Sado et al.

BMC Res Notes (2017) 10:533

DOI 10.1186/s13104-017-2865-5 BMC Research Notes

RESEARCH NOTE Open Access

Epidemiology of self‑medication
with modern medicines among health care
professionals in Nekemte town, western
Ethiopia
Edao Sado1*†, Endashaw Kassahun2†, Getu Bayisa3, Mohammed Gebre3, Ayana Tadesse3 and Balisa Mosisa4

Abstract 
Objective:  Self-medication is defined as use of medicines to treat self-recognized illnesses. It is widely used in Ethio-
pia. However, its extent of use is unknown among health professionals. This study aimed to assess prevalence and rea-
sons of self-medication with modern medicines among health professionals. A cross-sectional study was conducted
on the health professionals, working in the public health facilities. Data were collected from March to May, 2016 using
semi-structured questionnaire. Data were entered and analyzed using statistical package for the social sciences. A chi
square test was used as test of significance at 95% of confidence interval.
Results:  A total of 154 health professionals were enrolled, with 53% were being females. The finding revealed that
prevalence of self-medication with modern medicines was 67.5%. Financial constraints (32.5%) and familiarity with
medicines (24%) were the major reasons of self-medication. It also showed that self-medication with modern medi-
cines was significantly associated with marital status (χ2 = 19.57, P = 0.00). Analgesics (53%) and antibiotics (36%)
were the most commonly used categories of medicines. Self-medication with modern medicines was highly prac-
ticed among health professionals. Financial constraints and familiarity with medicines were the two major reasons of
practicing.
Keywords:  Self-medication, Modern medicines, Ethiopia

Introduction Health professionals are familiar with medicines so

Self-medication is defined as use of medicines by indi- they are different from the other population in terms
viduals to treat self recognized illnesses [1]. It includes of medicine use [6]. Knowledge and access to prescrip-
diagnosing and treating one’s own illness and prescrib- tion medicines are potential factors for self-prescribing
ing for one’s self [2, 3]. It is highly practiced in developing among health professionals. Other factors that are often
countries, which might be due to availability of medicines quoted include the complaint of extensive demands on
from informal sectors such as open marker, supermarket, their time, issues of privacy and confidentiality [6]. Health
and inadequate health care services [4]. Self-medication professionals expect that their patients to seek appropri-
with both over the counter and prescription only medi- ate health care when they get sick. However, they do not
cines are common in developing countries [5]. seek appropriate health care by themselves. For example,
they might be inappropriately self-medicate with pre-
scription only medicines, which lead to irrational use of
*Correspondence: [email protected]; [email protected] medicines [7, 8]. This might be due to a perception that
†
1
Edao Sado and Endashaw Kassahun contributed equally to this work self-prescribing with prescription only medicines such
Pharmacoepidemiology and Social Pharmacy Unit, Department
of Pharmacy, College of Health Sciences, Wollega University, P.O.Box 395,
as narcotics analgesic is safe; which is not allowed even
Nekemte, Ethiopia illegal for self-prescribing [8, 9]. Various studies showed
Full list of author information is available at the end of the article

© The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
(http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
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and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/
publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Sado et al. BMC Res Notes (2017) 10:533 Page 2 of 5

