Original Article

Prevalence and pattern of self-medication

practices in an urban area of Delhi, India
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Varun Kumar, Abha Mangal, Geeta Yadav, Deepak Raut, Saudan Singh
Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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ABSTRACT
Quick Response Code:
Background: Self-medication is one of the major health concerns Website:
worldwide and World Health Organization has laid emphasis on www.mjdrdypu.org
correctly investigating and controlling it. There is much public and
professional concern regarding self-medication practices, which DOI:
has dramatically increased in the last few decades, especially
10.4103/0975-2870.148828
in the developing countries. Hence, this study was designed to
study the prevalence and practice of self-medication practices in
an urban area of Delhi, India. Materials and Methods: A cross-
sectional study was conducted in March 2013 and data were prevalence in India increasing from 31% in 1997[2] to 71%
collected by personal interviews using pretested questionnaires. in 2011.[3] The nature and extent of self-medication varies
An urban colony in the south district of Delhi was chosen and the according to cultural, social, and educational influences.[4]
eldest member of the family, present at the time of the visit was
interviewed. Data were collected from 236 persons and analyzed
using SPSS version 21. Results: The prevalence of self- World Health Organization has defined self-medication
medication was 92.8% (95 confidence interval: 66.5-79.4). 74.9% as “use of pharmaceutical or medicinal products by the
preferred allopathic medicines. Self-medication was found to be consumer to treat self-recognized disorders or symptoms,
practiced more among younger persons than older age group the intermittent or continued use of a medication previously
persons (P = 0.000). Graduates and postgraduates practiced self-
prescribed by a physician for chronic or recurring disease
medication more than others (P = 0.002). Common cold (61.6%)
and fever (51.8%) were the most common ailments for which or symptom, or the use of medication recommended by
self-medication were practiced. Paracetamol and cough syrups lay sources or health workers not entitled to prescribe
were the most commonly used class of drugs. Conclusion: The medicine.”[5]
prevalence of self-medication in this study was high. Drugs
especially antimicrobials were not taken for the proper length
Self-medication is associated with risks such as misdiagnosis,
of time. Awareness regarding self-medication practices to help
patients decide on the appropriateness of self-medication is use of excessive drug dosage, prolonged duration of
required. use, wastage of resources, and increased resistance to
pathogens.[6] Further there is an increase in the promotion
Keywords: India, self-medication, urban area of self-medication products, which has enhanced consumer
and patient awareness of the availability of products.[7]
Introduction Despite these drawbacks, self-medication is an important
Self-medication is one of the major health concerns component of primary health care. There are some
worldwide and World Health Organization (WHO) has advantages of self-medication like treating minor symptoms
laid emphasis on correctly investigating and controlling it.[1] and ailments that do not require medical attention and
There is much public and professional concern regarding thereby decreasing the burden on delivering health
self-medication practices, which has dramatically increased care. However, there are several critical issues that must
in the last few decades, especially in the developing be explored before promoting the potential benefits of
countries. Studies have reported wide variations in its self-medication. Any self-medication product should be safe

Address for correspondence:

Dr. Varun Kumar, Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
E-mail: [email protected]

16 Medical Journal of Dr. D.Y. Patil University | January-February 2015 | Vol 8 | Issue 1
 Kumar, et al.: Self-medication practices in India

for use. This implies the availability of appropriate consumer the study after explaining the purpose of the study. Written
information and avoidance of any delay in diagnosis and informed consent was obtained from the study participants
treatment of diseases not suitable for self-medication.[8] and thumb imprint was obtained from illiterates after
assuring full confidentiality. Then, they were personally
Since the individual bears the primary responsibility for interviewed.
using self-medication, they should be able to recognize
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the symptoms they are treating, to determine that their Sample size
condition is suitable for self-medication, to choose an The prevalence of self-medication practices was 31.3% in
appropriate self-medication product and to follow the a similar study conducted in urban resettlement colony in
directions for use of the product as provided in the product New Delhi.[12] This was used to determine the minimum
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8KKGKV0Ymy+78= on 12/22/2023

