Chang Jie, Wang Qing, Fang Yu
Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.
BMJ Open. 2017 Dec 19;7(12):e017306. doi: 10.1136/bmjopen-2017-017306.
Self-medication with over-the-counter medicines (OTCs) and prescription-only medicines (POMs) are both pervasive in China, although the latter is an inappropriate practice. We examined the relationship between socioeconomic status (SES) and self-medication with OTCs versus POMs.
Multivariate logistic regressions based on the Andersen framework were estimated using a subsample of respondents aged 45 years and over from the China Health and Retirement Longitudinal Study collected between 2011 and 2013 (n=23 699). As dependent variables, we used OTC and POM consumption without a medical prescription. SES was operationalised by household income per capita and education. Control variables included health indicators, demographic characteristics, and health behaviours.
In our study sample, 32.69% and 15.02% of people aged 45 years and over had self-medicated with OTCs and POMs in the 4 weeks before the survey, respectively. OTC use by income exhibited an inverse U shape. Respondents from middle income groups were more likely to self-medicate with OTCs compared with those from the lowest and highest income groups. In contrast, respondents from the lowest income group were more inclined to self-medicate with POMs. There was a clear trend towards more self-medication with OTCs, but not POMs, among those with higher educational attainment.
People with low income tended to rely on self-medication with POMs for treatment, which is risky and of low quality. A health education programme for older people, particularly those living in low-income households, aimed at improving the quality of self-medication behaviour is warranted. Urgent measures are needed to address the issue of easy access to POMs at community pharmacies, and to improve access to formal medical care among the low-income population.
在中国,非处方药(OTC)和处方药(POM)的自我药疗都很普遍,尽管后者是一种不当做法。我们研究了社会经济地位(SES)与使用非处方药和处方药进行自我药疗之间的关系。
基于安德森框架的多变量逻辑回归分析,使用了2011年至2013年期间收集的中国健康与养老追踪调查中45岁及以上受访者的子样本(n = 23699)。作为因变量,我们使用了无医生处方的非处方药和处方药消费情况。社会经济地位通过人均家庭收入和教育程度来衡量。控制变量包括健康指标、人口特征和健康行为。
在我们的研究样本中,45岁及以上的人群中,分别有32.69%和15.02%的人在调查前4周内使用非处方药和处方药进行了自我药疗。按收入划分的非处方药使用呈倒U形。与最低和最高收入组相比,中等收入组的受访者更有可能使用非处方药进行自我药疗。相比之下,最低收入组的受访者更倾向于使用处方药进行自我药疗。在受教育程度较高的人群中,使用非处方药进行自我药疗的趋势明显,但使用处方药进行自我药疗的情况并非如此。
低收入人群倾向于依靠使用处方药进行自我药疗来治病,这存在风险且质量较低。有必要为老年人,特别是低收入家庭的老年人开展健康教育项目,以提高自我药疗行为的质量。需要采取紧急措施解决社区药店处方药容易获取的问题,并改善低收入人群获得正规医疗服务的机会。