Medical

Communication

Biosci. Biotech. Res. Comm. 9(4): 737-742 (2016)

A sociological study of self-medication

among 18-50 year-old people in Ahvaz

Ali Hossein Hosseinzadeh

, Abdoreza Navah

, Mehrnaz Mohammaedzadeh

, Fereidoon

Naja Shabankareh

and Maryam Ghanavati

Department of Social Sciences of Shahid Chamran University, Ahvaz, Iran

Research Attaris Expert, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

ABSTRACT

Self-medication is one of the problems encountered in treatment cycles. Unfortunately, given the prevailing social

perception of medicine as a safe and healing substance, the problem of self-medication not only seems inevita-

ble, but it should also be considered a social pathology. Thus, the present study was aimed at identifying the fac-

tors associated with indiscriminate use of drugs among 18-50 year-old citizens in Ahvaz. The present research

is a descriptive cross-sectional study conducted as a survey in 2013. Cluster random sampling was used to select

229 citizens of Ahvaz aged between 18 and 50 years as the sample. The required data were collected through a

questionnaire accompanied by an interview. Research  ndings showed that diazepam pills and cold tablets had

the highest frequency of consumption among the statistical population. Acetaminophens and antihistamines were

ranked next. The  ndings also indicated that awareness of the consequences of drug use, awareness of drug use

practices, public health level, and age had signi cant relationships with self-medication. Society’s unawareness and

common misconceptions and false beliefs among the public (drug use culture) are the most important reasons for

irrational and indiscriminate use of drugs in Iran, as compared to the global standards. Correcting wrong drug use

practices, especially self-medication, requires comprehensive public education and culture-building at the societal

level.

KEY WORDS: SELF-MEDICATION, SELF-TREATMENT, DRUG

737

ARTICLE INFORMATION:

*Corresponding Author: Naja -f@ajums.ac.ir

Received 13

Sep, 2016

Accepted after revision 25

Nov, 2016

BBRC Print ISSN: 0974-6455

Online ISSN: 2321-4007

Thomson Reuters ISI ESC and Crossref Indexed Journal

NAAS Journal Score 2015: 3.48 Cosmos IF : 4.006

reserved.

Online Contents Available at: http//www.bbrc.in/

738 A SOCIOLOGICAL STUDY OF SELF-MEDICATION AMONG 18-50 YEAR-OLD PEOPLE IN AHVAZ BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

Ali Hossein Hosseinzadeh et al.

INTRODUCTION

Medicine and its various branches are aimed at main-

taining and improving public health level and help-

ing patients regain their health. These goals are realized

through a series of factors. Provision, distribution and

consumption of drugs are among the keys to achieving

this goal(Afkar, 2006). In fact, drug use, as one of the

links of the treatment chain, is inevitable. Medical experts

believe that accurate and systematic use of drugs can lead

to patient recovery in many cases. Today, scienti c and

industrial advancements in medical and pharmaceuti-

cal  elds have provided access to a wide range of drugs.

Unsystematic access to drugs can cause many problems

such as indiscriminate and improper use of drugs(Arab

et al., 2014; Dejman et al., 2015). As deduced from the

discussions, drug use is linked to all cultural, social and

ideological aspects of society. Unfortunately, society only

perceives drugs as safe and healing substances, while the

medical literature considers any drug as a double-edged

sword. One edge of the sword  ghts with the causes of

disease and the other one can put human health at risk

due to the lack of awareness regarding the correct use of

the drug(Moghadam Nia and Ghadimi, 2000).

Currently, self-medication and improper use of drugs

is considered as one of the major healthcare problems in

many countries, especially Iran(Bennadi, 2014; Mogh-

adam Nia and Ghadimi, 2000). The  ndings of studies

conducted in various countries, including Iran, are indic-

ative of a high prevalence of self-medication and irra-

tional use of drugs. According t o the statistics provided

by the U.S. National Institute on Drug Abuse (NIDA), the

prevalence rate of self-medication has increased from

22.1% in 2002 to 32.71% in 2003 (Awad et al., 2008).

Furthermore, the prevalence rates of self-medication in

Bangladesh, Tanzania, Nigeria, and Nepal were reported

81%, 56%, 63%, and 75%, respectively (Mortazavi and

Hajebi, 2003)|.

Given Iran’s consumption culture, the country’s sit-

uation regarding irrational use of drugs is more criti-

cal. According to the latest statistics, Iran’s prevalence

rate of self-medication is almost three times the global

average rate. Thus, Iran is ranked the twelfth country

with the highest prevalence rate of self-medication in

the world. In Asia, It is ranked number two only after

China(Moghadam Nia and Ghadimi, 2000; Mortazavi

and Hajebi, 2003; Persell, 2011). The attempts made to

adjust Iran’s pattern of drug use have failed to bring

success and the country’s pharmaceutical system is still

faced with the problem of improper and indiscriminate

use of drugs and self-medication. This has caused bac-

terial resistance, failure of optimal treatment, uninten-

tional poisoning, unintended side effects and compli-

cations, pharmaceutical market disruption,  nancial

loss, and an increase in pharmaceutical expenditure per

capita in Iran(Sattari et al., 2012). Adjusting Iran’s pat-

tern of drug use and developing appropriate healthcare

policies aimed at preventing the increasing prevalence

of self-medication requires, in the  rst place, a detailed

understanding of the factors in uencing the consump-

tion behavior of individuals and scienti c explanation

of the phenomenon.

