|Year : 2021 | Volume
| Issue : 1 | Page : 22-27
Evaluation of practices of self-medication among undergraduate dental students in Riyadh
Umbreen Noor Muhammad
Department of Basic Sciences, Riyadh Elm University, Riyadh, Saudi Arabia
|Date of Submission||14-Aug-2020|
|Date of Acceptance||27-Sep-2020|
|Date of Web Publication||17-Apr-2021|
Dr. Umbreen Noor Muhammad
Department of Basic Sciences, Riyadh Elm University, Riyadh
Source of Support: None, Conflict of Interest: None
Introduction: Self-medication (SM) and purchase of over-the-counter medication have been in practice in medical fields. Dental students have the knowledge of pharmacological drugs and they have a higher chance than the population to indulge in SM.
Aim: The aim of the study was to evaluate the practice, awareness, and attitude of undergraduate dental students toward SM and its relation with gender and to assess whether this practice differs among students of different years of study.
Methods: A cross-sectional survey was conducted using simple random sampling among undergraduate dental students in a private dental college in Riyadh. A self-designed online questionnaire was used to collect data, which was validated and used for the research
Results and Discussion: A total of 465 students (31% males and 69% females) responded to the survey. 60% of the students agreed to practice SM and it was significantly (P < 0.05) higher in females than males. With each successive year of study, there was significant decrease (P < 0.05) in the practice of SM and significant increase (P = 0.000) in the level of awareness toward SM. Body aches (57%) and mouth ulcers (35%) were the most common indications to practice SM regarding general and oral health, respectively. Most commonly used medicines were analgesics. Previous experience to treat the same illness was the most common reason for practicing SM, and the primary source of medicine was the medicine present at home.
Conclusion: More than half of the respondents practiced SM for minor illnesses, and it was higher among females and students of preparatory years. There was less awareness among dental students relating to survey items such as importance of completing the course of medicine and adverse drug reactions. This study highlights the need to develop awareness and interventions to assess this health problem among dental undergraduates.
Keywords: Dental students, questionnaire, Riyadh, self-medication
|How to cite this article:|
Muhammad UN. Evaluation of practices of self-medication among undergraduate dental students in Riyadh. Saudi J Oral Sci 2021;8:22-7
| Introduction|| |
According to the World Health Organization, self-medication (SM) is defined as “the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms.” It may be considered as a part of self-care that deals with maintenance of health, prevention, and treatment of diseases. In general, it is believed that SM could be commonly practiced in those countries where health-care facilities are very expensive and not covered by insurance. However, SM is also popular in the countries like Kingdom of Saudi Arabia (KSA), where the health-care facilities are borne by government.,
The important factors that can influence the practice of SM may include gender, age, and level of education. Misused of prescribed drug, failure to comply with drug regulations, not reading the instructions before use, taking the excessive dose, and other inappropriate behavior toward SM are mostly practiced by young adults. The literature showed that practice of SM among university students ranges from 38.5% in Ethiopia to 98% in Palestine. As the students related to health-care professions differ from general population regarding the knowledge on the medicines and diseases and have the ability to reflect their knowledge into practice, SM has been often evaluated in these individuals. A study from Jordan reported that SM practice is higher in medical as compared to nonmedical students. Practice of SM may vary among different populations. In KSA, studies regarding SM practice have been conducted among pharmacy, medical, and nursing students,, but little data is available about SM practices in this region focusing on dental undergraduates. It is important to conduct the study of this nature among these individuals as it will help enlighten this problem among them and will illuminate the need to develop educational interventions regarding its practice and limitations in this region.
In the view of above, the present study was conducted with following aims and objectives: to assess the practices, awareness, and attitude of undergraduate dental students toward SM and its relation with gender and to assess whether this practice of SM differs among students of different years of study.
| Materials and Methods|| |
This descriptive cross-sectional study was conducted among male and female undergraduate dental students in a private dental college in Riyadh from May to June 2020, after obtaining institutional review board approval letter (FRP/2020/244/183/177) from the research center web portal. The study participants were divided into following groups: level 1–4 as preparatory years, level 5–8 as preclinical years, and level 9–12 as clinical years. The students were informed about the purpose of this study and also that their responses would be kept confidential and anonymous.
An online well-structured questionnaire [Appendix I] was designed using Google Forms. The questionnaire included the questions related to practices, awareness, and attitude toward SM. The demographic information (gender, age, level, or year of study) was also obtained. This questionnaire was adopted from a published study conducted by Kumar et al., but it was again evaluated for validity and reliability by conducting a pilot study. The pilot study was conducted by letting the survey filled by 20 participants and the data were inserted in SPSS software (Statistical Package for the Social Sciences, version 22.0, SPSS Inc., Chicago, IL, USA) to determine the reliability by using Cronbach's coefficient alpha. Validity of the questionnaire was tested by sending it to experienced researchers in the college, and changes were made according to their feedback and comments.
