Epidemiology of self-medication in Ethiopia: a systematic review and meta-analysis of observational studies

Abstract

BackgroundSelf-medication is the use of drugs to treat self-diagnosed disorders and/or symptoms, or the intermittent or continued use of a prescribed drug for recurrent disease or symptoms. This phenomenon is alarmingly increasing over time despite the occurrence of health-related hazards. This study is, therefore, aimed to quantitatively estimate self-medication practice and possible reasons for it in Ethiopia.MethodsData were identified from major databases and indexing services including EMBASE (Ovid), PubMed, MEDLINE (Ovid), and Google Scholar. Both published and unpublished records addressing self medication practice in Ethiopia without time limit were included for the study. Data were extracted with structured format prepared in Microsoft Excel and exported to OpenMeta[analyst] version 3.3 software for analyses. Pooled estimation of outcomes was performed with DerSimonian-Laird random-effects model at 95% confidence level. Sensitivity and subgroup analyses were also considered. Degree of heterogeneity of studies was presented with I2 statistics. Publication bias was also performed with the help of Comprehensive Meta-Analysis version-3 software and presented with funnel plots of standard error supplemented by Begg’s and Egger’s tests. The study protocol is registered on PROSPERO with reference number ID: CRD42018093790.ResultsA total of 27 studies with 9586 participants were included for the study. The pooled prevalence of self-medication in Ethiopia was found to be 44.0% (95% confidence interval [CI]: 35.1, 52.8). Geographical-based subgroup analysis revealed that the highest prevalence was observed at the capital of Ethiopia, Addis Ababa, 62.8% (95% CI: 42.3, 83.2). Population based analysis indicated that healthcare professionals and students were the main practitioners of self-medication. Besides, the prevalence of self-medication practice in pregnant women is approximately 22.9% (95% CI: 9.8, 36). The most common reasons to practice self-medication were previous experience of clients and/or familiarity of treatments, 31.3% (95% CI: 21.5, 41.1) and perceived mildness of the illness, 31.1% (95% CI: 26.0, 36.2). The pooled prevalence of analgesics, antimicrobial agents and gastrointestinal drugs were 46.1% (95% CI: 36.2, 56.1), 28.2% (95% CI: 19.6, 36.8), and 14.9% (95% CI: 7.8, 21.9), respectively.ConclusionSelf-medication practice becomes a common phenomenon in Ethiopia. The use of prescription-only medications including antimicrobial agents without medical consult has become alarmingly high. This practice will come with potential health related hazards including emergence of antimicrobial resistance. Therefore, there must be a multitude of strategies for reversing the current worrying trends of self-medication.Electronic supplementary materialThe online version of this article (10.1186/s40360-018-0248-8) contains supplementary material, which is available to authorized users.

<p>Self-Medication Practices and Associated Factors Among Health-Care Professionals in Selected Hospitals of Western Ethiopia</p>

“…This finding was correlated with previous reports done in different areas. 2,8,9,13,19,22,27 This means that HCPs particularly physicians had imposed their subjective judgment in determining both their diagnosis and treatment. 8,22,45 Indeed, it has been observed that HCPs get access to medication as well as their knowledge of drug use is a major reason for the high rate of the SMPs.…”

“…The World Health Organization (WHO) defined self-medication (SM) as "the use of drugs to treat self-diagnosed diseases or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms". [1][2][3] SM as one element of self-care involves the process of getting and consuming drugs without the advice of a physician either for diagnosis, treatment, prescription, surveillance or monitoring. [4][5][6][7][8][9] It is also associated with the selection, procurement and use of medicines by individuals to treat self-diagnosed conditions as well as giving medications to other household members or dependent.…”

“…13 Populationbased analysis indicated that the prevalence of SMPs is alarmingly high among health-care professionals (HCPs), despite knowing the consequences and potential risks. 2,19,20 The problem of SM among HCPs represents serious issues for both patients and physicians. 21,22 The medical profession expects patients to seek appropriate medical help when they encounter significant problems with their health and yet HCPs do not behave in this way when it comes to their health.…”

“…26 However, inappropriate SMP could have serious implications and global concern especially among elderly and special physiological conditions like pregnancy and lactation. 2,23,[28][29][30][31] It results in economic wastages, drug interactions, contraindication, prolong suffer, damaging of vital organs as well as responsible for the development of antimicrobial-resistant pathogens. 22,24,30,32 It is also hazards to health because of the wrong diagnosis, inappropriate dosage regimen, risk of adverse drug reactions, incorrect choice of therapy, use of unnecessary expensive drugs, masking of severe disease as well as the risk of dependence and abuse.…”

“…8 Temporal increment and high prevalence of SM among HCPs is also a major bottleneck for Ethiopia. 2,10 In Ethiopia, the extent of SMPs among HCPs is not yet fully known. The study aimed to assess the current situation of SMP among HCPs in governmental hospitals of Western Ethiopia.…”