labeling.[9] sample size for this study using the formula, n = z2pq/d2,
where n = minimum sample size; z = 1.96 at 95% confidence
As per drug laws applicable to India, self-medication are interval obtained from standard statistical table of normal
permitted for over-the-counter (OTC) drugs, but in India distribution; P = estimated prevalence of self-medication
there is no specific list of OTC drugs. The OTC Committee in a given population (31.3% or 0.313); q = precision that
of the Organization of Pharmaceutical Producers of India is, (1-p) or 0.687 and d = relative error of 20%. Using this
is working toward the promotion of responsible self- formula the minimum sample size calculated was 211 and
medication and creating awareness in the general public in this study, data were collected from 236 individuals.
as well as the government.[10] Self-medication in modern Data were analyzed using Statistical Package for Social
pharmaceuticals seems to be a field in which information is Sciences (SPSS) version 21, IBM. Chi-square test was used for
scarce and only a very little information has been available drawing statistical inferences and P < 0.05 were considered
about self-medication and its major determinants, especially as significant.
in developing countries.[11] Hence, the present study was
designed to study the prevalence of self-medication and its Operational definition
pattern in an urban area of Delhi, India. For the purpose of study, self-medication is defined as use
of any pharmaceutical or medicinal products to treat self-
Materials and Methods recognized disorders or symptoms in the previous 1 month.

Study design Results

This study was of cross-sectional design and conducted
Among 236 study participants, 130 (55.1%) were males.
during the months of March and April 2013. The district of
81 (34.3%) were between 30 and 39 years of age and
South Delhi was selected by convenience due to easy access.
216 (91.5%) belong to Hindu religion. On educational
There are 16 urban colonies in the selected district and one
background, 151 (64%) were graduates and 36 (15.3%)
among them was selected by simple random sampling. House
were postgraduates. According to revised Kuppusamy’s
listing was done in the selected urban colony and every fifth
socioeconomic classification 2012, 144 (61%) belong to
house was included in the study.
upper middle socioeconomic class [Table 1].
Data collection
Of 236 study participants, 219 (92.8%) people took
Data were collected by personal interviews by trained medicines without doctor’s prescription and among them
personnel using pretested questionnaire. Study subjects 164 (74.9%) preferred allopathic medicines. There was
were the elder most members in each of the selected house no significant association between self-medication and
available at the time of visit. If any of the members of the gender (P = 0.182), but there was a significant association
selected house cannot be reached after three consecutive with age (P = 0.000) with younger age groups practicing
visits, the next house was included in the study. Registered self-medication more than older age group persons.
medical practitioner, pharmacist, nurse, and paramedic Significant association was also found with educational
personnel were excluded along with those who refused to statuses of the study participants (P = 0.002), with graduates
participate in the study. and postgraduates practicing self-medication more than
others. However, there was no association with religion
Ethical issues (P = 0.566) and socioeconomic status (P = 0.213) [Table 2].
Resident Welfare Association of the selected urban colony Awareness about self-medication was seen in 226 (95.8%)
was contacted and their permission was obtained to conduct study subjects [Table 3].

Medical Journal of Dr. D.Y. Patil University | January-February 2015 | Vol 8 | Issue 1 17
 Kumar, et al.: Self-medication practices in India

Table 1: Distribution of study subjects according to socio-demographic Table 2: Distribution of study subjects according to self-medication
factors (n = 236) practices (n = 236)
Socio-demographic factors Number Percentage Socio-demographic factors Self-medication P value
Age in completed years Present (%) Absent (%)
<20 6 2.5 Age in completed years
20-29 54 22.9 <20 5 (83.3) 1 (16.7) 0.000
30-39 81 34.3 20-29 52 (96.3) 2 (3.7)
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40-49 60 25.4 30-39 77 (95.1) 4 (4.9)

50-59 33 14.0 40-49 55 (91.7) 5 (8.3)
>60 2 0.8 50-59 30 (90.9) 3 (9.1)
Sex >60 0 (0.0) 2 (100.0)
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Male 130 55.1 Sex

