Demographic information
Three hundred and sixteen of the 343, students completed the questionnaires (response rate of 92%).
Table 1 shows that the total sample size was 316; 54.4% were female, and 45.6% were male. The most common age group was 21-23 years, accounting for 68.7% of the total sample, while 83.5% lived in urban areas and 16.5% lived in rural areas. Regarding specialty, 50.3% studied medicine and 49.7% pharmacy. Regarding education level, the highest percentage was 34.5% for first year students. It was seen that 86.1% did not have health insurance, and 88.3% reported having no medical illness.
Table 1. Demographic characteristics of the students (n=316)
|
Groups
|
N
|
%
|
Gender
|
Male
|
144
|
45.6
|
Female
|
172
|
54.4
|
Age
|
18–20
|
60
|
19.0
|
21–23
|
217
|
68.7
|
24–27
|
39
|
12.3
|
Area of living
|
Urban
|
264
|
83.5
|
Rural
|
52
|
16.5
|
Specialty
|
Medicine
|
159
|
50.3
|
Pharmacy
|
157
|
49.7
|
Education level
|
First year
|
109
|
34.5
|
Second year
|
52
|
16.5
|
Third year
|
83
|
26.3
|
Fourth year
|
72
|
22.8
|
Do you have health insurance?
|
Yes
|
44
|
13.9
|
No
|
272
|
86.1
|
Do you have any medical illness?
|
Yes
|
37
|
11.7
|
No
|
279
|
88.3
|
Students’ knowledge of self-medication
More than half (81.6%) of students had adequate knowledge that SM is defined as self-consuming medication without receiving advice from a physician. Moreover, the majority (94.3%) of students knew that all medications (prescription, OTC and herbal) had adverse effects. Most of them (94.9%) recognized the importance of seeking physician help in case of adverse drug effects. A total of 308 (97.5%) students were aware that using medications with unknown substances in patients with liver and kidney disease is dangerous, and nearly all students knew that increasing or decreasing medication doses without a doctor consultation can be dangerous. More than half (88.3%) of students knew that SM can mask signs and symptoms of some diseases (Table 2).
The total knowledge scores ranged between 0 and 7; a poor level was considered for a total score of 0, 1, 2, 3 or 4 out of 7, and a good level was considered for a total score of 5, 6 and 7 out of 7. The results show that 17 out of 316 students, which represent 5.4% of the total sample, had poor knowledge of SM, indicating total scores lower than 5, while the other 299 students, which represent 94.6% of the sample, had good knowledge of SM, indicating total scores of 5 and above.
Table 2. Self-medication knowledge of Medical and Pharmacy students (n=316)
Question
|
n
|
%
|
1- SM is defined as self-consuming of medication without getting advice from a physician.
|
Yes*
|
258
|
81.6
|
No
|
32
|
10.1
|
I don’t know
|
26
|
8.2
|
2- SM is safe?
|
Yes
|
72
|
22.8
|
No*
|
197
|
62.3
|
I don’t know
|
47
|
14.9
|
3- All medications (prescription, OTC and herbal) have adverse effects?
|
Yes*
|
298
|
94.3
|
No
|
13
|
4.1
|
I don’t know
|
5
|
1.6
|
4- Increasing or decreasing medication dose without a doctor consultation can be dangerous?
|
Yes*
|
307
|
97.2
|
No
|
5
|
1.6
|
I don’t know
|
4
|
1.3
|
5- In case of adverse effects, physician help must be sought.
|
Yes*
|
300
|
94.9
|
No
|
1
|
0.3
|
I don’t know
|
15
|
4.7
|
6- Using medications with unknown substances in patients with liver and kidney disease is dangerous.
|
Yes*
|
308
|
97.5
|
No
|
3
|
0.9
|
I don’t know
|
5
|
1.6
|
7- SM can mask signs and symptoms of some disease?
|
Yes*
|
279
|
88.3
|
No
|
7
|
2.2
|
I don’t know
|
30
|
9.5
|
Poor knowledge
|
17
|
5.4
|
Good knowledge
|
299
|
94.6
|
*: Choose answer which you consider a good response
Table 3 demonstrates a statistically significant association (P < .05) between good knowledge and the following student characteristics: being female and pharmacy students.
