-four patients were consulted among them, 96.6% (average age 38.7 ± 8 years; average income: 100 ± 12 USD; gender male/ female ratio: 0.86) practice self-medication with antimalarials. They used it for the first time at an average age of 13-17 years. Quinine (36.4%) andCarica papaya(0.4%) are the most used remedies in conventional and non-conventional medicine, respectively. Several risks are incurred during this practice when the most cited are worsening side effects (53%), incomplete treatment (37%) and appearance to health sciences (37%). Age (17-35 and > 65 years old), low income (50-150 USD), membership in a health sector and the claim to know antimalarial drugs, predispose patients to self-medication. There is an urgent need to regulate this practice to avoid its harmful consequences.

Summary Objectives There has been no review on the prevalence, possible causes, and clinical outcomes of self-medication with antibiotics (SMA) in the Middle East. Methods Databases were searched (January 2000 through June 2016) for articles on SMA among adults aged ≥18 years living in the Middle East. A hand search for relevant citations and key journals was also performed. Results Twenty-two studies were found. The prevalence of SMA ranged from 19% to 82%. Age, sex, and educational and income levels were the main determinants of SMA. Socio-cultural, economic, and regulatory factors were the most commonly cited reasons for SMA. Penicillins were the antibiotics most commonly used; the antibiotics were obtained mainly via stored leftover drugs, pharmacies without prescriptions, and friends/relatives. SMA was mainly for upper respiratory tract problems. The primary sources of drug information included relatives/friends and previous successful experience. Inappropriate drug use such as wrong indication, short and long duration of treatment, sharing of antibiotics, and storing antibiotics at home for use at a later time were reported. Negative and positive outcomes of SMA were identified. Conclusions It is important to understand the links between different factors promoting SMA and to assess the changing trends in order to derive strategies aimed at reducing drug-related health risks.

Background: Self-prescription is when an individual self-recognizes his/her illness or symptoms thereby consume medications without a doctor’s supervision. Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are common medications taken by young individuals. The great availability of these drugs and the individual’s education level are all important factors that contribute to the pattern of self-treatment. The aim of this study is to assess the paracetamol and NSAIDs use by self-prescription among health sector students in Imam Abdulrahman Bin Faisal University in Dammam, Saudi Arabia.Methods: 600 health sector students from IAU were involved in a cross-sectional study that was done from January 2019 to February 2019. An electronic questionnaire was used to gather information about socio-demographic data, consumption features of paracetamol and NSAIDs, and reasons for consumption without prescription. Systematic random sampling was done to select the study population.Results: 513 students out of 600 were dependent on self-prescription; therefore, the remaining 87 were excluded from the study. 85.77% of students are between 20-23 years were most of them are female medical students. Pharmacies and retails were reported by more than half (89.47%) as the main sources of obtaining paracetamol and NSAIDs. 90.25% used these medications based on their own experience as they believed they have good knowledge. Moreover, half considered prescriptions to be unnecessary and time wasting.Conclusions: The findings of the study could reflect the need for revising the medical services in the university in particular and the whole country, as the study shows that most of the youth relay on self-medication.

RESUMEN La automedicación es una práctica riesgosa cuyas consecuencias incluyen enmascaramiento de una enfermedad, aparición de reacciones adversas, interacciones medicamentosas, aumento de la resistencia a ciertos tipos de fármacos y fármaco dependencia. La Organización Mundial de la Salud contempla la posibilidad de educar a la población en prácticas de automedicación responsable, señalando al profesional farmacéutico como figura clave de este proceso educativo. El presente trabajo analiza las conductas de automedicación en una población encuestada de 600 estudiantes de la Universidad Cooperativa de Colombia Campus Neiva. Los resultados de la encuesta han sido analizados en forma global y diferenciando a los encuestados en subgrupos de: a) programa académico y b) variables sociodemográficas. Los resultados indican que la automedicación es una práctica común en estudiantes de la Universidad Cooperativa de Colombia Campus Neiva que no siempre se lleva a cabo de acuerdo con las recomendaciones de la OMS para poder considerarse una práctica responsable y segura. SUMMARY Self-medication is a dangerous practice with consequences including masking of disease, adverse reactions to medications, drug interaction, resistance to certain types of therapeutic agents and drug dependence. The World Health Organization has considered the possibility of educating population in practices of responsible self-medication, pointing at the pharmacist as a key figure in this educational process. In the present work we have analyzed the self-medication conducts of 600 surveyed college students of the Universidad Cooperativa de Colombia Sede Neiva (UCC). The overall results of the survey have been analyzed; we have also divided the surveyed population in subgroups of: a) Academic program and b) Sociodemographic variables. Results indicate that self-medication is a common practice among college students of UCC, and that it is not always practiced according to WHO recommendations for responsible, safe self-medication.