METHODS

This research was a descriptive-survey study. The statis-

tical population consisted of all 18-50 year-old citizens

who had visited 24-hour pharmacies in Ahvaz. The indi-

viduals would be considered in the study if they were

older than 18 years, at least literate and willing to par-

ticipate. The data collection tool was a researcher-made

questionnaire. The questionnaire consisted of two parts.

The  rst part dealt with demographic characteristics,

including gender, marital status, age, education, and job.

The second part covered research. The variables were

evaluated based on 40 items and a  ve-point Likert scale

(very high, high, medium, low, very low).

The questionnaire’s face and content validities were

measured. Accordingly, the questionnaire was prepared

based on the credible sources and books on the sub-

ject and presented to two experienced scholars in the

 elds of social and cultural studies for approval. Upon

approval, 40 questionnaires were distributed among the

population. Next, faculty members (from different uni-

versities) with adequate experience and expertise reeval-

uated the results obtained through completed question-

naires. Their comments and corrections were applied to

the questionnaire. Ultimately, the questionnaire’s valid-

ity was con rmed. Cronbach’s alpha coef cient was

used to measure the questionnaire’s reliability. The value

of alpha was 0.814. Therefore, the questionnaire had an

appropriate degree of reliability. Frequency, percentage

and mean values (descriptive statistics), Pearson’s cor-

relation coef cient, Spearman’s correlation coef cient,

and analysis of variance (ANOVA) (inferential statistics)

were used to analyze the collected data.

RESULTS

According to the descriptive statistics, the sample con-

sisted of 94 females (41%) and 135 males (59%). Of the

229 residents, 109 individuals were married (47.59%),

86 were single (37.55%), and 34 were divorced (14.88%).

Frequency distributions of other demographic variables

are shown in the demographic variables table (Table 1).

The  ndings showed that more than 92% of respond-

ents had practiced self-medication at least once last year.

BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS A SOCIOLOGICAL STUDY OF SELF-MEDICATION AMONG 18-50 YEAR-OLD PEOPLE IN AHVAZ 739

Ali Hossein Hosseinzadeh et al.

In addition, 34% of respondents had visited pharmacies

to buy drugs without a prescription. The prevalence of

self-medication was highest (35.4%) in the 30-49 age

group. The lowest prevalence of self-medication (7.2%)

was seen among teenagers (18-20 age group). Diaz-

epam pills and cold tablets had the highest frequency

of consumption among the statistical population. Aceta-

minophens and antihistamines were ranked next and

Magaldtrate suspension had the lowest frequency of

consumption (Figure 1).

In the inferential statistics section, Pearson’s corre-

lation coef cient was used to test research hypotheses.

As shown in Table 2, awareness of the consequences of

drug use, awareness of drug use practices, public health

level, and age had signi cant relationships with self-

medication. The relationship between self-medication

and awareness of the consequences of drug use is nega-

tive. In other words, an increase in awareness of the

consequences of drug use leads to a decrease in self-

medication. The relationship between age and self-med-

ication is positive, meaning self-medication increases

with age (Table 2).

As education is an ordinal variable, Spearman’s cor-

relation coef cient was used to test the related hypoth-

esis. The results showed that there was a signi cant

relationship between education and self-medication.

The relationship was very strong and negative, i.e., self-

medication decreased with education level (Table 3). In

addition, the results showed that no signi cant relation-

ship was found between gender, marital status, and job

of the respondents and self-medication.

Table 1: Distribution of demographic variables of

population

Variable Number Percent

Gender

Female 94 41%

Male 135 59%

Marital status

Married 109 47.60%

Single 86 37.56 %

Divorced 34 14.84

Education level elementary 39 17.03%

Junior 44 19.21%

Diploma 105 45.85%

Bachelor 22 9.61%

Graduate 19 8.30%

Employment status Practitioner 58 25.33%

Jobless 171 74.67%

FIGURE 1. Diagram of used drugs

740 A SOCIOLOGICAL STUDY OF SELF-MEDICATION AMONG 18-50 YEAR-OLD PEOPLE IN AHVAZ BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

Ali Hossein Hosseinzadeh et al.