Female 106 44.9 Male 118 (90.8) 12 (9.2) 0.182
Religion Female 101 (95.3) 5 (4.7)
Hindu 216 91.5 Religion
Islam 13 5.5 Hindu 201 (93.1) 15 (6.9) 0.566
Sikh 6 2.6 Islam 12 (92.3) 1 (7.7)
Christian 1 0.4 Sikh 5 (83.3) 1 (16.7)
Educational status Christian 1 (100.0) 0 (0.0)
Illiterate 5 2.1 Educational status
Primary school 3 1.3 Illiterate 3 (60.0) 2 (40.0) 0.002
Middle school 4 1.7 Primary school 2 (66.7) 1 (33.3)
High school 37 15.6 Middle school 3 (75.0) 1 (25.0)
Graduate 151 64.0 High school 33 (89.2) 4 (10.8)
Postgraduate 36 15.3 Graduate 145 (96.0) 6 (4.0)
Socioeconomic class (revised Postgraduate 33 (91.7) 3 (8.3)
Kuppuswamy classification, 2012) Socioeconomic class (revised
Upper 77 32.6 Kuppuswamy classification, 2012)
Upper middle 144 61 Upper 71 (92.2) 6 (7.8) 0.213
Lower middle 12 5.1 Upper middle 135 (93.8) 9 (6.2)
Upper lower 2 0.8 Lower middle 11 (91.7) 1 (8.3)
Lower 1 0.4 Upper lower 1 (50.0) 1 (50.0)
Lower 1 (100.0) 0 (0.0)

Among those who practice self-medication, 117 (53.4%)

had used it more than twice during the last 3 months and 26 Table 3: Awareness about self-medication among study subjects
(11.9%) had spent more than six hundred rupees for it during (n = 226)
Awareness about self-medication* Number (%)
the same duration. 159 (72.6%) felt that self-medication was
Taking drugs without prescription 164 (72.6)
more convenient while 49 (22.3%) felt that it was cheap and
Herbal remedies 54 (23.9)
30 (13.6%) replied they resorted to self-medication because Food supplements 38 (16.8)
of nonavailability of doctors. Traditional products 38 (16.8)
*Multiple responses

Regarding the sources of information for the self-medication,

majority 102 (46.5%) started using it from their own past experience 85 (38.8%) followed by consulting a pharmacist
experience. Cough 135 (61.6%) was the most common 65 (29.6%). 106 (55.7%) study subjects reported that they
symptom for using self-medication followed by fever 131 can fully understand all the instructions given in the
(59.8%). Paracetamol was the most commonly used drug package insert while 80 (42.1%) reported that they could
followed by cough syrups and 16 (7.3%) experienced side- only partly understand and 4 (2.2%) reported they can’t
effects of drugs during the course of the self-treatment understand at all.
[Table 4].
Antibiotics were used by 52 (23.7%) participants practicing
With respect to self-medication usage, the type self-medication reported using antibiotics and among them
of medicine 114 (52.1%) was the most important 42 (80.7%) changed the dose of antibiotic during the course
consideration followed by the brand of medicine 83 of self-treatment. 14 (27%) switched antibiotics and the
(37.9%). In majority of cases, knowledge regarding the availability of cheaper alternative antibiotic was the main
dosage of self-medication was obtained through previous reason for switching antibiotics. 40 (76.9%) reported they