Introduction: Self-prescription of medicines are common especially in low income countries. Paracetamol is a common medicine that is self-prescribed also among university students. Incorrect use of paracetamol can lead to ill effects on health including liver failure. There is scarce evidence of the use of paracetamol by self-medication in Nepal. The objective of this study is to evaluate the paracetamol use by self-prescription among the undergraduate students of BPKIHS.Methods: A cross-sectional study was conducted among 570 undergraduate students of BPKIHS from February 2016 till July 2016. Pretested semi-structured, self-administered questionnaire was used to collect information regarding socio-demographic characteristics, paracetamol use and perception regarding paracetamol use. Systematic random sampling was done from a list of all medical dental and nursing students to select the study sample. Results: Most (86%) students are in the category of 20-24 years. Female students are slightly more than male. Majority of the students are from Nepal. More than half of the students are from medical stream. Self-prescription of paracetamol is seen among 90.1% of the students in our study. Correct dose of paracetamol was mentioned by less than half (49.3%) of the students. Self-prescription of paracetamol is considered beneficial by all participants of this study.Conclusions: Self-prescription of paracetamol by health sciences students of B P Koirala Institute of Health Sciences is high, while the knowledge of correct dose of paracetamol for adults is low. There is a need to further explore this gap and possibly conduct further studies for other medicines as well. Keywords: Paracetamol; Self-prescription; health sciences students; undergraduate students. | PubMed

A comparative analysis of four nineteenth-century medicine chests from the collection of the National Maritime Museum in Greenwich, London and the lives of their owners, shows that although the nineteenth century saw a rampant growth in medicinal consumer goods, the availability of effective self-prescription drugs remained limited, even to those affluent enough to acquire a ‘personal’ medicine chest. The article shows that retail medicine chests sold by high street chemists fitted into broader socio-economic developments, such as the increased mobility of Victorian Britons and the rise of the high street and consumer culture. Moreover, the chests were personalized by their owners, and functioned simultaneously as practical objects and status symbols, distinguishing the psychology of nineteenth-century health consumers from their modern counterparts. Analysis of the contents of medicine chests gives a vivid impression of the palliatives available to nineteenth-century naval men and their families, as well...

Background: Self-prescription by physicians is a form of self-care that has generated considerable controversy in recent years. The prevalence of self-prescription practices by physicians has been widely studied in North America, Europe and Asia. Few studies on physician self-prescribing and prescribing for family members have been carried out in Nigeria. The primary aim of this study was to investigate the prevalence of self-prescription by medical doctors in Nigeria.Method: The study was carried out on medical doctors working in two public sector tertiary healthcare facilities in Nigeria; the Federal Medical Centre, Ido-Ekiti, and the University of Ilorin Teaching Hospital, Ilorin. This was a questionnaire-based, cross-sectional survey of different categories of medical doctor working in two healthcare institutions. A semi-structured questionnaire was used to collect demographic data on the respondents, self-prescription practices, prescribing for family and friends, reasons for self-prescription and th...

(Received: January 6, 2014; Revised: April 2, 2014; Accepted: April 9, 2014)Abstract : In this study, trends in the sales of antimicrobials for use in livestock facilities and fisheries from 2003to 2012 were investigated with regard to antimicrobial group, antimicrobial usage, and animal species. The overallamount of antimicrobials sold each year from 2003 to 2007 was 1,500 tons, after which they decreased, with thelowest sales being 936 tons in 2012. The total volume of antimicrobials used for feed additives decreased markedlyby 94% from 2003 to 2012, which was mainly attributed to banning of feed additives. However, antimicrobialconsumption through self prescription by farmers for disease prevention and treatment increased by 25% from 2003to 2012. The largest volume of antimicrobials sold was for use in pigs (48~57%), followed by poultry (18~24%),fisheries (11~25%), and cattle (5~8%). Tetracycline was the highest selling antimicrobial, followed by penicillinsand sulfonamides, although the overall sale of all three antimicrobials gradually decreased over the study period.This study demonstrated that the total consumption of antimicrobials has gradually decreased since 2008.Nevertheless, usage by nonprofessionals increased, which can ultimately cause emergence and spread of antimicrobialresistance. Thus, early establishment of veterinary prescription guidelines for prudent use of antimicrobials is urgentlyneeded in Korea. Keywords : antimicrobials, fisheries, livestock, sales

Objective: To identify practice and pattern of self-medication use among new patients in ophthalmology clinic in a suburban community. Background: Self medication is a common practice all over the world. When consumers self-medicate without first consulting the eye care giver, issues of safety and inappropriateness of use arise. Methods: A cross sectional, analytic and questionnaire based study of 470 consecutive patients seen between April and June 2011 in a tertiary eye care centre in Nigeria was conducted. Data were analyzed using SPSS and p value

In brief: Gynecomastia is a cruel irony for bodybuilders who use steroids in hope of perfecting their somatotype. These athletes and their advisers perpetuate locker-room theories about which drugs to use to avoid this widely acknowledged feminizing effect. This paper presents four case reports of bodybuilders whose self-administered drug programs resulted in gynecomastia. These examples illustrate treatment strategies bodybuilders have advocated for the prevention and self-treatment of gynecomastia, which include the use of tamoxifen, mesterolone, and human chorionic gonadotropin. In fact, the recommended treatment is complete cessation of drugs. By dispelling unfounded treatment methods, physicians might help to discourage these athletes from such drug use.