Table 3. Association between knowledge and demographic variables (n=316)
|
Knowledge Level
|
Chi-Square
|
p value
|
Poor
|
Good
|
Gender
|
Male
|
8.3%
|
91.7%
|
4.534
|
0.033*
|
Female
|
2.9%
|
97.1%
|
|
|
Age
|
18–20
|
5.0%
|
95.0%
|
.468
|
0.791
|
21–23
|
5.1%
|
94.9%
|
|
|
24–27
|
7.7%
|
92.3%
|
|
|
Area of living
|
Urban
|
6.1%
|
93.9%
|
1.461
|
0.227
|
Rural
|
1.9%
|
98.1%
|
|
|
What is your specialty?
|
Medicine
|
9.4%
|
90.6%
|
10.334
|
0.001**
|
Pharmacy
|
1.3%
|
98.7%
|
|
|
Education level
|
First year
|
8.3%
|
91.7%
|
7.069
|
0.070
|
Second year
|
1.9%
|
98.1%
|
|
|
Third year
|
1.2%
|
98.8%
|
|
|
Fourth year
|
8.3%
|
91.7%
|
|
|
Do you have health insurance?
|
Yes
|
9.1%
|
90.9%
|
1.383
|
0.240
|
No
|
4.8%
|
95.2%
|
|
|
Do you have any medical illness?
|
Yes
|
2.7%
|
97.3%
|
.590
|
0.442
|
No
|
5.7%
|
94.3%
|
|
|
*significant at p < .05
Students’ attitudes toward self-medication
Table 4 shows the students’ responses to the seven questions on attitudes toward SM. The highest mean score was 3.49 out of the 5-point scale for (The availability of OTC medicines and the belief on its safety leading me to use SM), followed by mean score 3.29 for (Easy access to health care information and facilities, the main cause that medical and pharmacy student use self- medication). The lowest mean score of agreement was 1.98 out of 5 (no need for training to use SM?). The overall mean score for attitudes toward SM was 2.92 out of the 5 scales, with an SD of 0.692, which represents approximately 58.4% of the total sample, and has high agreement with the questions on attitudes toward SM at Qassim University, Saudi Arabia.
Table 4. Medical and Pharmacy students’ attitudes toward self-medication (n=316)
Question
|
N
|
Minimum
|
Maximum
|
Mean
|
Std. Deviation
|
1- Self–medication part of self care.
|
316
|
1
|
5
|
3.10
|
1.309
|
2- No need for training to use self-medication?
|
316
|
1
|
5
|
1.98
|
1.238
|
3- Medical and pharmacy students are able to diagnose different diseases.
|
316
|
1
|
5
|
3.12
|
1.176
|
4- Medical and pharmacy students are able to treat different diseases.
|
316
|
1
|
5
|
2.98
|
1.268
|
5- Do you recommend self medication to others?
|
316
|
1
|
5
|
2.48
|
1.268
|
6- Easy access to health care information and facilities, the main cause that medical and pharmacy student use self- medication.
|
316
|
1
|
5
|
3.29
|
1.183
|
7- The availability of OTC medicines and the belief of its safety leading me to use SM.
|
316
|
1
|
5
|
3.49
|
1.256
|
Attitude
|
316
|
1
|
5
|
2.92
|
0.691
|
Table 5 demonstrates a statistically significant difference (P < .05) in the mean attitude score and the following student characteristics: being male, being 21-23 years old, and being pharmacy students.
A statistically significant negative relation between knowledge and the self–medication part of self-care (r= -0.152, p< 0.05). The higher the knowledge of SM, the lower the believe in the SM part of self care. In addition, there was a statistically significant negative relation between knowledge and recommendation of SM to others (r= -0.143, p< 0.05). Hence, the higher the good knowledge of SM, the lower the recommendation of SM to others.
Table 5. Association between knowledge score and attitudes score (n=316)
|
Spearman's rho
|
P value
|
Significance
|
1- Self–medication part of self care.
|
-0.152
|
0.007
|
<0.001
|
S
|
2- No need for training to use self- medication?
|
-0.087
|
0.123
|
>0.05
|
N.S.
|
3- Medical and pharmacy students are able to diagnose different diseases.
|
-0.063
|
0.264
|
>0.05
|
N.S.
|
4- Medical and pharmacy students are able to treat different diseases.
|
-0.089
|
0.115
|
>0.05
|
N.S.
|
5- Do you recommend self medication to others?
|
-0.134
|
0.017
|
< 0.05
|
S
|
6- Easy access to health care information and facilities, the main cause that medical and pharmacy student use self- medication.
|
0.129
|
0.022
|
< 0.05
|
S
|
7- The availability of OTC medicines and belief of its safety leading me to use SM.
|
0.082
|
0.148
|
>0.05
|
N.S.
|
Attitude
|
-0.093
|
0.097
|
<0.10
|
S
|
Students’ practices toward self-medication
The students’ practice towards the statements about SM is illustrated in Table 6. More than half (63.9%) of the students reported that they had practiced SM in the last 6 months. The majority (79.1%) of respondents knew the medication classification of OTCs and prescription drugs. Pain killers were the most common medication used for SM by the majority of the students (88.29%), followed by antipyretics (49.68%). It was also observed that 36.71% of the students reported having self-medicated with antihistamine; others are listed in Table 6.