The collected data were analyzed using SPSS version 22, where descriptive statistics was used for calculation of the proportions. Cross-tabulation was also achieved using Chi-square tests to compare the study groups on the basis of gender and year of study. The statistical significance was set at P < 0.05.
| Results|| |
Cronbach's coefficient alpha value for the current study was 0.942. This study assessed a total of 465 students (31% males and 69% females). [Figure 1] and [Figure 2] show the distribution of respondents according to the level of study and age, respectively. Majority of the respondents (60%) showed prevalence toward SM and it was significantly higher (P < 0.05) in females as compared to males [Table 1]. The prevalence of SM was significantly lower (P < 0.05) with each successive year of study. There was no significant correlation between the prevalence of SM and age of the respondents.
|Table 1: Prevalence of self-medication among male and female respondents|
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Body aches (57%) and mouth ulcers (35%) were the most common indications regarding general and oral health, respectively, to practice SM. The practice of SM significantly (P < 0.05) differed among male and female respondents regarding conditions such as flu, body aches, headache, and cough [Table 2]. Both male and female respondents reported analgesics as the most common medicines used for SM. Analgesics were predominantly (P = 0.014) used by females while antibiotics were predominantly (P = 0.000) used by males. 45% of the respondents also used herbal medicines. Primary source of medicine was the prepaid medicine that had not been fully utilized (83%), followed by medicine given by family or friend (69%), bought at the pharmacy (64%), and internet (35%) without a doctor's prescription. Previous experience to treat the same illness (86%) followed by having sufficient pharmacological knowledge (65%), save money (12%), and save time (2%) were the reasons for taking a medicine without a doctor's prescription. [Table 3] and [Table 4] show attitude and awareness toward SM among students of different years of study, respectively.
|Table 3: Attitude toward self-medication among students of different levels of study|
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|Table 4: Awareness toward self-medication among students of different levels of study|
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| Discussion|| |
SM is considered as a global phenomenon with a higher prevalence among citizens of KSA. Cronbach's coefficient alpha value for the current study was 0.942, signifying high internal consistency. This study demonstrated that 60% of the respondents practiced SM. There is lack of data about the prevalence of SM among dental students in this region, but one study that includes pharmacy, dentistry, and medicine students showed the combined prevalence of 49.44%. The prevalence in our study was lowered as compared to general public in the KSA (81.4%). It can be attributed to the reason that medical education gives knowledge and awareness about adverse consequences of taking drugs without doctor prescription, leading to decreased prevalence in dental students as compared to the laypeople. In our study, practice of SM was significantly higher in female than male students. Similar finding was also found in KSA and India. This can be due to the reason that females have greater disposition to recognize, admit, and voice their symptoms than males.
In agreement with other studies,,,,, the most common indications to use SM were body aches, cold/flu symptoms, cough, and headache. This might be due to the reason that respondents considered these illnesses insignificant that do not require visit to the doctor. This practice should be discouraged as, in some cases, the primary symptoms are mild and wrong diagnosis and irrelevant treatment may lead to adverse outcomes. In this study, significantly higher percentage of males used antibiotics as compared to females. It is not safe to practice this behavior as it can lead to antibiotic resistance, treatment failure, and drug toxicity. The most common reason for taking a drug without a doctor's prescription was based on previous experience to treat the same illness. This aligned with observation from other studies., It can be considered as one of the major implications of improper SM practice that can lead to serious consequences.
In this study, practices of SM significantly decreased toward the higher level of study. Concurrent with this finding, students of preclinical and clinical years significantly showed more positive attitude toward SM as compared to preparatory years [Table 4]. Similar observations were reported by Seam et al.
This study demonstrated that level of awareness was significantly lower (P = 0.000) in the students of preparatory years as compared to preclinical and clinical years [Table 3]. Irrespective of the years of the study, higher percentage of the respondents reported awareness about parameters such as dose, expiry date, and checking insert before use, but the students of preparatory years reported less awareness on the importance of completing the course of medicine and adverse drug reactions, which is consistent with the study by Kalyan et al.,,, It can be due to the reason that pharmacology is introduced in the curriculum after preparatory years and inadequate information and knowledge on the use of drug is considered as one of the main contributing factors for practicing SM.,
One of the limitations of the study is that the study sample was dentistry students only. Practice of SM among interns and postgraduate students was not assessed. Another factor is that, in self-reporting studies, there is always a possibility of under- or over-reporting.
| Conclusion|| |
The study points out that the female group of dental students, especially in the preparatory years, tend to use SM at a higher scale. A higher proportion of the students were noted to indulge in SM with comparatively less awareness on adverse drug reactions including incomplete drug dose regimen. Future studies on comparison with other health science students as well as nonhealth science-related students will be beneficial in discriminating the SM practice among students who are aware of pharmaceutical drugs and those who are not aware. It is also recommended based on the results of the study the need for conducting continuous medical/dental education programs to instigate the changes in the practice of SM, while focusing on the impact that an incorrect SM regimen can have on the health of the individual.
I would like to thank all the students, who participated in this study.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| Appendix I|| |
Level of study:
Practice toward Self-Medication:
A. Do you take the drugs/medicines often without prescription? Yes No
B. With the exception of medicines that are prescribed to you by your general practitioner; have you ever taken the drugs or medicine for following symptoms/conditions?
