A systematic review of self-medication practice during the COVID-19 pandemic: implications for pharmacy practice in supporting public health measures

Abstract

IntroductionSince the COVID-19 pandemic, self-medication had become highly popular due to the risk of virus infection and overwhelming medical resources. Pharmacists are well-positioned to provide public health education and disease prevention. This study aims to provide an overview of the research about self-medication during COVID-19 and the role of pharmacists in ensuring the drug safety related to self-medication.MethodsDatabases (PubMed, Google Scholar, Scopus, EBSCO host, and Web of Science) were searched for published studies on the practice of self-medication in COVID-19 pandemic without restriction in population and location. Primary search terms were “self-medication,” “self-care,” “self-management,” “non-prescription drugs,” “2019nCoV,” and “COVID-19.” Studies conducted during the pandemic but not exclusively for COVID-19 disease were eligible for inclusion.ResultsThe database search yielded a total of 4,752 papers. After appropriate screening, 62 articles met the inclusion criteria. Most of the studies were cross-sectional in nature. The review highlighted a very high prevalence of self-medication during COVID-19, ranging from 7.14 to 88.3%. The purpose of self-medication was mainly to treat and prevent COVID-19; fever, body aches, cough, headache, and sore throat were the most frequently mentioned indications. Categories of drugs commonly used in self-medication included antibiotics, herbs, vitamins, and analgesics, most of which came from pharmacies. Information about self-medication usually obtained from relatives and friends, social networks and health care professionals. Common reasons for self-medication included saving money and time, prior experience and mild illness; reasons associated with COVID-19 were mainly fear of contracting the virus and poor access to doctors. Gender, age, education, marital status, and concern about COVID-19 were the most usual associated factors. The role of pharmacists in self-medication included sources of information, advice on medication use, and management of adverse reactions.ConclusionDuring the COVID-19 pandemic, self-medication practices were widespread and varied across countries and populations. Self-medication has emerged as an important component of health care, but also as a huge global challenge. The engagement of healthcare administrators and policy makers are essential to regulate self-medication practices. The expertise and favorable conditions of pharmacists make them positioned as key roles in public health interventions for self-medication.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=395423, identifier CRD42023395423.

Assessing the Reasons and Adverse Effects of Self-Medication in the Context of the COVID-19 Pandemic in Sierra Leone. A Case Study of Moriba Town Section

“…Other studies conducted in Columbia and Saudi Arabia also showed a higher prevalence of selftreatment, 60,61 pointing to the necessity for addressing the factors that drive individuals to self-medicate of which the most common were fears related to infection, quarantine, and societal stigma were the predominant motivations for selfmedication. 62,63 However, studies done on self-medication during COVID-19 pandemic in: United States 13%, Australia 11%, Germany 11%, Spain 9%, United Kingdom 9%, Mexico 8%, and Italy 8% 64 showed disparity with the current report which may be due to drug policies and better health infrastructure. Nonetheless, this reflects the heightened anxiety and concerns prevalent during the pandemic, emphasizing the need for clear communication and support mechanisms.…”

“…The main issues with self-medication include resource waste, boosting pathogen resistance, and significant risks to health such as adverse effects, drug interactions, abuse, and extended pain are just a few of the problems that come with unsupervised medication. 27 , 28 Antimicrobial resistance is a worldwide issue attributed to self-medication, particularly in underdeveloped nations where drugs are readily accessible. 26…”

Development and psychometric properties of a self-medication behavior inventory

“…For this purpose, a logical or deductive partitioning method was used, which included literature review and evaluation of the indicators of the construct to be measured. The literature review highlighted four dimensions critical to self-medication behavior: Avoidance (Sharif et al, 2012 ; Castillo Martínez and Pérez-Acosta, 2021 ; Zambrano Barriga and Cusme Torres, 2023 ), Prevention (Zheng et al, 2023 ), Influence (Burak and Damico, 2000 ; Anghel and Craciun, 2013 ; Zeb et al, 2022 ) and Attitude (Krueger et al, 2005 ; Parihar et al, 2018 ; Sulistyowatia et al, 2022 ).…”

“…Prevention, as discussed by Zheng et al ( 2023 ), encompasses actions taken to prevent disease or discomfort (Sharif et al, 2012 ).…”

“…Such behaviors tend to increase and are further reinforced by the safety signals accompanying avoidance responses, offering positive reinforcement (Domjan and Grau, 2015 ). In the same direction, there are prevention measures derived from the fear of contracting a contagious disease (Zheng et al, 2023 ). Furthermore, individuals might seek to avoid the discomfort or inconvenience associated with long waits at health clinic (Sharif et al, 2012 ) or the avoidance of aversive states of negative affect (Kassel, 2010 ).…”