Introduction: Self-prescribing or medicating ‘by proxy’ is not an autonomous, free and voluntary decision in the case of children. On the contrary, in this case it is based on the subjective interpretation of symptoms made by the mother or by a third person who is legally responsible for the minor. Analysing this situation is of great importance in order to know the determining factors, perceptions, and realities related to this problem. Methods: Our proposal is to perform a prospective observational study for analysing maternal and familiar determinant factors related to self-prescribing and self-medicating ‘by proxy’ in paediatrics. A validated survey was developed to be applied to mothers of children aged 0–14 who are users of the Paediatric Emergency Department in a hospital. Results: A total of 1.714 mothers were recruited in a random period of time. This sample included 345 mothers who exclusively self-medicated their children (case group), and 1.369 mothers (control group) who did not meet this requirement. The overall percentage of medicating ‘by proxy’ was 32.8%. There is a significant association between self-medicating and educational level of the mother, the number of children, and the birth order among siblings. Neither maternal age nor social-occupational level are related to this problem. Most frequently used drugs include antipyretics and ‘anticatharrals’, usually administered as a monotherapy. Conclusions: Our results seem to indicate that the educational level and the parental experience acquired with previous children could generate the required confidence in parents to choose the medication by themselves. Almost 85% of these drugs come from the ‘home first-aid kit’. Resumen: Introducción: La autoprescripción o medicación «por poderes» en el niño no es una decisión autónoma, libre y voluntaria del paciente, sino que se fundamenta en la interpretación subjetiva que hace de los síntomas la madre o una tercera persona responsable del menor. Analizar esta situación nos parece de vital importancia, a fin de conocer condicionantes, percepciones y realidades relacionadas con esta problemática. Métodos: Nos planteamos analizar mediante un estudio observacional prospectivo condicionantes maternos y familiares relacionados con la autoprescripción y medicación «por poderes» en pediatría. Desarrollamos una encuesta validada para madres de usuarios de 0–14 años de un Servicio de Urgencias pediátricas hospitalario. Resultados: En un periodo de tiempo aleatorio se selecciona a 1.714 madres, de las cuales 345 habían automedicado exclusivamente a sus hijos (grupo problema), las otras 1.369 (grupo control) no cumplían con el requisito anterior. La prevalencia total de medicación «por poderes» fue del 32.8%. Hay unaasociación significativa entre la automedicación y el nivel de estudios maternos, el número de hijos, el orden que ocupa entre los hermanos. Ni la edad materna, ni el nivel sociolaboral de la familia se relacionan con el problema. Los fármacos utilizados con más frecuencia incluyen antitérmicos y «anticatarrales», habitualmente como monoterapia. Conclusiones: Nuestros resultados parecen indicar que el nivel educativo, y la experiencia adquirida por las madres con hijos previos, les genera la confianza suficiente para elegir los fármacos, que casi en el 85% de los casos proceden del «botiquín doméstico».

Resume L’automedication antibiotique se pose avec gravite dans les pays en developpement ou ces medicaments sont facilement disponibles souvent sans ordonnance medicale. Objectifs Estimer et decrire l’automedication antibiotique de meme qu’identifier les facteurs et les perceptions du public associes a cette automedication. Patients et methodes Dix-huit pharmacies privees ont ete aleatoirement selectionnees a Abidjan. Les donnees ont ete recueillies a l’aide de questionnaires structures et de guides d’observation. Des focus groups ont ete egalement realisees avec le public frequentant les pharmacies privees et le personnel de ces pharmacies. Resultats Mille cent vingt-trois achats d’antibiotiques ont ete observes dont 242 achats realises en automedication (21,5 %). Sur 1765 personnes interviewes, 1054 (59,7 %) ont obtenu des antibiotiques pour une automedication dans les 12 mois precedant notre etude. Le personnel des pharmacies a delivre les antibiotiques aux clients en fournissant tres rarement des informations sur la posologie, la prise en fonction des repas et la duree du traitement. La regression logistique a indique que la probabilite de pratiquer l’automedication antibiotique augmente avec l’âge, le niveau scolaire et l’achat d’antibiotiques au marche. Au contraire, cette probabilite diminue avec l’adhesion a une assurance maladie, la connaissance des risques lies a la pratique de l’automedication et la capacite a definir la resistance bacterienne. Conclusions Cette etude constitue la premiere conduite en Cote d’Ivoire analysant les facteurs impliques dans l’automedication antibiotique. Elle souligne la necessite d’implanter des interventions durables pour le controle de l’utilisation des antibiotiques.

Resume La frequence de la consommation de tabac chez les patients schizophrenes varie entre 60 et 90 % des sujets selon les etudes contre 23 a 30 % en population generale. Les patients schizophrenes inhalent la fumee plus profondement, leur taux d’extraction de nicotine par cigarette est plus eleve que celui des sujets temoins. La dependance tabagique est severe dans cette population. Comme en population generale, la consommation de tabac est liee aux autres dependances, en particulier l’alcoolodependance et la dependance au cannabis. La reduction de l’esperance de vie liee au tabac chez les patients schizophrenes est principalement liee a l’augmentation du risque cardiovasculaire. Celui-ci est aggrave par d’autres facteurs de risque egalement plus frequents chez les patients schizophrenes, en particulier les troubles de la glycoregulation, les troubles du metabolisme lipidique, l’obesite et la sedentarite. La consommation de tabac semble liee a une automedication de certains symptomes psychotiques, en particulier de certaines anomalies cognitives. Les effets de la consommation de tabac sur la cognition des patients schizophrenes restent cependant modestes et transitoires.

Our understanding of the world around us is derived from our observations. The accuracy of our inferences depends on the representativeness of those observations. Selection bias limits the accuracy of our inferences. Systematic selection bias occurs when the particular outcome observed caused the observation; this type of bias can lead to dramatic errors in inference. We describe examples of selection bias, provide a mathematical formulation of the systematic selection bias phenomenon, and discuss how biased observations may affect people's impressions of important issues in dermatology.

RESUME Bien qu’encore relativement limitee en France, la pratique de l’automedication est en developpement, notamment du fait du desengagement des systemes de prise en charge dans la couverture du « petit risque ». Mais qu’entend-on au juste par automedication ? Quelles sont les differentes situations d’automedication que l’on peut rencontrer, et quel est le role du pharmacien dans chacune de ces situations ? Quels sont enfin les risques de l’automedication ?

