Journal of Education and Ethics in Dentistry

ORIGINAL ARTICLE
Year
: 2013  |  Volume : 3  |  Issue : 1  |  Page : 21--25

Evaluation of self-medication practices among undergraduate dental students of tertiary care teaching dental hospital in South India


Venumbaka Siva Kalyan1, K Sudhakar1, P Srinivas2, GVS Sudhakar3, KVNR Pratap1, T Madhavi Padma1,  
1 Department of Public Health Dentistry, Mamata Dental College, Khammam, Andhra Pradesh, India
2 Department of Prosthodontics, Mamata Dental College, Khammam, Andhra Pradesh, India
3 Department of Oral and Maxillofacial Surgery, Mamata Dental College, Khammam, Andhra Pradesh, India

Correspondence Address:
Venumbaka Siva Kalyan
Department of Public Health Dentistry, Mamata Dental College, Khammam - 507 002, Andhra Pradesh
India

Abstract

Background: The practice of self-medication may lead to lack of clinical evaluation by a trained medical professional and delay in effective therapy. It is known that even the students of health-care sciences indulge in it. The present study is aimed at assessing the attitude and behavior of dental students toward self-medication. Materials and Methods: A cross-sectional questionnaire based study was conducted in a private dental teaching hospital in South India. The undergraduate dental students from first year to final year who gave consent were included in the study. Information regarding the reason for self-medication, condition for which they self-medicated, type of drugs used, awareness about the drugs used and their source of information was collected. Data was summarized as the number and percentage. Chi-square test was used to test the significance and P < 0.05 was considered to be significant. Results: The prevalence of self-medication is 62.5%. Headache and mouth ulcers were the most common indications of self-medication. The most commonly used drugs were analgesics, antibiotics and antipyretics. Conclusion: The findings of this study reveal that the majority of the students self-medicate. As these students are future dental practitioners, self-medication as a regular practice by them should be curbed as their behavior may indirectly influence their patient«SQ»s health.



How to cite this article:
Kalyan VS, Sudhakar K, Srinivas P, Sudhakar G, Pratap K, Padma T M. Evaluation of self-medication practices among undergraduate dental students of tertiary care teaching dental hospital in South India.J Educ Ethics Dent 2013;3:21-25


How to cite this URL:
Kalyan VS, Sudhakar K, Srinivas P, Sudhakar G, Pratap K, Padma T M. Evaluation of self-medication practices among undergraduate dental students of tertiary care teaching dental hospital in South India. J Educ Ethics Dent [serial online] 2013 [cited 2019 Dec 10 ];3:21-25
Available from: http://www.jeed.in/text.asp?2013/3/1/21/126939


Full Text

 Introduction



A person who encounters health problem and yet believes that it does not require a visit to a doctor, practices self-medication. [1] This practice is prevalent in developing countries. [2],[3] Self-medication is defined as "the use of any medication for self-treatment without consulting a health-care professional." [4] It involves the use of drugs, which benefit and may also cause harm as well to the individual. According to Chang and Trivedi and Porteous et al., [5] self-medication when practiced correctly can save time and is economical to patients where professional care is relatively expensive and not readily available, thereby making the former an apparent choice. Major disadvantages of self-medication are lack of clinical evaluation of the condition by a trained medical professional and delay in effective therapy. It also results in unnecessary expense and drug dependence. [6],[7] The laxity in medical regulatory has resulted in availability of counter free drugs that are well in demand for highly prevalent diseases. [8] The menace of self-medication prompted World Health Organization to select the World Health Day theme for the year 2011 as "combat drug resistance-no action today, no cure tomorrow" in order to skirmish drug resistance by involving policy makers, planners, public, patients and finally the pharmacists and pharmaceutical industry. [9]

Factors responsible for self-medication are the individual's education, family background, availability of drugs and influence of print and electronic media. [10] A high level of professional education is considered as a predictive factor for self-medication. [11] Most of the studies on self-medication carried out on health-care students, involved medical, pharmacy and nursing sciences. [1],[4],[12],[13],[14] There is a dearth of studies on dental students. Thus this study was undertaken with an aim to assess the self-medication practices among undergraduate dental students of tertiary care teaching dental hospital in South India.

