Data Mining of community pharmacy records unearthed massive self-medication for treatment of COVID-19 in Uganda

ABSTRACT

Introduction/ Background: Self-Medication (SM) involves the utilisation of medicines to treat self-recognised symptoms or diseases without consultation and irrational use of over-the-counter drugs. We aimed to estimate the extent of SM for drugs used to treat COVID-19 symptoms through data mining of community pharmacy records in Uganda. Methods: The study was conducted in Kampala, Uganda where we extracted data from community pharmacies with functional Electronic Health Records between January 2018 and June 2021. The data included number of clients purchasing the following drugs that were used to treat COVID-19 and its symptoms Azithromycin, Augmentin, Dexamethasone, Vitamin C, Vitamin D and Zinc. A negative binomial model was used to estimate the incident rate ratios for each drug to compare the effect of COVID-19 on SM. Data mining, cleaning and analysis were performed using R Software. Results: We extracted data from 10 community pharmacies in Kampala. 369 clients purchased at least one of the six drugs in the 12 months preceding March 2020 and a three-fold increase of 1202 customers between March 2020-June 2021. There was a statistically significant increase in SM of Azithromycin during the COVID-19 pandemic with Incidence Rate Ratio (IRR) 1.17 (95% CI 1.06 - 1.32), 1.07(95% CI 1.04-1.11) for Vitamin C, and 2.13 (95% CI 1.02 - 6.05) for Vitamin D. We observed non- significant increases, 1.04 (95% CI 0.88-1.26) for Augmentin, 1.21 (95% CI 0.94-1.68) for Dexamethasone, and 1.11 (95% CI 0.94-1.68) for Zinc. Impact During the COVID-19 pandemic, the lack of definitive treatment or limited access to vaccines led to increased SM. This work demonstrates the potential impact on SM on drug resistance and drug development pipelines needs to be explored through innovative data science tools. Conclusion: Community pharmacy data records are a valuable source for identification of SM in Africa. SM to treat COVID-19, including the irrational use of antibiotics and other OTC drugs may lead to polypharmacy and fuel the looming pandemic of antibiotic resistance.