RESUME Selon l’Organisation Mondiale de la Sante en 2000, « l’automedication responsable consiste, pour les individus, a soigner leurs maladies grâce a des medicaments autorises, accessibles sans ordonnance, surs et efficaces dans les conditions d’utilisation indiquees ». Dans ce domaine, les orientations prises par l’Agence Francaise de Securite Sanitaire des Produits de Sante sont: une revision des indications des anciennes specialites, la definition d’un champ d’indications possibles adaptees a un benefice en sante publique, l’exoneration « switch » au cours des dix dernieres annees d’une quinzaine de principes actifs, une amelioration de la lisibilite des notices, une adaptation des conditionnements a cet usage, la redaction de recommandations, et la recherche de nouveaux modes de surveillance des effets indesirables. L’organisation et la promotion de ce mode de prise en charge constituent le meilleur rempart contre toutes les voies paralleles d’acces au medicament ou a des produits non autorises.

RESUME Les principales classes pharmacologiques de l’automedication: analgesiques, antitussifs, antihistaminiques, regulateurs des fonctions digestives n’utilisent que des medicaments en principe bien toleres dans leurs conditions normales d’emploi. Les effets indesirables que l’on observe sont dus a des mesusages: mauvaise indication ou surdosage, associations intempestives avec des medicaments prescrits ou encore parce qu’un mauvais choix masque une maladie grave. Ils sont en grande partie evitables. La mise en evidence de ces effets indesirables est pratiquement acquise lorsqu’ils sont graves car ils entrainent une hospitalisation. En revanche, les effets indesirables moins graves sont plus delicats a collecter. Ils peuvent l’etre par les professionnels de sante au contact de l’utilisateur: son medecin traitant, le pharmacien qui a delivre le medicament, la societe pharmaceutique qui l’a fourni. Ils peuvent aussimener des activites de prevention utilisant les moyens informatiques actuels et des structures d’ecoute et de veille.

Background: Self-treatment and treatments of friends or relatives is a controversial issue, tolerated by some and discouraged by others, including professionals. The author studied the attitudes toward self-treatment of depression among psychiatrists in Michigan. Method: A questionnaire asking whether the psychiatrist would or did self-treat for depression was mailed to 830 members of the Michigan Psychiatric Society. Results: The response rate was 68.3% (567 psychiatrists). Almost 43% of responders would consider self-medication or would self-medicate if afflicted with mild/moderate depression. Seven percent would self-medicate or consider self-medication for severe depression or if suicidal ideation became a component of one’s depression. In the past, 15.7% responders treated themselves for depression. Conclusion: These results suggest that a considerable number of psychiatrists would treat themselves for depression, possibly because of fear of stigma or fear of a permanent record, or other reasons.

EnglishFor more than 30 years, field studies have shown that chimpanzees ingest items of low nutritional value such as rough leaves, bitter stems and clay, apparently thereby protecting themselves against parasites and modulating their health. The authors describe the diversity and the biological activities of items of low nutritional value used by Kanyawara chimpanzees in Uganda, according to scientific observations enriched by the viewpoints of local field assistants and a traditional healer. Their perception of chimpanzees' behaviour and the overlap with human medicinal uses led the authors to explore chimpanzee behaviour in a comparative cultural perspective. In spite of the rarity of such observations on wild individuals, study of self-medicative practices offers the opportunity to suggest an epistemology of the chimpanzee so as to better understand the acquisition and transmission of behaviours linked to diseases.FrenchDepuis une trentaine d'années, des études de terrain ont montré que les chimpanzés ingèrent régulièrement des matériels de faible valeur nutritive comme des feuilles rugueuses, des tiges amères ou encore des argiles qui peuvent influer sur leur santé. Les données scientifiques décrites ici soulignent la diversité et les activités biologiques des items non-nutritifs utilisés par les chimpanzés de Kanyawara en Ouganda et s'enrichissent des témoignages des assistants et du médecin traditionnel local. Leur perception de ces comportements et les recouvrements avec les usages ethnomédicinaux permettent d'explorer le comportement des chimpanzés dans une perspective de comparaison culturelle. Cette étude est aussi l'occasion de souligner l'intérêt - malgré la difficulté inhérente à des observations rares portant sur des individus sauvages - d'une épistémologie du chimpanzé qui doit permettre de mieux appréhender l'acquisition et la transmission des comportements en lien avec la maladie.

The aim of this study was to estimate the prevalence of self-medication with proprietary medicines and herbs in Khartoum State, Sudan, and to evaluate factors associated with self-medication.A pre-piloted questionnaire was used to collect data from a sample of 1,200 individuals, selected from all three cities of Khartoum State using a multistage stratified clustered sampling.The response rate was 83.3%. Medicines, including herbs, were used by 81.8% of the respondents without a medical consultation within 2 months prior to the study period. Proprietary medicines alone were used by 28.3% (CI: 25.6-31.2), herbs alone by 20.7% (CI: 18.3-23.4), while 32.8% (CI: 29.9-35.8) had used both. Self-medication with proprietary medicines was least common with the middle-aged (OR: 0.12; 0.09-0.17), the elderly (OR: 0.29; 0.20-0.42) and low level of education [illiterate (OR: 0.26, 0.18-0.37) and primary/intermediate school (OR: 0.07, 0.04-0.11)]. It was most associated with low (OR: 5.3; 3.8-7.4) and middle income (OR: 4.3; 3.1-5.9), but no gender difference was found (P0.05). Self-medication behaviour with herbs was most associated with middle-age (OR: 1.7; 1.3-2.2), female gender (OR: 2.2 (1.7-2.8) and lowest income earners (OR: 2.5; 1.9-3.5).The prevalence of self-medication with medicines including herbs in urban areas of Khartoum State is high. Self-medication behaviour varies significantly with a number of socio-economic characteristics. Our findings have major public health policy implications for countries like Sudan.

