Diseño, construcción y evaluación de una escala para medir la actitud hacia la automedicación en adolescentes / Design, construction and assessment of a scale to measure the attitude towards the self-medication in adolescents

Fundamentos: En las últimas décadas se está produciendo un incremento en la conducta de automedicación de los jóvenes. Aunque existen distintos instrumentos que tratan de medir la conducta de automedicación, ninguno aborda la medición de la actitud que subyace. El objetivo de este trabajo fue diseñar y evaluar una escala de medida de la actitud hacia la automedicación en los adolescentes y la valoración de sus propiedades psicométricas. Métodos: Construcción y validación de una escala de actitud hacia la automedicación a partir de los datos obtenidos en febrero de 2012 de 665 adolescente con media de edad 15.5 años (D.T = 1.1) en centros educativos de la Comunidad de Madrid. Para la validación de la escala se realizó un Análisis Factorial Exploratorio (AFE) y un Análisis Factorial Confirmatorio (AFC). Resultados: El AFE reveló tres factores latentes: Automedicación y regulación de emociones negativas (9 ítems), Automedicación basada en pares y publicidad (5 ítems) y Automedicación por decisión propia (3 ítems), con adecuados índices de fiabilidad. En el AFC realizado sobre dos modelos de medida rivales, el modelo de 3 factores presentó unos índices de ajuste más satisfactorios. Los resultados de la aplicación de este modelo para el AFC sobre una muestra aleatoria de la mitad de los sujetos del estudio también mostraron unos índices de ajuste aceptables. Conclusiones: La escala propuesta tiene adecuadas propiedades psicométricas y aunque posee diferentes contenidos latentes muestra unidimensionalidad. Tanto la consistencia interna de la escala como de los tres factores que la forman son aceptables. Los índices de bondad de ajuste son adecuados

Background: An increase in the self-medication in youth has been observed in last decades. Although there are several instruments to measure the behavior of self-medication, none of them work is aimed to measure the underlying attitude. The goal of this study was to design and evaluate an attitude towards self-medication measurement scale in youth and adolescence and the assessment of its psychometric characteristics. Methods: Development and validation of the Attitude towards self-medication Scale based on the data obtained in February 2012 of 665 adolescents with an average age of 15.5 years (D.T = 1.1) in educational centers of the Community of Madrid. An Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were computed. Results: EFA revealed a 3 factors solution: Self-medication and regulation of negative emotions (9 items), Peer-based self-medication and advertising (5 items) and Self-medication by own decision (3 items), with adequate reliability indexes. A CFA comparing 2 alternative models revealed that the 3 factor model yielded more satisfactory fit indexes. Results from a CFA for this model was also performed with a random sample, comprising half of the participants, also showed adequate fit indexes. Conclusions: The developed scale showed acceptable psychometric properties, and even with different latent factors it shows unidimensionality. Inner consistency of the overall scale and of each of the three factors is acceptable. Goodness of fit indexes is adequate

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

BACKGROUND: Self-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. METHODS: This 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. RESULTS: Based 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". CONCLUSIONS: Based 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.

Self-Medication in University Students from the City of Mansoura, Egypt.

Background. Self-medication is a common practice in developed and developing countries. Objectives. To explore the prevalence of self-medication practices among university students, probable reasons, symptoms requiring self-medication, and sources of advice. Methods. A descriptive cross-sectional study was carried out in Mansoura University, Egypt, and included 1st and last year students of both medical and nonmedical faculties. Results. Prevalence of self-medication was 62.9%. Younger age, female, medical, and ever-married students and those having home pharmacy tended to self-medicate more than their peers with significant difference between them. Being medical student, being from urban area, having good current health condition, being careless about health, and having drugs stored at home pharmacy were independently associated with the likelihood of self-medicating. Conclusion. Prevalence of self-medication among university students is high which constitutes a health problem that needs intervention.

Use of medicines by homeless people in Porto, Portugal.

The objective of this study was to describe patterns of medication use among homeless adults from the city of Porto, Portugal. We recruited 146 homeless participants in four social services institutions. Data on the use of medicines in the previous week were collected using face-to-face interviews. We described the prevalence and main correlates of use of medicines from different Anatomical Therapeutic Chemical classification (ATC) groups. A total of 56.8% of the homeless reported to have used at least one medicine in the previous week. The most frequently reported were benzodiazepines (21.9%) and antipsychotics (15.1%); socio-demographic characteristics, lifestyle variables and use of health care were not found to be significantly associated with their use. The prevalence was 1.4% for anti-inflammatory and antirheumatic products, and 6.2% for antihypertensives, diuretics and beta-blocking agents. Medicines pertaining to the nervous system ATC group were by far the most frequently used, while those for the treatment of other common chronic and acute conditions seem to be underused.