C. With the exception of medicines that are prescribed to you by your general practitioner; have you ever used in some cases these medicines?
D. Source of the medicine:
E. Reasons for taking the medicine without a doctor's prescription;
Awareness toward Self-Medication:
| References|| |
World Health Organization. The role of pharmacist in self-care and self-medication. In: Report of the 4th
WHO Consultative Group on the Role of Pharmacist. Geneva (CH): World Health Organization; 1998.
Kanwal ZG, Fatima N, Azhar S, Chohan O, Jabeen M, Yameen MA. Implications of self-medication among medical students-A dilemma. JPMA 2018;68:1363.
Alhomoud F, Aljamea Z, Almahasnah R, Alkhalifah K, Basalelah L, Alhomoud FK. Self-medication and self-prescription with antibiotics in the Middle East-do they really happen? A systematic review of the prevalence, possible reasons, and outcomes. Int J Infect Dis 2017;57:3-12.
Makeen HA, Albarraq AA, Banji OJ, Taymour S, Meraya A, Saad Alqhatani S, et al. Knowledge, attitudes, and practices toward self-medication in a rural population in South-Western Saudi Arabia. Saudi J Health Sci 2019;8:54-9. [Full text]
Mahzari YI, Aldhfyan YM, Aldossary AM, Alghamdi EA. Self-medication in Saudi Arabia-A cross sectional study. Int J Med Res Health Sci 2019;8:79-85.
Lee CH, Chang FC, Hsu SD, Chi HY, Huang LJ, Yeh MK. Inappropriate self-medication among adolescents and its association with lower medication literacy and substance use. PLoS One 2017;12:e0189199.
Abay SM, Amelo W. Assessment of self-medication practices among medical, pharmacy, and health science students in Gondar University, Ethiopia. J Young Pharm 2010;2:306-10.
Sawalha AF. A descriptive study of self-medication practices among Palestinian medical and nonmedical university students. Res Social Adm Pharm 2008;4:16472.
Alshogran OY, Alzoubi KH, Khabour OF, Farah S. Patterns of selfmedication among medical and nonmedical University students in Jordan. Risk Manag Healthc Policy 2018;11:169-76.
Albusalih FA, Naqvi AA, Ahmad R, Ahmad N. Prevalence of self-medication among students of pharmacy and medicine colleges of a public sector university in Dammam City, Saudi Arabia. Pharmacy (Basel) 2017;5:51.
Aljaouni ME, Hafiz AA, Alalawi HH, Alahmadi GA, AlKhawaja I. Self-medication practice among medical and non-medical students at Taibah University, Madinah, Saudi Arabia. Int J Acad Sci Res 2015;3:54-65.
Kumar N, Kanchan T, Unnikrishnan B, Rekha T, Mithra P, Kulkarni V, et al
. Perceptions and practices of self-medication among medical students in coastal South India. PLoS One 2013;8:e72247.
AlRaddadi KK, Barakeh RM, AlRefaie SM, AlYahya LS, Adosary MA, Alyahya KI. Determinants of self-medication among undergraduate students at King Saud University: Knowledge, attitude and practice. J Health Spec 2017;5:95-101. [Full text]
Karimy M, Rezaee-Momtaz M, Tavousi M, Montazeri A, Araban M. Risk factors associated with self-medication among women in Iran. BMC Public Health 2019;19:1033.
Chawda HM, Panchasara AK. Self-medication among medical and dental students in tertiary care teaching hospital of Udaipur, India. Int J Basic Clin Pharmacol 2018;7:1637-41.
Kalyan VS, Sudhakar K, Srinivas P, Sudhakar GVS, Pratap KVNR, Padma TM. Evaluation of self-medication practices among undergraduate dental students of tertiary care teaching dental hospital in South India. J Educ Ethics Dent 2013;3:21-5. [Full text]
Seam OR, Bhatta R, Saha BL, Das B, Hossain MM, Uddin SM, et al
. Assessing the perceptions and practice of self-medication among Bangladeshi undergraduate pharmacy students. Pharmacy 2018;6:6.
Aldeeri A, Alzaid H, Alshunaiber R, Meaigel S, Shaheen NA, Adlan A. Patterns of self-medication behavior for oral health problems among adults living in Riyadh, Saudi Arabia. Pharmacy (Basel) 2018;6:15.
Abu-Mostafa NA, Al-Mejlad NJ, Al-Yami AS, Al-Sakhin FZ, Al-Mudhi SA. A survey of awareness related to the use of antibiotics for dental issues among non-medical female university students in Riyadh, Saudi Arabia. J Infect Public Health 2017;10:842-8.
Albatti TH, Alawwad S, Aldueb R, Alhoqail R, Almutairi R. The self medication use among adolescents aged between 13–18 years old; Prevalence and behavior, Riyadh-Kingdom of Saudi Arabia, from 2014–2015. Int J Pediatr Adolesc Med 2017;4:19-25.
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4]