Chloroform, methanol, and water extracts from medicinal plants used as self-medication by AIDS patients in Thailand were evaluated for their antimycobacterial activity using the microplate Alamar b...

An ethnobotanical comparison between two small communities of Sardinia (Escolca and Lotzorai) has been completed. The results indicate the use of a large number of plants for self-medication of easily resolved pathologies. Indices have been applied to identify the phytotherapeutic consensus of the two communes in numerical terms.

The Industria Latinoamericana de Automedicacion Responsable (Latin American Self-Medication Industry) sponsored a regional study aimed at analyzing responsible self-medication and the ability of co...

Resume Si l’association entre traits de personnalite, troubles affectifs et abus de substances est bien demontree, la majorite des etudes porte sur des populations cliniques, ce qui empeche des conclusions sur la direction de causalite. L’objectif de cette etude est d’examiner, sur des sujets non cliniques, s’il existe des traits de personnalite precis ou des problemes de l’humeur associes a la consommation de substances psychoactives. Deux modeles d’association ont ete examines, celui d’automedication et celui de deviance sociale. Fondes sur un echantillon de 685 individus, 98 sujets ont ete selectionnes pour former 4 groupes de consommation : les non-consommateurs, les consommateurs d’alcool, de cannabis et d’autres substances illicites. Seuls les consommateurs d’autres substances illicites differaient significativement des non-consommateurs et uniquement pour le trait « recherche de nouveaute ». De plus, la comparaison des 4 groupes de consommation a montre que ces scores de recherche de nouveaute augmentaient lineairement du groupe des non-consommateurs au groupe des consommateurs des substances les plus deviantes. Ceci soutient la conclusion selon laquelle le modele de deviance sociale serait plus pertinent que celui d’automedication pour expliquer la co-occurrence de certains traits de personnalite ou problemes affectifs et de la consommation de substances dans une population non clinique.

Resume Pour les « petits maux » de l’enfant, le pharmacien d’officine est souvent sollicite par les parents, pour un conseil. Cependant, les medicaments disponibles chez l’enfant sans prescription medicale sont peu nombreux, et la plupart des medicaments conseils disponibles sans ordonnance n’ont pas ete evalues chez l’enfant. Objectif. – L’objectif de notre travail a ete d’analyser les pratiques de conseil a l’officine dans quelques situations cliniques courantes, dont la diarrhee aigue du nourrisson. Materiel et methodes. – Nous avons envoye un questionnaire a un echantillon de pharmaciens d’officine de la region Midi-Pyrenees, les interrogeant sur leur conseil, medicamenteux on non, a partir d’un cas simule de diarrhee aigue non compliquee chez un bebe de huit mois. Les reponses obtenues ont ete confrontees aux donnees de la litterature, et pour les medicaments, aux mentions figurant dans le resume des caracteristiques du produit (RCP). Quarante et un pour cent des pharmaciens ont repondu, correspondant a un total de 101 questionnaires exploitables. Resultats. – Une solution de rehydratation orale n’a ete proposee que par seulement 48,5 % des repondeurs. Une boisson inadaptee (soda, jus de pomme du commerce) a ete proposee dans 71,3 % des cas, et l’arret de l’alimentation lactee dans 40 %. La plupart des pharmaciens (77 %) ont propose un medicament ayant une indication dans la diarrhee aigue et une utilisation pediatrique prevue. Cependant, dans 12,9 % des cas, le medicament conseille etait inapproprie ou contre-indique (loperamide, nifuroxazide, micro-organismes uniquement en comprimes ou gelules). Conclusion. – Meme si la plupart des reponses donnees par les pharmaciens sont appropriees, de nombreuses ameliorations sont necessaires : trop de pharmaciens ont conseille des medicaments anti-diarrheiques malgre leur absence d’efficacite demontree dans la prevention de la deshydratation, trop peu ont conseille des solutions de rehydratation orale malgre leur interet majeur, largement demontre depuis de nombreuses annees.

Aims: To describe the self-reported medicine use for common health complaints among 11 - 15-year-olds in Denmark during a ten year period, 1988 - 1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep. Methods: Four cross-sectional surveys of 11 - 15-year-old students in random samples of schools in Denmark, conducted in 1988 (n=1,671), 1991 (n=1,860), 1994 (n=4,046) and 1998 (n=5,205). The surveys were similar with regard to sampling and data collection. Data were collected by self-administered questionnaires in the classroom. Results: A large proportion of 11 - 15-year-olds reported medicine use during the past month. It was most common to take medicines for headache (used by 55% of 15-year-old girls and 36% of 15-year-old boys in 1998) and stomach ache (33% among 15-year-old girls in 1998). Pain reliever use was higher among girls than boys and this sex difference increased with age. There was an upward trend in reported medicine use from 1988 to 1998, in particular regarding medicine for stomach-ache among 13- and 15-year-old girls. A large proportion of girls were frequent users of medicine for headache, stomach-ache, and sleeping difficulties. Conclusion: A high proportion of 11 - 15-year-old girls and boys reported medicine use in relation to common health complaints. The proportion of users increased during the past decade. It is suggested that more information about medicine be built into health education programs in the future.