Consumption of medicines in high-risk pregnancy: evaluation of determinants related to the use of prescription drugs and self-medication

The use of drugs during pregnancy still represents a challenge for medicine, since the majority of drugs cross the placental barrier with a potential to cause several congenital problems to the fetus, and most of them have not been clinically tested in pregnant patients. At the same time, the medicalization phenomenon, self-medication, and lack of patient information about the misuse of medicines are additional problems. Thus, the aim of this study was to evaluate the pattern of medicine consumption in high-risk pregnancies and the determinants related to this consumption pattern. In order to do so, a cross-sectional descriptive study was performed with puerperal women who had a history of high-risk pregnancy. Statistically significant associations were found between self-medication and fewer prenatal visits, and cigarette use during pregnancy and a higher number of children. According to these data, the vulnerability of this population to the risks of drug use is evident, demonstrating a gap that requires urgent interventions in health-care education.

O uso de medicamentos na gestação representa, ainda hoje, um desafio para a medicina, visto que grande parte dos fármacos atravessa a barreira placentária e, na maioria, não foi testada clinicamente em gestantes, podendo vir a ocasionar diversos problemas congênitos ao feto. Ao mesmo tempo, a automedicação, o fenômeno da medicalização e a falta de informação sobre os riscos do mau uso de medicamentos são problemas adicionais. Diante disto, o objetivo deste estudo consistiu em avaliar o padrão de consumo de medicamentos na gestação de alto risco e os determinantes relacionados ao seu padrão de consumo. Para tanto, realizou-se um estudo descritivo de corte transversal com puérperas, que apresentaram gestação de alto risco. Verificaram-se associações estatisticamente significativas entre automedicação e mulheres com menor número de consultas de pré-natal, uso de cigarro na gestação e maior número de filhos. De posse destes dados, fica evidente a vulnerabilidade dessa população aos riscos decorrentes do uso de medicamentos, sendo esta lacuna um campo de prática com necessidade de intervenções urgentes no âmbito da educação em saúde.

Nonmedical use of prescription opioids among adolescents: subtypes based on motivation for use.

The purpose of this study was to advance our understanding of nonmedical use of prescription medications by identifying the distinguishing characteristics of 2 subtypes of adolescent nonmedical users of prescription opioids that have been previously described. A Web-based, self-administered survey was completed by 2,597 7th-12th grade students. Sensation-seeking nonmedical users were best characterized by rule breaking and aggressive behaviors and possible substance dependence. Medical users and nonmedical self-treating users were best characterized by somatic complaints, anxiety and depressive symptoms, and history of sexual victimization.

Self-medication: initial treatments used by patients seen in an ophthalmologic emergency room.

OBJECTIVE: This study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients' use of both homemade preparations and manufactured products before seeking specialized care. MATERIALS AND METHODS: We conducted a cross-sectional analytic survey of consecutive patients seen in the ophthalmology emergency room of a teaching hospital. RESULTS: The sample included 561 subjects, 51.3% males and 48.7% females, with a mean age of 39.8 years. Prior to seeking emergency care, 40.5% reported self-medicating; 29.4% used a homemade preparation (13.9% referred to an industrialized product like boric acid as a homemade preparation), and 11.1% used a manufactured product. The most frequently used products included a boric acid solution (53.3%), a normal saline solution (35.7%), herbal infusions (6.1%) and breast milk (4.8%). Viral conjunctivitis was the most frequent diagnosis (24.4%), followed by the presence of a corneal foreign body (7.4%). No significant differences were found in the self-treatment of ocular injuries according to gender (p = 0.95), level of education (p = 0.21) or age (p = 0.14). In addition, self-medication practices were not related to the medically judged severity of the condition. CONCLUSION: Patients often attempt to treat conditions that require ophthalmologic emergency care by self-medicating with homemade or manufactured products. The most widely used products include boric acid, normal saline, leaf infusions and breast milk. This behavior occurs independently of educational level, gender, age or the nature of the ocular condition. Self-medication is a culturally driven practice that is used even in cases of acute ocular injuries.

