Published on February 15, 2014
Practice and Predictors of selfmedication among urban and rural adults in Sri Lanka, three decades after Market Economic Reforms Dr. Pushpa Ranjan Wijesinghe MD- Rostov (General Medicine) MSc, MD-Colombo (Community Medicine) MPH-New Zealand ( Bio-security)
Background • Practice of self-medication in communities in varying • • • • degrees Increased private sector involvement in health & pharmaceutical care since 1977 Increased utilization of private health / pharmaceutical care for out patient conditions Competition of the pharmaceutical companies for a larger share of over the counter drug market What is the status of self-medication in settings of contrasting health and pharmacy care infra-structure in this context ?
Objective • To describe the current practice and predictors of self-medication in a selected urban and rural area in Sri Lanka Methods • Study design • A community based cross –sectional study • Study Population • Adults over 18 years of age, irrespective of sex , permanently residing in the selected districts over a period of 1 year
Urban district 8 Urban Council areas Rural district Stratification n= 900 n= 900 30 GN divisions PSU 7 Regional Council (PS ) areas PPS 30 GN divisions PSU 30 Households per a GN division Voters list 30 Households per a GN division 1 individual per house (900) Kish Table 1 individual per house (900)
Study Instruments • Interviewer administered questionnaire (IAQ) • Validated Likert scale to assess the Perceived satisfaction with available pharmacy services – Access, Continuity, General Satisfaction of services – Availability , Affordability, Efficacy of drugs – Inter-personal explanation, Considerateness • Validated Likert scale to assess the perceived access to allopathic medical care – – – – Availability of services, Regularity and acceptability of services Affordability of services Concern for clients
SOCIO DEMOGRAPHIC FACTORS BELIEFS & ATTITUDES ACCESS FACTORS Enabling factors Predisposing factors Medication use Need variables ACTUAL OR PERCEIVED MORBIDITY Anderson and Newman’s health services utilization model
Practice of medication use urban (n=863) Prevalence of medication use (95% confidence interval ) 33.9% (30.7%-37.1 %) Urban ( n =293 ) Rural (n=846) 35.3% (32. 1-38.5) Rural ( n=846) Only allopathic medicine users 91.4% 84.6% Only traditional medicine users 3.8% 12.4% Both allopathic and traditional medicine users 4.8% 3.0% urban (n=863) Rural (n=846) Prevalence of self medication * 12.2% (10% -14.4%) 7.9% (6.1%-9.7%) Self medication as a proportion of medication use * 37.2% 25.6% * P < 0.05
Practice of self-medication Urban Rural Conditions of Acute onset and short duration 58% 67% Perceived non-severity of the condition for physician consultations 55% 64% Previous satisfactory response of the same drug to a similar condition 53% 60% Self-medication without any symptom 09% 12% Using previous prescriptions for self medication for purchasing drugs 37% - - 45% Self-medication with one drug 49% 73% Self-medication with 2 drugs 28% 18% Using labels/blister packs of previously used drugs for purchasing drugs
Predictors of self medication Urban Predisposing variables Household number ≤ 2 Non-affirmation of drugs availability at informal places Need Variables Symptoms ≤ 2 Enabling Variables Adjusted OR ( 95% CI) Rural Adjusted OR ( 95% CI) 4.3 ( 1.1-17.5) - 0.3 (0.1-0.8) - Adjusted OR ( 95% CI) 7.9 (3.4-18.9) Adjusted OR ( 95% CI) Adjusted OR ( 95% CI) 2.4 (1.1-5.8) Adjusted OR ( 95% CI) Higher satisfaction with acceptability of medical services 0.96 (0.93-0.98) - Affordability of medical services - 0.4 (0.2-0.7) Technical competence of pharmacy staff - 2.8 (1.1-7.3)
Conclusion & recommendations • Self-medication is more prevalent in the urban setting • Prevalence of SM is lower than global estimates • Self-medication with 1-2 drugs selected on previous experience is an initial individual response for diseases of acute onset and perceived to be of less severity • Lower symptom count is a need variable acting as a proxy measure of perceived severity of the morbidity • Self medication is dependent on characteristic access measures unique in the two specific settings • Findings should be utilized to – Shape policy changes related to implementation of the CDD act – Design IEC programs for consumers moving towards selfmedication – Enhance the capacity of rural pharmacists/assistants as the first contact points in the rural sector
Limitations • Less valid data as compared to data collected in a prospective follow up study using a diary method • Non-objective measurement of the severity of the condition • Social desirability bias due to use of public health midwife for data collection • Perceived access measures to health care and pharmaceutical services reflect general rather than specific context
Calcification Inhibitors in CKD and Dialysis Patients
Dr. Ahmed Al-Moghazy presenting a research about "use of CAM in Type II D.M." which was approved in the ICIUM (international conference on ...
He also reviews scientific papers for presentation at international ... (ICIUM), Antalya, Turkey (2011); ... ISPOR 2013 Meeting Travel Scholarship ...
Learning behaviour of Medical students and facilitation of active learning , outcome based education, ... Oral and Poster Presentation( with abstract) 2010 :
Educational/professional Qualifications: ... (ICIUM), Antalya, Turkey, 2011; Dharmaratne, ... (Oral Presentation), ...
... (ICIUM), Antalya, Turkey, 2011; Dharmaratne, T.M.S.H., Marambe, K.N., ... (Oral Presentation), Annual Scientific Sessions of Kandy Society of Medicine, ...
Habeeb Ibrahim Abdul Razack ELS CMPP. Senior Medical Writer at Cactus Communications. Location Bengaluru, Karnataka, India Industry Pharmaceuticals
BMC Health Services Research 2013 13 ... Presentation at the Third International Conference ... Turkey. 2011, http://www.inrud.org/ICIUM ...
Habeeb Ibrahim Abdul Razack ELS CMPPS berufliches Profil anzeigen LinkedIn ist das weltweit größte berufliche Netzwerk, das Fach- und Führungskräften ...