Traditional Chinese herbal medicines are widely available in Western society and are popular as a form of 'natural' alternative medicine. Their use is increasing, as they are perceived to be free of side effects, but they remain largely unregulated. We describe two patients who suffered severe hepatitis, one of whom died, after taking Chinese herbal remedies for minor complaints. We also review the English-language literature on hepatitis associated with Chinese herbs. Two products appear to be implicated frequently: Jin bu huan was taken by 11 patients, and Dictamnus dasycarpus was taken by six patients, including both fatal cases. It is difficult to provide conclusive evidence of what caused hepatitis, as these products are mixtures that may contain adulterants. These cases highlight not only the potential dangers of these products to consumers but also the need for greater control of their manufacture and use.

Objectifs: L'utilisation inappropriee de medicaments sur ordonnance peut avoir des consequences significatives. Meme si les populations autochiones du Canada sont soupconnees d'un taux eleve d'utilisation inappropriee, l'information ecrite fait defaut. Pour mieux compreadre cette question, nous avons etudie une population autochtone suivant en traitement pour la toxicomanie. Methodes: Nous avons interroge des clients autochiones qui avaient acces a un traitement de la toxicomanie a Calgary (Alberta), relativement a l'utilisation de medicaments sur ordonnance l'annee precedente, a la frequence d'utilisation et aux sources des medicaments, si utilises de facon inappropriee Resultats: Soixante-neuf pour cent des clients ont rempli le questionnaire (n = 144). La plupart des repondants avaient entre 31 et 50 ans (56 %), et 52 % etaient des hommes. Sur les repondants, 48 % ont declare utiliser les medicaments sur ordonnance de facon impropre, 8 % ont indique une utilisation appropriee, et le reste s'utilisait pas de medicaments. Les sedatifs ou les relaxants etaient les inappropriee des medicaments, 47 % en avaient utilise plus de 10 fois l'annee precedente. Les sources habituelles de ceux qui faisaient une utilisation inappropriee des medicaments incluaient des medicaments donnes par un and ou un etranger (52 %), des medicaments achetes dans la rue (45 %) et des medicaments prescrits par un medecin (41 %). L'âge egal ou superieur a 30 ans etait associe a l'utilisation inappropriee. Le sexe, le lieu de residence et le statut d'Autochtone n'etaient pas associes a l'unlisation inappropriee. Conclusion: L'utilisation inappropriee de medicaments sur ordonnance etuit un probleme significatif chez une population autochtone suivant un traitement de la toxicomanie, et nombre de ces personnes avaient acces a ces medicaments par l'intermediaire d'un medecin qui les leur prescrivait.

This paper presents findings from a study that investigated the relationship between research and practwice on a Nursing Development Unit (NDU) in a hospital in the UK. The over-arching aim of the NDU was to promote individualised patient care. This requires the experiences and life goals of the patient, including the patient's and family construction of risk, to inform the care planning process. Two projects, undertaken by nurses on the ward, one on inpatient self-medication and the other on the management of falls, are analysed as case studies in order to address the questions: (1) How do nurses develop and research patient-centred care? (2) What are the implications of their choice of methodology in relation to their stated aims of individualising care? The paper demonstrates how conventions about research methodology and outcomes dominated the nurses' interpretation of research, the hospital research agenda and the literature on the research topics. These conventions shaped the construction of risk an...

An increasing number of drugs are becoming available over-the-counter, empowering patients to treat them- selves. Although drugs presently available over-the-counter are generally safe, there are issues of safety and possible delays in diagnosis of serious conditions. Therefore it is vital that patients are made aware of the indications and limitations of over-the-counter drugs through improved communication and education. Pharmacists and drug companies will have an increasingly important role in giving information and advice to patients. This review looks at the present and future of over-the-counter medication, highlighting the safety aspects.

The last 30 years has brought significant changes to self care through responsible self medication. From being essentially unregulated in the 1960s, over-the-counter (OTC) medicines have been transformed by the evolving statutory and regulatory initiatives into a mature market with a high level of consumer confidence in their safety and expected benefits. This paper reviews the legislative/regulatory achievements that have modernized self care with OTCs, including the statutory and regulatory basis for OTCness, the criteria and studies used as a basis for permitting OTC availability, and the paradigm for interaction between regulators and sponsors, as well as the challenges still facing the industry.

OBJECTIVE: To develop valid, reliable criteria for assessing the appropriateness of the management of common ailments and nonprescription drug therapy in community pharmacies in the UK. METHODS: The criteria were developed by an expert panel using the nominal group technique. The validity of the criteria was tested by surveying a random sample of pharmacists who were asked to rate the importance of each criterion on a semantic differential scale from 1 (low) to 7 (high). Subsequently, the reliability of the criteria was assessed: a random sample of pharmacists were each asked to apply the criteria to four vignettes of patient counseling on two separate occasions. RESULTS: All assessment criteria exceeded our predefined level of face, content, and consensual validity. In reliability testing, the overall assessment of appropriateness, along with five component assessment criteria, surpassed our predefined level of reliability. Three criteria, however, did not meet our predefined standard. These criteria were rational content of advice, rational product choice, and referral to another health professional. CONCLUSIONS: This represents the first systematic attempt to develop an instrument of general applicability for assessing the appropriateness of patient counseling and to subject it to rigorous validity and reliability testing. We suggest that further work is required to refine the criteria that did not meet reliability standards and to understand the decision-making processes underlying the assessment of vignettes of patient counseling.