Self-medication: initial treatments used by patients seen in an ophthalmologic emergency room

OBJECTIVE: This study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients' use of both homemade preparations and manufactured products before seeking specialized care. MATERIALS AND METHODS: We conducted a cross-sectional analytic survey of consecutive patients seen in the ophthalmology emergency room of a teaching hospital. RESULTS: The sample included 561 subjects, 51.3 percent males and 48.7 percent females, with a mean age of 39.8 years. Prior to seeking emergency care, 40.5 percent reported self-medicating; 29.4 percent used a homemade preparation (13.9 percent referred to an industrialized product like boric acid as a homemade preparation), and 11.1 percent used a manufactured product. The most frequently used products included a boric acid solution (53.3 percent), a normal saline solution (35.7 percent), herbal infusions (6.1 percent) and breast milk (4.8 percent). Viral conjunctivitis was the most frequent diagnosis (24.4 percent), followed by the presence of a corneal foreign body (7.4 percent). No significant differences were found in the self-treatment of ocular injuries according to gender (p = 0.95), level of education (p = 0.21) or age (p = 0.14). In addition, self-medication practices were not related to the medically judged severity of the condition. CONCLUSION: Patients often attempt to treat conditions that require ophthalmologic emergency care by self-medicating with homemade or manufactured products. The most widely used products include boric acid, normal saline, leaf infusions and breast milk. This behavior occurs independently of educational level, gender, age or the nature of the ocular condition. Self-medication is a culturally driven practice that is used even in cases of acute ocular injuries.

Adherence behaviour with psychotropic medication is a form of self-medication.

Adherence with psychotropic medication is at least at poor as adherence with medication for physical health problems. There has been an assumption this was due to loss of insight resulting from psychiatric disorders themselves. Consequently, interventions have focussed on treating the underlying psychiatric disorder and generating psychological strategies to promote awareness. Recent surveys of patient preferences for information and involvement in health care decisions highlight that most individuals want to participate in the process of medical care. Patients often have strong pre-existing beliefs about different therapeutic options. This is supported by the self-determination theory which distinguishes between autonomous behaviour and behaviours that are influenced by external forces. When considering the patient perspective in medication adherence, it is useful to consider the self-medication hypothesis. This can equally be applied to prescribed and non-prescribed drugs. The self-medication hypothesis states that patients decide to start, adjust or stop prescribed medication according to perceived health needs. Such decisions are often conducted intentionally and rationally, given the information available to the patient and their understanding of their condition. In this narrative review, the evidence for and against intentionality in psychotropic adherence behaviour is examined. Studies of compliance and related predictors are examined in depression, schizophrenia and bipolar affective disorder. Results suggest that although concordance depends on patient, illness and clinician factors, patient choice is usually the final common pathway. Illness severity and insight is important in some cases but can act in concert with cognitive factors. Individuals appear to prefer to take medication "as required" (symptomatically) rather than prophylactically. Significant influences upon self-medication habits are prior health beliefs, medication attitudes, adverse effects and adequacy of communication from the health care professional. The self-medication hypothesis applied to prescribed psychotropic medication should assist rather than heed clinicians in improving adherence by taking a patient centred approach and where possible promoting patient autonomy.

Ethnic differences in elders' home remedy use: sociostructural explanations.

OBJECTIVE: To determine if ethnic differences in elders' use of home remedies are explained by structured inequalities. METHOD: Dichotomous indicators of "food" and "other" home remedies were obtained from a randomly selected cohort of older adults with diabetes (N=701). Analyses evaluated if differences in availability of care, economic hardship, and health status explained ethnic differences in home remedy use. RESULTS: Differences in residential location, discretionary money, and health partially explained greater home remedy use among Black and Native American elders relative to whites. CONCLUSIONS: Ethnic differences in elders' use of home remedies are not largely attributed to socially structured inequalities.

Drug use in sports: a veritable arena for pharmacists.

OBJECTIVE: To describe opportunities and obligations for pharmacists regarding doping control in sports, and to present information and resources on drugs and dietary supplements that are popular among athletes for performance enhancement. DATA SOURCES: Sports medicine journals and articles in English obtained from Medline (1966 through June 2003) using the search terms doping in sports, drugs in sports, dietary supplements, sports, amphetamine, stimulants, ephedrine, ephedra, caffeine, anabolic steroids, human growth hormone, erythropoietin, darbepoetin, androstenedione, dehydroepiandrosterone, and creatine. Information was also obtained from sports-governing agencies, such as the National Collegiate Athletic Association and the International Olympic Committee. STUDY SELECTION: Studies and reports that were credible and scientifically sound that evaluated the ergogenic effects of drugs and dietary supplements. DATA EXTRACTION: By the author. DATA SYNTHESIS: Pharmacists can participate in doping control programs in a number of ways. Pharmacists also have an obligation when counseling, advising, and treating athletes to help them avoid banned substances. Athletes use a host of drugs for their performance-enhancing effects, many of which are banned by major sports-governing bodies. Myriad dietary supplements are marketed to athletes, claiming to have ergogenic effects. Some of these popular supplements have proven performance-enhancing effects, while others do not. Adverse effects of these drugs and dietary supplements are discussed. CONCLUSION: A variety of drugs and dietary supplements have proven performance-enhancing effects in athletes. However, many of these substances have adverse effects and are banned by various sports-governing organizations. Pharmacists can play a key role in participating in doping control programs, and can prevent athletes from inadvertently consuming a banned substance.