 Materials and Methods



This questionnaire based study received ethical clearance from College Research Ethics Committee prior to its commencement. The questionnaire was tested for face validity by a panel of "experts" and modified in accordance with their recommendations to ensure comprehensive ability of dental students to be surveyed. Internal consistency of the questionnaire was assessed using Cronbach's alpha, which was 0.78 and to ensure reliability of data, test-retest agreement of the responses for the questionnaire was assessed in 10% of participants using kappa statistic and it was found that 90% agreement for responses. The questionnaire consisted of two parts: The first part (Part A) consisted of questions pertaining to demography of students such as age, gender and year of study. Second part (Part B) of the questionnaire was related to self-medication practices. The questionnaire was accompanied by a consent form and an information sheet explaining the purpose of research and providing promise of confidentiality.

The survey was designed for all the dental students (first year to final year) and the students present on the day of the study and who gave consent were included in the study as they were informed of their right not to complete the questionnaire or answer any specific question if not willing. For better understanding the exact meaning of certain terms such as self-medication, halitosis, antipyretic drugs and periodontal problems were explained to the students before the initiation of the study. The questionnaires were distributed in the classrooms and collected immediately after completion.

The survey being descriptive, data was summarized as the number and percentage. Some of the questions had multiple options to choose from; hence the sum of the total may not always be 100%. The data was coded and entered into Microsoft excel sheet which were then analyzed using the statistical package for the social sciences SPSS Inc., 233 SouthWacker Drive, 11 th floor, Chicagoversion 16. Chi-square test was used to test the significance. P < 0.05 was considered to be significant.

 Results



Demography

Out of 360 students, a total of 336 were participated in this study, which consists of 103 were males and 233 were females with a median age of 21 years. The response rate was 93.3%. Demographics of the participants are represented in [Table 1].{Table 1}

Immediate response of the students when they fall sick

[Table 2] represents the data regarding immediate response of the students when they fall sick. Majority (62.5%) of the students were self-medicated. The difference in the proportion of students, across 5 years of graduation, in resorting to self-medication was statistically significant.{Table 2}

Practice of self-medication

Reasons for opting self-medication

The most common reasons cited were that the condition did not merit doctor's intervention (58%) followed by the need of emergency relief (31.5%), which were statistically significant when tested among all the students. The other reasons cited were time saving (4.8%) and economical (5.7%). About 9% of the participants considered it as a learning opportunity and 10% opted for self-medication as a matter of ease and convenience.

Indications of self-medication

There were several indications quoted by respondents [Table 3]. With respect to general health the most common indications were headache (71.4%) followed by cough, cold and sore throat. Pertaining to oral heath, most common indications were mouth ulcers followed by tooth ache.{Table 3}

Drugs used as self-medication

[Table 4] represents the data pertaining to drugs used as self-medication. The most common drugs were analgesics (62.5%), antibiotics (52%) and antipyretics (43.5%).{Table 4}

Frequency of use

About 52% of the students under study practiced self-medication 2-3 times a month. While 8% of them practiced self-medication once in 2-3 weeks, 25% of the students practiced occasionally.

Awareness regarding self-medication used

The data regarding the awareness of the students on various aspects of self-medication such as the dosage, adverse drug reactions, expiry date and the importance of completing the course of self-medication are mentioned in [Table 5].{Table 5}

Source of information regarding the self-medication used

Parents (50.9%), followed by the textbooks (39%) and pharmacist (39%) were the major sources of information. Internet, advertisements, health magazines and senior friends were other sources mentioned by the participants.

 Discussion



Self-medication is a prevailing problem among health-care students. [1],[4],[12],[13],[14],[15],[16],[17] It has grave consequences because it can influence their future professional decisions. [15] It may also affect the student's ability to counsel the patients regarding best health-care practices. This is one of the two studies conducted exclusively on the dental students in the Indian sub-continent. Similarly two studies were conducted in Brazil [16] and Nigeria. [18] Studies were also conducted on general population [19],[20] attending dental clinics regarding their practice of self-medication where in a low prevalence was reported when compared with our study involving dental students. This finding is an unsettling factor.