that they self-medicate with modern medicines without Data collection tool
consulting other health care professionals, which lead Self-administered semi-structured questionnaires were
to development of pill for every ill culture in the medi- adapted from previously published article [13]. The ques-
cal community. Self-medication with modern medicines tionnaire was translated into Afan Oromo, the official
has many problems. The major problems are over pre- language of the study zone by a panel of experts fluent
scribing, misuse, use of unnecessary expensive drugs and in the language. The Afan Oromo language version was
overuse of antibiotics. These problems are great issues of used to collect data. Questionnaire was pre-tested on the
global concern [10, 11]. 10% of studied health care professionals, who are work-
A study conducted in India showed that a lower degree ing in the public health care facilities found in a Ghimbi
of illness is the main reason of practicing self-medication town. Data collection was commenced after small
among health professionals [12] while studies done in amendment was made on the questionnaire in the field of
Malaysia and Pakistan showed familiarity with treatment professionals based on the results of pretest.
as a main reason of practicing self-medication [7, 13, 14].
Though different studies have been conducted in differ- Data management and analysis
ent parts of Ethiopia, the extent of self-medication among Data were coded, entered and analyzed using Statisti-
health professionals is not assessed yet. Therefore, this cal Package for the Social Sciences (SPSS) version 17
study was conducted to assess prevalence of self-medica- for windows, and Microsoft Office Excel 2007. Descrip-
tion with modern medicines among health care profes- tive statistics were expressed by using frequencies and
sionals; and to identify major reasons of self-medicating. proportions. A Chi square was used as test of signifi-
cance at 95% of confidence interval. A P value of 0.05 or
Main text less than 0.05 was used as the cut-off level for statistical
Methods significance.
Study setting and study design
The study was conducted on health care profession- Ethical clearance
als, who were working in the public health care facilities Ethical clearance was obtained from the Institutional
found in a Nekemte town, western part of Ethiopia. The Research Ethics Review Committee of Wollega Univer-
town is located at 328  km away from Addis Ababa, the sity, College of Health Sciences. A letter of cooperation
capital city of the country. The town was selected as it is was written from the Department of Pharmacy to the
the largest and most populous town in the western part concerned health facilities for further cooperation. The
of Ethiopia. At the time of data collection, there were objective of the study was explained to the study par-
two public health centers and one public hospital. We ticipants and a written consent was obtained from each
included all of them in the study. participant.
A cross-sectional study was conducted from March to
May, 2016 among health professionals to assess the prev- Results
alence of self-medication with modern medicines; and Socio demographic characteristics of respondents
to identify major factors leading to self-medication with A total of 169 health professionals were recruited but
modern medicines. only 154 (91.1%) of them completed questionnaire.
Among 154 respondents, 81 (53%) were females. Sev-
Sample size and sampling technique enty-six (49%) of the respondents were in the 20–29
Sample size was calculated by using single proportion age groups and 54 (31.5%) were in the 39–39 age groups
formula [15], which is n = z2 pq/d2, where z is estimated while the rest 24 (15.6%) were aged more than 39 years.
at 1.96 for a 95% confidence level, P is 50% of the esti- Sixty-two (40%) respondents had been working as health
mated prevalence and d is the level of acceptable error care professionals for 5 or less than 5 years. One hundred
estimated at 5%. After considering sample size adjust- five (68.2%) of the respondents were unmarried. Majority
ment to the population and taking 16% compensation for 88 (57.2%) of the respondents were nursing professionals
non-response, the sample size was determined to be 169. (Table 1).
We used simple random sampling to select a health
professional among those working in the public health Reasons for self‑medication and category of medicines used
facilities found in the town. A health professional was Among 154 respondents, 104 (67.5%) of them were prac-
randomly selected from the total health professionals ticing self-medication with modern drugs within last
working in the public health care facilities. He/she was 2 months of recall period. Analgesics 56 (36.1%) and anti-
included in the study if he/she was available in the health biotics 37 (23.9%) were the most commonly used medi-
facilities during data collection. cines categories. Financial constraints 50 (32.5%) and
Sado et al. BMC Res Notes (2017) 10:533 Page 3 of 5

Table 1  Socio demographic characteristics of respondents significantly associated with marital status (χ2  =  19.57,
Variables Number (n = 154) Percentage P = 0.00) (Table 3) at 95% of confidence interval.

Gender Discussion
 Male 73 47 The aim of the present study was to assess epidemiology
 Female 81 53 of self-medication with modern medicines among health
Age care professionals. The finding of this study suggested
 20–29 76 49 that two-thirds (67.5%) of health professionals were self-
 30–39 54 31.5 medicating with modern medicines. This figure was com-
 > 39 24 15.6 parable with findings reported from study conducted in
Years of practice Malaysia [13]; and it was less than the findings reported
≤  5 62 40 from study conducted in India, Pakistan and Ghana [10,
 5–10 56 37 12, 14]; and it was higher than the reports from study
 ≥ 10 36 23 done in America [16]. This discrepancy might be due to
Marital status different factors such as variation in income of the pro-
 Unmarried 105 68.2 fessionals, availability of social health insurance for pro-
 Married 49 31.8 fessionals, and governing laws, which prohibit sales of
Field of practice prescription only medicines as over the counter.
 Medical 13 8.4 In contrary to study conducted in India, which
 Nurses 88 57.1 showed self-medication was significantly associated
 Pharmacy 13 8.4 with female sex, it was not significantly associated with
 Othera 40 26 sex of the studied populations in this study [12]. How-
a
Other : Includes laboratory personnel, health officer, sanitarians, and anesthetics ever, it was significantly associated with marital status
of the studied population (­ X2 = 19.57, P = 0.00) at 95%
confidence interval, where unmarried health profession-
familiarity with medicines 37 (24%) were the most com- als had more tendency to self-medicate with modern
monly mentioned reasons to self-medicate with modern
medicines (Table 2).
Table 3  Factors influencing self-medication with  modern
Factors influencing self‑medication with modern drugs drugs
To assess the association of self-medication with socio- Variables Self-medication with MDs Chi square
demographic variables of studied participants, we calcu-
Yes (n = 104) No
lated Chi square test. We found that self-medication was
Gender
 Male 49 24 χ2 = 0.2312
Table 2  Reasons for self-medication and category of used  Female 55 26 P = 0.6306
medicines Age
Variables Frequency Percentage  20–29 56 20 χ2 = 2.77
 30–39 34 20 P = 0.2503
Reasons for self-medication  ≥ 40 14 10
 Familiarity with drugs 37 24 Year of experience
 Mildness of illness 21 13.6 ≤ 5 46 16 χ2 = 2.1787
 Privacy 26 16.9  5–10 36 20 P = 0.3364
 Less cost/financial constraint 50 32.5  ≥ 10 22 14
 Lack of time 11 7.1 Marital status
 Others 9 5.9  Unmarried 85 20 χ2 = 19.57
Category of medicines used  Married 19 30 P = 0.0000
 Analgesics 56 36.1 Field of professionals
 Antibiotics 37 23.9  Medical 13 0 –
 Oral contraceptives 26 16.8  Nurses 56 32
 Antacid 20 12.9  Pharmacy 10 3
 Oral hypoglycemic agents 10 6.5  Othera 25 15
 Others 6 3.9 a
  Laboratory personnel, Health officer and Sanitarians
Sado et al. BMC Res Notes (2017) 10:533 Page 4 of 5