Resume La possession par un voyageur en pays d'endemie palustre d'un medicament de reserve a visee therapeutique peut se reveler judicieuse en cas de survenue pendant le sejour d'une fievre dont l'origine palustre sera ou non confirmee. La prescription medicale d'un tel medicament avant le depart est indiquee, en plus de la prophylaxie antivectorielle, chez les equipages de compagnies aeriennes soumis a des expositions breves et repetees, et aussi chez le voyageur sejournant plus de sept jours, la ou il est impossible de recourir a un medecin dans les 12 heures ou d'obtenir l'antipaludique adequat pour assurer en urgence le traitement. Le choix de l'antipaludique de reserve doit tenir compte du type de la chimioresistance de Plasmodium falciparum dans la region visitee, du suivi ou non d'une chimioprophylaxie, du statut et de l'etat de sante du voyageur concerne, des eventuelles contre-indications et des effets indesirables du medicament. En pratique, et selon les rares enquetes publiees, de nombreux voyageurs emporteraient avec eux un medicament de reserve dont ils feraient un usage therapeutique moderement superieur au risque theorique de contracter une infection palustre dans la zone du sejour. L'avenir du traitement de reserve parait dependre, d'une part, de la mise a disposition du voyageur de tests manuels fiables et d'emploi simple lui permettant d'etablir le diagnostic de paludisme et, d'autre part, de la commercialisation de nouveaux antipaludiques, efficaces et peu toxiques, pour en realiser le traitement.

A dialogue-driven, case-by-case, weight-of-the-evidence approach utilizing specific switch criteria and encompassing the application of evolving science and technology continues to be the foundational underpinning of the pivotal benefit-risk assessment determining over-the-counter (OTC)ness of an ingredient. As an OTC scientific/regulatory paradigm, it is robust and should be preserved, especially in any guidances the Food and Drug Administration (FDA) may issue about the “OTC-ability” of specific therapeutic agents.

OBJECTIVE: To define the utilization pattern of nonprescription therapies in patients with congestive heart failure (CHF) and to compare this pattern with that of an age- and gender-matched control group without any self-reported heart conditions. DESIGN: Survey questionnaire completed by participants at home. SETTING: Ambulatory CHF clinic in a tertiary care hospital. SUBJECTS: Patients attending the clinic between July 1995 and May 1996 who agreed to participate. Control subjects were age- and gender-matched participants identified and approached by participating patients. OUTCOME MEASURES: Nonprescription therapies used at least once weekly. RESULTS: Completed questionnaires were received from 180 (75%) of the 239 patients who agreed to participate and from 133 controls. Mean age of responding patients was 69 years (63% men). Controls were younger, with a mean age of 64 years (63% men). The most commonly used nonprescription medication categories for both patients and controls, with no significant intergroup differences, were vitamins and minerals (59% patients, 50% controls), pain relievers (48% and 43%, respectively), herbal or health food products (38% and 38%), antacids (26% and 28%), and laxatives (24% and 21%). Significantly fewer patients than controls used cough and cold products (9% vs. 17%; p < 0.05), specifically oral decongestants (0.6% vs. 5%; p < 0.01), and more patients than controls used nutritional supplements (17% vs. 4%; p < 0.01). CONCLUSIONS: Overall, use of nonprescription therapies by our CHF clinic patients is similar to that of an age- and gender-matched population without a self-reported heart condition. The differences in medication use observed between patients and controls included cough and cold products that might be harmful. This likely reflects appropriate caution with which CHF patients approach nonprescription therapies.

Most over-the-counter (OTC) pharmaceutical container labels are printed in very small type. Consequently, people with visual impairments (e.g., presbyopia in older adults) have difficult reading the material. Some OTC drugs are packaged in containers with easy-open caps. This design increases the surface area that could be used to enhance the labeling. In Experiment 1, older adults (M = 75.1 years, SD = 8.1) evaluated six container label variants for an actual OTC product. Besides having a multipanel main label, four containers had labels attached to the cap that displayed the most important information in large print but differed in color. Two control containers lacked a cap label; one had only a four-panel main label, and the other had only the front label. Participants ranked the containers on six dimensions (e.g., label noticeability, willingness to read). Results showed greater preference for containers with the cap labels. Experiment 2 again examined preferences but also measured information-acquisition performance after participants (M = 79 years, SD = 5.8) were briefly exposed to a realistic-appearing, but fictitious, OTC medication. Results showed greater knowledge and preference for containers with the cap labels. Experiment 2 showed that one of the cap colors (yellow) that was different from the main label was preferred over the white and orange (the same colors as on the main label), but color distinctiveness as an explanation was not fully supported because the green cap was not significantly different from the other cap labels. Implications for communicating information about OTC drugs using expanded labels are discussed.