Table 6. Students’ practices toward self-medication (n=316)
Question
|
n
|
%
|
1- Did you practice SM in the last 6 months?
|
Yes
|
202
|
63.9
|
No
|
114
|
36.1
|
2- How frequently did you visit the pharmacy to purchase drugs without a prescription for yourself in the last 6 Months?
|
Once
|
153
|
48.4
|
Twice
|
65
|
20.6
|
Three times
|
60
|
19.0
|
Four times
|
16
|
5.1
|
Five times
|
3
|
0.9
|
More than five times
|
19
|
6.0
|
3- Do you know if the medicines you consumed needed prescription or not?
|
Yes
|
250
|
79.1
|
No
|
33
|
10.4
|
I don’t know
|
33
|
10.4
|
4- Which of the following drugs have you taken without prescription during the last 6 months?
|
Pain killers
|
279
|
88.29
|
Antibiotics
|
110
|
34.81
|
antipyretics
|
157
|
49.68
|
Antihistamines
|
116
|
36.71
|
Cough syrups
|
42
|
13.29
|
Cold and flu preparations
|
59
|
18.67
|
Antacid drugs
|
30
|
9.49
|
Drugs for constipation
|
42
|
13.29
|
Drugs for diarrhea
|
9
|
2.85
|
Anti-emetics
|
12
|
3.8
|
Nasal/Ear/Eye drops
|
100
|
31.65
|
Topical agents (skin treatment
|
96
|
30.38
|
Nutritional/energy supplements
|
92
|
29.11
|
Herbs
|
69
|
21.84
|
5- For which of the following indications have you taken medications without prescription during the last 6 months?
|
I do not take
|
199
|
62.97
|
Headache
|
204
|
64.56
|
Cough & common cold
|
110
|
34.81
|
Fever
|
98
|
31.01
|
Infection
|
22
|
6.96
|
Heart burn
|
23
|
7.28
|
Allergy
|
47
|
14.87
|
Disorder of digestive system
|
37
|
11.71
|
Body pain
|
66
|
20.89
|
Tooth pain
|
41
|
12.97
|
Acne/skin diseases
|
90
|
28.48
|
Menstrual problems
|
78
|
24.68
|
Insomnia
|
22
|
6.96
|
6- Source of Information About SM
|
Relatives
|
68
|
21.52
|
Friends
|
32
|
10.13
|
Personal knowledge
|
205
|
64.87
|
Multi media
|
84
|
26.58
|
Advised by Doctors but without prescription
|
114
|
36.08
|
Pharmacists or those working in the pharmacy
|
160
|
50.63
|
7- What do you know about the drug you requested?
|
Name of the drug
|
275
|
87.03
|
Indication
|
237
|
75
|
Dose
|
216
|
68.35
|
How to use
|
246
|
77.85
|
Frequency
|
200
|
63.29
|
Duration
|
183
|
57.91
|
Storage of the drug at home
|
158
|
50
|
8- Do you know the potential adverse reactions of the drug with which you self-medicated?
|
Yes
|
219
|
69.3
|
No
|
57
|
18.0
|
I don’t know
|
40
|
12.7
|
9- From where did you SM?
|
Pharmacy
|
298
|
94.3
|
Street market
|
14
|
4.43
|
Herbal store
|
38
|
12.03
|
Relative/friend
|
28
|
8.86
|
10- Reasons for SM
|
To save money
|
49
|
15.51
|
To save time
|
145
|
45.89
|
Privacy
|
33
|
10.44
|
Needed quick relief
|
201
|
63.61
|
No hospital nearby
|
36
|
11.39
|
Previous experience
|
158
|
50
|
Health problem not serious
|
212
|
67.09
|
Embarrassed of discussing own symptoms
|
8
|
2.53
|
11- Have you ever experienced a negative side effect after SM?
|
Yes
|
71
|
22.5
|
No
|
245
|
77.5
|
If yes
|
Drug side effects
|
49
|
69.01
|
Disease recurrence
|
12
|
16.9
|
Resistance to drug
|
9
|
12.68
|
Drug interactions
|
8
|
11.27
|
12- Do you feel confident with the use of SM?
|
Yes
|
246
|
77.8
|
No
|
70
|
22.2
|
More than half (64.56%) of respondents reported that the most frequent causes for the practice SM were headache followed by cough and the common cold (34.8%). Other episodes included fever, acne, menstrual problems, body pain and allergies (31%, 28.48%, 24.68%, 20.89%, and 14.87%, respectively). More than half (64.87%) of respondents reported that their personal knowledge was the major source of information for the practice of SM. Approximately two-thirds (69.3%) of respondents knew the potential adverse reactions of the drug. The majority (94.3%) of respondents reported that they obtained SM from a pharmacy, and 12% used SM from herbal stores.
Two-thirds (67%) of respondents reported that they self-medicated because of nonseriousness of the illness, followed by quick relief (63.61%). Approximately one-quarter (22.5%) of respondents reported that they experienced a negative side effect after SM. Approximately 69% of them reported side effects from the drug. The majority (77.8%) of respondents reported that they felt confident about the use of SM.