Self-medication among the elderly in Iran: a content analysis study

Abstract

BackgroundSelf-medication is described as the use of drugs without a physician’s prescription to treat self-recognized illness or symptoms, and an important health issue among the elderly. Despite the wide range of different definitions, recognizing all forms of self-medication among older adults, particularly, in developing countries, help healthcare professionals and providers to reduce harmful effects of self-medication. The purpose of this study is to describe the practice of self-medication and its related factors among elderly people in Iran based on the experiences of people who are involved in this phenomenon.MethodsThis qualitative study was conducted using content analysis. Purposive sampling was used to select the participants and continued until saturation. The participants were the elderly, their care-givers, physicians, and pharmacists. Data was collected using semi-structured interviews, and analysis was done using an inductive approach. The theory of planned behavior was used as a framework to explain the role of the emerged factors in the occurrence of self-medication behavior.ResultsBased on the expressed experiences of the participants, factors related to the practice of self- medication among the elderly in Iran fit in these 5 categories: “patient’s attitudes towards disease, treatment, and physicians”, “living with disease”, “unfriendly environments”, “enabling health system”, and “influential others”.ConclusionsBased on the results of this study, self-medication of the elderly in Iran has commonalities with many countries in regard to over-the-counter medications and complementary and alternative medicine; however, self-medication is also seen with drugs that require a prescription but can easily be obtained from pharmacies. Contributing factors, apart from the elderly themselves, include their families, caregivers, and social circle, the physical environment where they live, and the health system from which they receive services.

Prevalence and associated factors of self-treatment behaviour among different elder subgroups in rural China: a cross-sectional study

“…Some studies indicated that the self-care practice of some patients with chronic diseases is associated with the high perceived susceptibility of disorders [48,49]. On the other hand, elders with the habits of self-care in TCM have higher affinities to TCM [34], and these elders tend to seek medical help in TCM sectors, in which they may be confronted with less barrier during the process of seeing and communicating with doctors compared to the western medicine sectors [51,52], especially for empty-nest elders without support from younger family caregivers [12]. These findings may explain the lower rate of self-treatment among elders with higher affinities for TCM in this empty-nest subgroup.…”

“…According to the WHO, selfmedicine refers to the use of medicine by individuals to treat self-recognised illness or symptoms [11]. The forms of self-medication included over-the-counter (OTC) medicine use, prescription medication purchased using expired and non-refillable prescriptions, leftover drugs from old prescriptions, prescription medications offered by family and friends, and so on [12]. Besides selfmedication, there are other common approaches of selftreatment including massage, physiotherapy and so on.…”

“…Female sex, visits to pharmacists, depression, functional dependency, recent hospitalisation, oral pain and restriction of physical inactivity are positively associated with self-medication, whereas medical appointments, married status, use of health services, satisfaction with living arrangement, living in institutional settings and private health plans are negatively related to the choice of self-medication [9]. Long-term illness is broadly proven to be associated with the higher possibility of self-medication [12] or self-treatment [17]. The decision to self-treat involves an interaction between internal dynamic and external strengthening mechanisms, including individual, household, accessibility and medical insurance system factors [17].…”

Application of Freire's Adult Education Model in Modifying the Psychological Constructs of Health Belief Model in Self-medication Behaviors of Elderly: a randomized controlled trial

“…Some possible methods of getting hold of medications may include access to medicines without a prescription, using previously prescribed medications for similar cases, distributing prescribed medicines among family members and friends, as well as using the leftover medicines (1,2). In addition, refusing to comply with prescriber's instructions by taking relatively high dose of a medicine or for long period of time, or even declining to complete the prescribed course of treatment can be considered under the same concept (3,4). Chronic diseases that mostly affect older people lead to pain, disability, decline in quality of life, and increased need for medications.…”

“…Likewise, several studies suggest that the costs of treatment rise as people get older (3,6). Previous studies show complications of self-medication among elderlies can cause even more harms than good; therefore, it seems to be fundamental to identify such underlying behaviors and try to modify them so that the elderlies can have a long and healthy life (7).…”