To define the satisfaction rate and the dropout causes of intracavernous self-injection therapy in impotent patients.A total of 250 impotent patients treated with intracavernous injection of drugs from 1991 to 1997 were mailed a questionnaire about their experience with this method. If the patient discontinued therapy, eight possible explanations for discontinuation were tested to identify reasons for terminating therapy (multiple choices were allowed). The causes of impotence were correlated with the rates of patients continuing or discontinuing therapy.144 of 250 patients (57.6%) returned the questionnaire. Of the 106 non-responding patients, 50% could not be reached due to relocation. The patients were divided into three groups according to the duration of injection use. In group I, 35 of 144 patients (24%) did not continue therapy at home because either they felt it was unnatural (20%), they were dissatisfied (20%), or they experienced improvement of spontaneous erections (15%). In group II, 57 of 144 patients (40%) continued therapy at home and dropped out after a mean duration of 6.9 (range 0.5-48) months due to dissatisfaction (22%), cost reasons (20%), or insufficient erection for penetration (19.4%). In group III, 52 of 144 patients (36%) were continuing therapy with a mean follow-up period of 19.8 (range 2-72) months. The mean ages were not statistically different in the three groups. Also the aetiologies of impotence were similar: 35% psychogenic, 25% organic, and 40% mixed psychogenic/organic. Patients with psychogenic aetiology seem to continue therapy more frequently than others.The long-term follow-up revealed a high attrition rate of intracavernous self-injection therapy. Patient dissatisfaction, cost, and insufficient erection for penetration were the major causes of dropout.

This paper discusses the origins of the over-the-counter (OTC) drug category and presents information about the process of switching a drug from prescription (Rx) to OTC status. It also reviews past and current drug laws in terms of how they relate to OTC drugs.

Geringe Eigentherapie in Frankreich Das Verhalten beim Kauf von Arzneimittein hat sich in Frankreich innerhalb von dreiBig Jahren grundlegend geàndert. Obwohl es schwierig ist, eine exakte Bilanz zu ziehen, belegen doch verschiedene Quellen, daB der Kauf von Arzneimittein ohne Rezept, das heiBt die Eigentherapie, deutlich zurûckgegangen ist. Dièse Entwicklung erfolgte vor dem Hintergrund der Verallgemeinerung der Krankenversicherung und der Zunahme des medizinischen Angebots. Wird sich dieser Trend môglicherweise umkehren? MaBnahmen zeichnen sich im Rahmen der Eindàmmung der Gesundheitsausgaben ab, wie beispielsweise die wirtschaftliche Ùberwachung der Verschreibungspraxis. Andere MaBnahmen sind im Hinblick auf eine europâische Harmonisierung denkbar, wie der freie Verkauf bestimmter Arzneimittel. Aufgrund der Verflechtung unterschiedlicher Interessen und des Strebens nach sozialer Gleichbehandlung ist es allerdings ungewiB, ob die Eigentherapie wieder ein Niveau erreichen wird, das mit dem in den Nachbarlàndem vergleichbar ist., Low Sales of Over-the-Counter Drugs in France Drug purchasing patterns have drastically changed in France over the last thirty years. Although it is difficult to establish accurate figures, many sources report that the bottom has fallen out of the over-the-counter drugs market. This is due to the spread of health insurance and growth in the medical supply. Might this trend turn around? Measures are emerging under the health expenditure control policy. One such measure is the economic control of doctors' prescriptions. Others are conceivable as part of European harmonisation, such as making1 certain drugs available for over-the-counter sale. The web of divergent interests and the concern for social equity make it uncertain that over-the-counter drugs will claw their way back to even a low level comparable, for example, with neighbouring countries., La faiblesse de l'automédication en France Le comportement d'achat de médicaments s'est radicalement modifié en France en une trentaine d'années. Malgré la difficulté d'établir un bilan précis, diverses sources attestent que l'acquisition de médicaments sans ordonnance de médecin - l'automédication - s'est effondrée. La généralisation de l'assurance maladie et la croissance de l'offre médicale constituent l'arrière-plan de cette transformation. La tendance peut-elle s'inverser ? Des mesures se profilent dans le cadre de la maîtrise des dépenses de santé, telles que l'encadrement économique des prescriptions des médecins. D'autres sont envisageables sous la perspective d'une harmonisation européenne, comme l'ouverture de la vente en libre accès de certains médicaments. Limbrication d'intérêts divergents et le souci d'équité sociale rendent incertaine une reprise de l'automédication, vers un étiage comparable, par exemple, à celui des pays voisins., Los puntos flacos de la automedicaciôn en Francia El comportamiento de compra de medicamentos ha cambiado del todo en Francia en unos treinta anos. Pesé a la dificultad de establecer un balance preciso, varias fuentes atestiguan que la adquisiciôn de medicamentos, sin receta - la automedicaciôn - ha bajado bruscamente. La generalizaciôn del seguro médico y el crecimiento de la oferta médica constituyen el trasfondo de tal transformaciôn. l Puede acaso invertirse esta tendencia? Unas medidas se perfilan en el marco del control de los gastos sanitarios, taies como el encuadramiento econômico de las prescripeiones de los médicos. Otras se plantean en la perspectiva de una armonizaciôn europea, como la autorizaciôn de la venta en libre acceso de ciertos medicamentos. La imbricaciôn de intereses divergentes y la preocupaciôn por la equidad social no parece ser favorable a una recuperaciôn de la automedicaciôn a un nivel comparable, por ejemplo, al de pafses vecinos., Lecomte Thérèse. La faiblesse de l'automédication en France. In: Economie et statistique, n°312-313, Mars 1998. pp. 101-107.

Recently there has been increasing interest in enabling consumers to more easily acquire information from over-the-counter (OTC) nonprescription pharmaceutical labels. Standardization of label form...

This study tested the hypothesis that use of nonprescription analgesics among women scoring high on premenstrual distress may generalize to time periods beyond the premenstrual phase. Fifty three female undergraduates completed Form C of the Moos Menstrual Distress Questionnaire and described their typical use of analgesics during the "average week." Results showed that symptoms of premenstrual distress were significantly related to both the frequency of analgesic use and the quantity consumed per occasion. These findings support the generalization hypothesis proposed by Blechman and her colleagues.