18 Medical Journal of Dr. D.Y. Patil University | January-February 2015 | Vol 8 | Issue 1
 Kumar, et al.: Self-medication practices in India

stopped taking antibiotic as soon as the symptom got relieved Overall only 23 (9.7%) people considered self-medication
without completing the entire course of treatment. The as a good practice. 131 (55.5%) said it was acceptable, while
average duration for which an antibiotic was used was 3.17 only 82 (34.8%) felt self-medication was not an acceptable
days [Table 5]. practice. 90 (38.1%) subjects felt confident that they were
competent enough in treating common ailments using
Table 4: Distribution of study subjects according to self-medication self-medication.
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practices (n = 219)
Self-medication practices Number (%) Discussion
Sources of information*
My own experience 102 (46.5) The prevalence of self-medication was found to be 92.8% in
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DoctorÊs old prescription 96 (43.8) the present study. This was very high when compared with
Recommendation by chemists 78 (35.6)
a study done by Lal et al.[12] in an urban resettlement colony
Opinion of family members 78 (35.6)
in Delhi during 2005 which reported prevalence of 31.3%. In
Opinion of friends 44 (20.1)
Advertisement 26 (11.8)
this study, self-medication practices were significantly more
Recommendation by net citizens 12 (05.5) in younger age group persons and also among graduates.
Common ailments for using self-medication* This high prevalence found in this study can be attributed
Common cold 135 (61.6) to better educational status and socioeconomic background.
Fever 131 (59.8) Similar studies carried out in India showed the prevalence of
Runny nose 93 (42.4) self-medication as 37% in urban areas and 17% in rural areas
Aches and pains 91 (41.5)
in India.[13] There was wide variation in prevalence of self-
Sore throat 57 (26.1)
Nasal congestion 53 (24.2)
medication ranging from 12.7% to 95% in other developing
Diarrhea 33 (15.1) countries.[14,15] Due to the different socioeconomic profiles
Vomiting 29 (13.2) and demographic characteristics of the populations studied,
Skin wounds 25 (11.4) it was difficult to compare the results.
Drugs used*
Paracetamol 167 (76.2) The common sources of information regarding self-
Cough syrups 129 (58.9) medication in the present study were found to one’s own
Digene 77 (35.1)
personal experience and doctors’ old prescription. Similar
Cetrizine 55 (25.1)
results were obtained in a study conducted in Karachi,
Antibiotics 52 (23.7)
Dependal 45 (20.5) Pakistan.[16] Results of the present study indicated that the
Rantac 33 (15.1) most common reasons for self-medication were minor
*Multiple responses ailments (68%) and lack of time to consult a doctor (26%),
which is similar to a study that reported the reasons as mild
Table 5: Distribution of study subjects according to antibiotic usage
illness (40%) and shortage of time to consult a doctor (32%).[1]
pattern
Antibiotic usage pattern Number (%) The most common reasons for self-medication in the present
Reasons for changing dosage of antibiotic (n=42)* study were found to be common cold (61.6%) and fever
Improving conditions 31 (73.8) (51.8%). Paracetamol and cough syrups were the most
To reduce adverse reactions 12 (28.5) commonly used class of drugs, which is similar to a study
Worsening conditions 10 (23.8)
done in Ahmadabad, India.[17] In concordance with previous
Drug insufficient for complete treatment 4 (9.5)
results,[18] our results also indicate that antimicrobials were not
Reasons for switching antibiotics (n=14)*
To reduce adverse reactions 9 (64.2)
commonly used for self-medication, and were mostly obtained
The former antibiotics didnÊt work 8 (57.1) on prescription and among those who use antibiotics; most
The latter one was cheaper 7 (50) of them did not take it for a complete course. The average
The former antibiotics ran out 6 (42.8) duration for which an antibiotic was used was 3.17 days. The
Reasons for stopping antibiotics (n=52)* duration of drug use was arrived at by asking the respondents,
After a few days regardless of outcome 5 (9.6) and “recall” bias may be a confounding factor.
After symptoms disappeared 39 (75)
A few days after the recovery 25 (48)
This study was conducted in an urban background having
After antibiotics ran out 3 (5.7)
At the completion of the course 22 (42.3)
relatively better socioeconomic and educational conditions
After consulting a doctor/pharmacist 8 (15.3) compared with the rest of India. The usage of self-medication
*Multiple responses was asked for the previous 3 months in which recall bias

Medical Journal of Dr. D.Y. Patil University | January-February 2015 | Vol 8 | Issue 1 19
 Kumar, et al.: Self-medication practices in India

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