The prevalence of self-medication is 62.5% in the present study. It was statistically significant among students of different years irrespective of exposure to pharmacology subject. This could be attributed to the white coat, [21] which signifies the professional look and thus facilitates easy purchase of drugs without prescription. Unlike in some of the developed countries [22] where stringent rules are applied to dispense the drugs, in many developing nations including India it is easier to procure drugs off the counter. This is also seen as a reason that students in our study could indulge in the practice of self-medication without check. A few studies [16],[23] reported that the presence of pharmacology as a subject in the undergraduate curriculum could have led some students to opt for self-medication. In contrast to the findings of our study, Aditya [24] reported a high prevalence among house surgeons when compared to their 3 rd year counter parts. This could be due to higher level of knowledge of medicine and greater exposure to drugs among the house surgeons.

"Minor illness not requiring a doctor's visit" was the most common reason cited by the respondents to use self-medication. It is similar to findings of Aditya and Badiger et al. [21],[24] However, it is observed that preferring self-medication for minor illnesses might lead to self-medication of prescription drugs, intake of excessive or inadequate low doses, misdiagnosis and delay in seeking professional care. [2] In agreement with various studies, [6],[4],[14],[25] head-ache, common cold, sore throat and fever were the most common indications of self-medications cited by our respondents.

As stated earlier, analgesics, antibiotics and antipyretics were used by the majority of the students in our study for self-medication. The most common indications of self-medication in our study explain the use of these drugs. It is already a known fact that medical knowledge increases the prescribing behavior of medical students. [2] The inappropriate use of these groups of drugs can lead to various side-effects such as a reduction in the ability of oral flora to resist the colonization of detrimental micro-organisms, [26] addiction, gastric irritation, liver toxicity and rebound head-ache syndrome. [27] It was also documented that irrational drug use led to the development of multi drug resistant bacterial strains (New Delhi Beta-lactamase) [28] in India. Therefore, such kind of practice should be discouraged. With regard to oro-dental problems, mouth ulcer was the most common need to self-medicate. This could be because as the study population is students where a high prevalence of apthae was reported by Donatsky [29] and Pratibha et al. [30] It is also reported [31] that apthae commonly occurs in the second decade, which represents the age group of our study population.

All the students irrespective of the year of the study reported that they were aware of the dosage, adverse drug reactions, expiry date and the importance of completing the course related to the self - medication drugs used by them. A less awareness was noted among the 1 st year students similar to the findings of Sontakke et al. [12] Non-inclusion of pharmacology as a subject in the 1 st year curriculum could be the reason. Parents were the main source of information related to self-medication in our study similar to the findings of Corrêa da Silva et al. and Meena and Kumar which espouses that the existence of home pharmacies and self-medication is culturally in vogue. [17],[32]

Limitations

The limitation of our study includes the smaller sample size; hence the results cannot be generalized. Aspects such as educational background of the parents of the sample subjects, socio-economic standards, urban/rural culture, beliefs in different systems of medicine and gender based differences were not included in our study. However, we believe that such considerations will be helpful to conduct future studies on a larger sample and will also guide in designing various health education strategies to educate the community on self-medication.

 Conclusion and Recommendations



The findings of this study reveal that the majority of the students self-medicate. The teachers and parents play an important role in inculcating best practices while combating emergencies as well as routine ailments. As these students are future dental practitioners, self-medication as a regular practice by them should be curbed as their behavior may influence their patient's health.

To conclude self-medicating practices are prevailing in the present generation of students of the institution where the study was conducted. Regulations should be made to sensitize the health care students regarding the ills of such practice. The concerned agencies should frame certain policies such as continuous monitoring of dispensaries/drugstores to issue drugs only on authorized prescription and accounting should be mandatory for every purchase made by the consumer.

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