Table 2: The relationship between awareness of the consequences of drug use,

awareness of drug use practices, Public health level and age

Variable Data interpretation

awareness of the

consequences of drug

use

The pearson correlation coef cient 1 -0.206

Signi cant level 0 0.002

Number 229 229

awareness of drug use

practices

The pearson correlation coef cient 1 -0.147

Signi cant level 0 0.026

Number 229 229

Public health level

The pearson correlation coef cient 1 -0.152

Signi cant level 0 0.021

Number 229 229

Age

The pearson correlation coef cient 1 -0.170

Signi cant level 0 0.010

Number 229 229

Table 3: The relationship between Education level and Drug use

Data interpretation Education level Drug use

Education level

correlation coef cient 1000 -0.189**

Signi cant level 0 0.004

Number 229 229

Drug use

correlation coef cient -0.189** 1000

Signi cant level 0.004 0

Number 229 229

DISCUSSION

According to the  ndings of the present study, the fol-

lowing drugs had respectively the highest percentage

of consumption among the respondents: diazepam,

cold tablets, acetaminophen-codeine, antihistamines,

Novafen, ibuprofen, cephalexin, and amoxicillin. Drugs

such as diazepam and lorazepam depress the central

nervous system. Although rational prescription of such

drugs by a physician has the desired effects on the

recovery of patients, indiscriminate and irrational use

of them can be very destructive(Buusman et al., 2007).

Given the pain-relieving properties and hypnotic effects

of these drugs, individuals will be more inclined to use

them over time and eventually become physically and

mentally dependent on them(Gunja, 2013).

Cold tablets are one of the drugs that are very widely

used for self-medication in Ahvaz. The results of new

studies published in the Journal of Pediatrics shows that

cold tablets can cause apnea (shortness of breath) in

children. In January 2008, U.S. Food and Drug Asso-

ciation (FDA) strictly prohibited over-the-counter cold

and cough medicines for children who are under age

two(Asta; Food and Administration, 2013)

Acetaminophens are one of the most commonly used

drugs in Iran. Most people take acetaminophens for

the slightest feeling of pain. Despite society’s percep-

tion of acetaminophens as simple and safe substances,

long-term use of these drugs can cause poisoning, which

in turn might lead to liver and kidney failure. In addi-

tion, use of codeine-based drugs and narcotic analge-

sic combinations can cause physical dependence over

time(Noshad et al., 2010).

From the pathological point of view, the results of

the present research indicated that there was a signi -

cant relationship between the awareness of the con-

sequences of drug use and self-medication. It seems

that Iranians’ mental image of drugs as safe and heal-

ing substances plays an important role in their drug

consumption behavior and self-medication practices

because many respondents believed that drugs used

for self-medication do not have signi cant side effects.

Selling of over-the-counter drugs by pharmacies has

also endorsed the aforementioned false belief. These

results are consistent with the results of two studies

conducted by Mohammadi et al. (2010) and Karimy

et al. (2010) (Al-Mohamadi et al., 2013; Karimy et al.,

2011).

BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS A SOCIOLOGICAL STUDY OF SELF-MEDICATION AMONG 18-50 YEAR-OLD PEOPLE IN AHVAZ 741

Ali Hossein Hosseinzadeh et al.

Naturally, drug use increases with age. Unfortu-

nately, self-medication and indiscriminate use of drugs

also tend to increase with age. Financial impotence and

physical disability are among the factors that contribute

to self-medication among the elderly(Azami-Aghdash et

al., 2015). Education was another variable that had a

signi cant relationship with indiscriminate use of drugs

and self-medication. Increase in the level of education

will not affect self-medication and indiscriminate use

of drugs in itself(Machado-Alba et al., 2014). Educa-

tion acts more like a mediator variable. Individuals with

a higher level of education are more aware and adopt

better decisions when faced with problems, diseases,

etc(Azami-Aghdash et al., 2015).

Although  ndings showed not signi cant relation-

ships between the respondents’ gender, martial status,

and job and self-medication, the results indicated that

females, married people and employed individuals prac-

tice self-medication more frequently than males, sin-

gle people and unemployed individuals. Unemployed

females show a stronger tendency towards use of tradi-

tional drugs and home remedies.

CONCLUSION

The problem of self-medication and indiscriminate use

of drugs has become a culture in the Iranian society and

is widely prevalent in the country. Unaware of the dire

consequences of self-medication for their health, many

people are very careless in using unprescribed drugs.

Society’s unawareness and common misconceptions and

false beliefs among the public (drug use culture) are the

most important reasons for irrational and indiscriminate

use of drugs in Iran, as compared to the global stand-

ards. Correcting wrong drug use practices, especially

self-medication, requires comprehensive public educa-

tion and culture-building at the societal level. Pharma-

ceutical macro-plans and policies should change direc-

tion so that intervention measures can be taken in order

to minimize the underlying factors of drug abuse and

use of harmful drugs. These measures include: (1) limit-

ing society’s unconditional access to drugs (2) educating

people on the rational use of drugs and restricting the

amount and type of drugs stored at home, (3) improving

the quality of health and medical services and increas-

ing public access to healthcare delivery system, and (4)

instructing people on how to use and store drugs (by

physicians and pharmacists).

AUTHORS CONTRIBUTIONS

All authors had equal role in design, work, statistical

analysis and manuscript writing.

Con ict of interest

The authors declare no con ict of interest.

FUNDING/ SUPPORT

This study was  nancially supported by grant U-95071

from the Ahvaz Jundishapur University of Medical Sci-

ences, Ahvaz, IR Iran

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