Chaudhry Bakhtawar, Azhar Saiza, Jamshed Shazia, Ahmed Jahanzaib, Khan Laiq-Ur-Rehman, Saeed Zahid, Madléna Melinda, Gajdács Márió, Rasheed Abdur
College of Pharmacy, University of Sargodha, Sargodha 40100, Pakistan.
Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, Universiti Sultan Zainal Abidin, Kuala Terengganu 21300, Malaysia.
Trop Med Infect Dis. 2022 Oct 25;7(11):330. doi: 10.3390/tropicalmed7110330.
Self-medication (SM) is characterized by the procurement and use of medicines by bypassing primary healthcare services and without consulting a physician, usually to manage acute symptoms of self-diagnosed illnesses. Due to the limited availability of primary healthcare services and the anxiety associated with the COVID-19 pandemic, the compulsion to SM by the public has increased considerably. The study aimed to assess the characteristics, practices, and associated factors of SM by the public during the COVID-19 pandemic in Sargodha, Pakistan. χ2-tests and univariable analyses were conducted to explore the identification of characteristics and the potential contributing factors for SM during COVID-19, while multivariable logistic regression models were run to study the effect of variables that maintained a significant association. The study was performed during July−September 2021, with n = 460 questionnaires returned overall (response rate: 99.5%). The majority of respondents were males (58.7%, n = 270) who live in the periphery of the town (63.9%, n = 294), and most of the respondents belonged to the age group of 18−28 years (73.3%, n = 339). A large number, 46.1% (n = 212), of the participants were tested for COVID-19 during the pandemic, and among them, 34.3% (n = 158) practiced SM during the pandemic; the most common source of obtaining medicines was requesting them directly from a pharmacy (25.0%; n = 127). The chances of practicing SM for medical health professionals were 1.482 (p-value = 0.046) times greater than for non-medical health personnel. The likelihood of practicing SM in participants whose COVID-19 test was positive was 7.688 (p-value < 0.001) times more than who did not test for COVID-19. Allopathic medicines, acetaminophen (23.6%), azithromycin (14,9%), and cough syrups (13%), and over the counter (OTC) pharmaceuticals, vitamin oral supplements, such as Vitamin C (39.1%), folic acid (23.5%), and calcium (22.6%), were the most commonly consumed medicines and supplements, respectively; being a healthcare professional or having a COVID-test prior showed a significant association with the usage of Vitamin C (p < 0.05 in all cases). Respondents who mentioned unavailability of the physician and difficulty in travelling/reaching healthcare professionals were found 2.062-times (p-value = 0.004) and 1.862-times (p-value = 0.021) more likely to practice SM, respectively; SM due to fear of COVID was more common in individuals who had received COVID-tests prior (p = 0.004). Practices of SM were observed at alarming levels among our participants. Consciousness and understanding about the possible adverse effects of SM must be established and validated on a continuous level; in addition, on a commercial level, collaboration from pharmacists not to sell products (especially prescription-only medicines) without a certified prescription must be developed and implemented.
自我药疗（SM）的特点是绕过初级医疗服务，在未咨询医生的情况下采购和使用药物，通常用于处理自我诊断疾病的急性症状。由于初级医疗服务的可及性有限以及与新冠疫情相关的焦虑情绪，公众进行自我药疗的冲动显著增加。该研究旨在评估巴基斯坦萨戈达在新冠疫情期间公众自我药疗的特征、行为及相关因素。进行卡方检验和单变量分析以探究新冠疫情期间自我药疗的特征识别及潜在影响因素，同时运行多变量逻辑回归模型来研究保持显著关联的变量的作用。该研究于2021年7月至9月进行，共收回460份问卷（回复率：99.5%）。大多数受访者为男性（58.7%，n = 270），居住在城镇周边地区（63.9%，n = 294），且大多数受访者年龄在18 - 28岁之间（73.3%，n = 339）。大量参与者（46.1%，n = 212）在疫情期间接受了新冠病毒检测，其中34.3%（n = 158）在疫情期间进行了自我药疗；获取药物最常见的来源是直接从药店获取（25.0%；n = 127）。医疗卫生专业人员进行自我药疗的可能性是非医疗卫生人员的1.482倍（p值 = 0.046）。新冠病毒检测呈阳性的参与者进行自我药疗的可能性是未进行新冠病毒检测者的7.688倍（p值 < 0.001）。最常使用的药物分别是对抗疗法药物，如对乙酰氨基酚（23.6%）、阿奇霉素（14.9%）和止咳糖浆（13%），以及非处方（OTC）药品，如维生素口服补充剂，维生素C（39.1%）、叶酸（23.5%）和钙（22.6%）；作为医疗卫生专业人员或之前进行过新冠病毒检测与维生素C的使用呈显著关联（所有情况p < 0.05）。提到医生无法提供服务以及前往/联系医疗卫生专业人员困难的受访者进行自我药疗的可能性分别高出2.062倍（p值 = 0.004）和1.862倍（p值 = 0.021）；因恐惧新冠而进行自我药疗在之前接受过新冠病毒检测的个体中更为常见（p = 0.004）。在我们的参与者中，自我药疗行为达到了令人担忧的程度。必须持续建立并验证对自我药疗可能产生的不良反应的意识和理解；此外，在商业层面，必须制定并实施药剂师之间的合作，即没有认证处方时不销售产品（尤其是仅凭处方销售的药品）。
