Tripković Katica, Nešković Andjelija, Janković Janko, Odalović Marina
City Institute of Public Health, Boulevard Despota Stefana 54a, Belgrade, 11000, Serbia.
Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Dr Subotica 15, Belgrade, 11000, Serbia.
Int J Clin Pharm. 2018 Jun;40(3):627-634. doi: 10.1007/s11096-018-0624-x. Epub 2018 Mar 30.
Background In spite of many benefits for individuals and community, self-medication has a number of potential risks. Objective To identify predictors of self-medication with over-the-counter and prescription (Rx) medicines without doctor's prescription. Setting Serbian population of 15 years of age and over. Method This was crosssectional, epidemiological study. Data have been drawn from Serbian National Health Survey 2013 database. Predictors of self-medication were determined among sociodemographic, health related and health services related factors, using multivariate logistic regression models. Main outcome measure Prevalence and predictors of selfmedication. Results The study included 14,623 participants. The prevalence of selfmedication was 27.1 and 24% after exclusion of vitamins, minerals and herbal preparations. Medicines for pain relief were the mostly used medicines without doctors' prescription in 18.4% of participants. A relatively high prevalence of self-medication with Rx medicines, (1) tranquilizers and sleeping pills, (2) antibiotics and (3) antihypertensives, was found, 4, 2.5 and 1.9%, respectively. Socio-demographic factors (middle age, female gender, higher level of education), health related factors (chronic disease, stress, physical pain), and health service related factors (nonrealized healthcare needs due to long waiting, dissatisfaction with publicly funded health services) have been found as significantly associated with self-medication. Conclusion Self-medication in Serbia is predicted by socio-demographic and health related factors, unmet needs for healthcare and dissatisfaction with publicly funded healthcare services. Improvements in healthcare system, particularly, shortening of long waiting for healthcare services and improvements in pharmaceutical services, particularly better control of Rx medicines dispensing, could contribute in improvement of responsible self-medication.
背景 尽管自我药疗对个人和社区有诸多益处，但仍存在一些潜在风险。目的 确定在无医生处方情况下自行使用非处方药和处方药（Rx）的预测因素。研究对象 塞尔维亚15岁及以上人群。方法 这是一项横断面流行病学研究。数据来源于2013年塞尔维亚国家健康调查数据库。使用多因素逻辑回归模型在社会人口统计学、健康相关因素和卫生服务相关因素中确定自我药疗的预测因素。主要观察指标 自我药疗的患病率及预测因素。结果 该研究纳入了14,623名参与者。排除维生素、矿物质和草药制剂后，自我药疗的患病率分别为27.1%和24%。在18.4%的参与者中，止痛药物是最常被无医生处方使用的药物。发现自行使用Rx药物（1）镇静剂和安眠药、（2）抗生素和（3）抗高血压药的患病率相对较高，分别为4%、2.5%和1.9%。社会人口统计学因素（中年、女性、较高教育水平）、健康相关因素（慢性病、压力、身体疼痛）以及卫生服务相关因素（因等待时间长未满足的医疗需求、对公共资助卫生服务的不满）已被发现与自我药疗显著相关。结论 塞尔维亚的自我药疗由社会人口统计学和健康相关因素、未满足的医疗需求以及对公共资助医疗服务的不满所预测。医疗保健系统的改善，特别是缩短医疗服务的长时间等待以及药学服务的改善，尤其是更好地控制Rx药物的配药，可能有助于促进负责任的自我药疗。