medicines. This significance might be due to the number Limitations

of surveyed respondents as majorities were unmarried, This study has two major limitations. First, the study was
which might be outlier the finding. Although self-med- carried out among health professionals working in the
ication was not significantly associated with age, the public health facilities only. Thus the findings cannot be
prevalence of self-medication higher in the respondents generalized to all health professionals working in Ethio-
with lower age categories. This was in contrary to the pia. Second, 2  months recall period was used to collect
reports of study conducted by Boateng, which showed information hence it might be subjected to recall biases.
higher rate of self-medication with higher respondent However, to our knowledge this article was the first to
age group [10]. assess prevalence of self-medication with modern medi-
This study revealed that financial constraints and famil- cines among health care professionals in Ethiopia.
iarity of the medicine were major reasons of practicing
Authors’ contributions
self-medication. This finding was similar to report from EK, ES: study design, data collection and analysis, interpret the data, draft
study done in Malaysia [13]. However, busy life sched- and reviewed the manuscript. BM, ES: Data entry, data analysis and reviewed
ule and previous experience of medicines were reported the manuscript. ES, GB, MG, AT: conception of the research idea, design of
the study, carrying out the data collection, and drafting the manuscript. All
as the major factors in the study conducted in Pakistan authors read and approved of the final manuscript.
[14]. Different studies also showed that low severity of ill-
nesses was the main cause for the practice of self-medica- Author details
1
 Pharmacoepidemiology and Social Pharmacy Unit, Department of Pharmacy,
tion, unlike to this finding [17, 18]. College of Health Sciences, Wollega University, P.O.Box 395, Nekemte, Ethiopia.
The study also revealed that analgesics and antibiot- 2
 Boru Meda Hospital, Amhara National Regional State, Dessie, Ethiopia. 3 Clini-
ics were the most commonly used categories of medi- cal Pharmacy Unit, Department of Pharmacy, College Health of Sciences, Wol-
lega University, Nekemte, Ethiopia. 4 Pharmaceutics Unit, Department of Phar-
cines. However, this finding was inconsistence with macy, College Health of Sciences, Wollega University, Nekemte, Ethiopia.
the reports from studies done by Boateng and Tensaw,
which reported a higher rate of antibiotics and analge- Acknowledgements
The authors would like to thank Wollega University for giving for logistic sup-
sics [1, 10]. This high prevalence of analgesic for self- port and all individuals who rendered help during the study period.
medication might be associated with their availability
as over the counter. It also suggested that antibiotics Competing interests
The authors declare that have no competing interests.
were also available as over the counter medicines, where
their uses were not supported by laboratory investiga- Availability of data and materials
tion. Antibiotics are susceptible to the risk of misuse The datasets used and/or analysed during the current study available from the
corresponding author on a reasonable request.
and yet they are often exposed to the high rate of self-
medication practices [19, 20]. Use of antibiotics as over Consent for publication
the counter drugs may cause the development of bacte- Not applicable.
rial resistance. Ethics approval and consent to participate
Ethical approval was obtained from the Institutional Research Ethics Review
Conclusions Committee of Wollega University. A written consent was obtained from each
study participant.
The aim of this study was to assess prevalence of self-
medication with modern medicines among health care Funding
professionals. The study revealed that self-medication This research was not funded by any institution. It was done by authors’
expenses.
with modern medicines was highly practiced among
health professionals. Familiarity with medicines, and
Publisher’s Note
financial constraints were the major mentioned reasons Springer Nature remains neutral with regard to jurisdictional claims in pub-
of self-medicating. Analgesics and antibiotics were the lished maps and institutional affiliations.
most commonly used categories of drugs.
Received: 24 July 2017 Accepted: 24 October 2017
Based on the findings, we proposed the follow-
ing recommendations to minimize prevalence of
self-medication:

••  In order to overcome financial constraints, social References

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