Medicamentos, embarazo y la clasificación de la Food and Drug Administration- FDA / Drugs, pregnancy and the FDA clasification

Recordemos que toda sustancia puede ser veneno todo depende de la dosis, es el este sentido que los medicamentos no son la excepción, por lo que el extremar todo tipo de cuidados en la adminsitración de medicamentos, es imprescindible, mucho más si hablamos de una etapa tan importante como es el embarazo. Este es un problema que se da a todo nivel, comenzando de la persona embarazada que se automedica, hasta llegar al personal de salud, que no toma encuenta la existencia de un posible embarazo y que el más "simple"de los fármacos puede afectar en el desarrollo del embrión o feto de acuerdo al caso, por lo que una evaluación del riesgo-beneficio es primordial antes de recomendar un medicamento. En este sentido la FDA (Food an Drug Administration) realizó una clasificación de los medicamentos de acuerdo a su potencial teratógenico, razon por la cual resulta importante tomar en cuenta la misma para conocer cuales son drogas que se ueden tomar durante el embarazo y cuales no.

Odontología y automedicación: un reto actual / Dentistry and self-medication: a current challenge

La automedicación se define clásicamente como el "consumo de medicamentos, hierbas y remedios caseros por propia iniciativa o por consejo de otra persona, sin consultar al médico". La solución a multitud de molestias y pequeños problemas de salud, a lo largo de la vida, se puede realizar desde la propia autonomía de una persona o una familia bien informada en el uso de técnicas y de medicamentos útiles y seguros para esta misión. Se revisa el concepto de automedicación y se hace hincapié en los errores habituales de la automedicación en odontología y sus consecuencias negativas ante las enfermedades sistémicas. La automedicación, llevada a cabo de forma responsable, es deseable porque esta forma independiente de procurar un tratamiento medicamentoso es complementaria a la labor asistencial de los profesionales de la salud, y también, porque se procura una independencia autoafirmativa en nuestros pacientes. Se concluye que la información, el consejo terapéutico y la educación son elementos básicos para llevar a cabo la automedicación responsable (AU)

Automedicación en alumnos del 3er y 4to curso de las Escuelas de Enfermería y Trabajo Social del Instituto "Dr. Andrés Barbero" de la Universidad Nacional de Asunción

Estudio descriptivo de una muestra de 158 estudiantes de las Escuelas de Enfermería y Trabajo Social del Instituto "Dr. Andrés Barbero" de la Universidad Nacional de Asunción, sobre el porcentaje de automedicación existente entre los estudiantes. Describe el motivo que los induce a automedicarse. Presenta factores determinantes a la hora de utilizar los fármacos

[Pharmacovigilance of self-medication]. / Pharmacovigilance de l'automédication.

Self-medication can be defined as obtaining and consuming one (or more) drug (s) without the advice of a physician either for diagnosis, prescription or surveillance of the treatment. Self-medication accounts for around 5 to 10 per cent of drug sales in France. There are few data on side effects of self-medication in France. The side effects of drugs taken by self-medication and reported to the Midi-Pyrenees drugs surveillance centre between January 1993 and June 1996 were investigated in the present study. There were 65 reports, mainly in women (58 per cent), i.e. around 2 per cent of the reports to the regional drugs surveillance centre. The most frequent side effects are neurological (32 per cent: mainly headache, vertigo, agitation, etc.), dermatological (18 per cent, mainly allergy), hepatic (10 per cent), digestive (7 per cent, mainly diarrhoea). There were 10 cases of anaphylactic shock and/or Quincke oedema. The drugs most frequently involved were analgesics and non-steroidal anti-inflammatory drugs (47 cases), neuropsychotropic drugs (7 cases), dermatological drugs (6 cases) or otorhinolaryngological drugs (6 cases).... 'Serious' side effects occurred in 40 per cent of the cases including 3 deaths. 'Severe' side effects were observed in 77 per cent of the reports. This study shows that the side effects of self-medication are relatively frequent and can be serious. They occurred more often in women than in men, mainly with analgesic and anti-inflammatory drugs. These data permit a better analysis of the risk/benefit ratio of self-medication. Drug surveillance studies of self-medication must be developed.