All through recorded history, humans have made use of preparations that are plant-based, but, containing biologically active, and sometimes highly effective substances as medicine. On a daily basis and the world over, people practice self-medication which has increasingly been accepted as a major component of self-care practice. This study examined the prevalence and impact of self-medication on the health of the people with the intention of making suggestion that can curb the challenges associated with it. In realizing this objective, the study made use of secondary data and found that; the practice of self-medication was high in Nigeria. Factors such as; lax in medical regulation, desire for self care, sympathy towards sick family members, poverty, pharmaceutical marketing and comparatively expensive and in some cases not readily available health care professional were responsible for this prevalence rate. The study also found that selfmedication though advocated for the role it plays in relieving symptom, contributes to direct reduction in system cost as it delays onset of morbidity and mortality; it also contribute to both morbidity and mortality in this era of fraudulent pharmaceutical products marketing. On the basis of these, the study recommended massive awareness campaign on the danger of selfmedication, strengthening of various pharmaceutical regulations among others as ways of curbing this social phenomenon of our time.

1.1 Background of Study
Self-medication is defined by the World Self-Medication Industry (WSMI) as the treatment of common health problems with medicines especially designed and labeled for use without medical supervision and approved as safe and effective for such use .1 It is common for individuals to feel unwell at one time or the other and the innate survival instinct in humans produces a tendency to treat themselves. Every day, all over the world, people, irrespective of how knowledgeable they may be, act on their health without consulting qualified health personnel; they practice what is known as self-care, a lifelong habit and culture, which largely and mostly all over the world, Nigeria inclusive is in form of self-medication.

Medicines for self-medication are often called ‘non-prescription’ or ‘over the counter’ (OTC) products, and are available without a doctor’s prescription through pharmacies and in some countries, in supermar­kets, chemists and other outlets. The medicines that require a doctor’s prescription are generally called prescription products (Rx products). Self-medication with OTC medicines is sometimes referred to as ‘responsible’ self-medication to distinguish this from the practice of purchas­ing and using a prescription medicine without a doctors’ prescription. This is irresponsible (and potentially dangerous) ‘self-prescription’, and has no place in self-care or (responsible) self medication. 2

The nature and extent of self medication indeed varies in different cultural contexts 3 and the socio-economic and educational influences may be greater than the influence of medical practice. 4 Self medication is indeed a very common practice, both in the economically deprived communities as much as it is in the economically privileged. Without doubt, self-medication by means of non-prescription medicines is a growing trend of ‘self-care’ which has its positive and negative aspects.

World-wide, consumers commonly reach for self-care products to help them solve their common health problems which include fever, body pains, indigestion, diarrhea, vomiting, cough, and upper respiratory tract infections.7 This is because it is considered easier, more cost-effective, time-saving, or the problem may seem too trivial to necessitate making an appointment with a healthcare professional, and in other cases, they may have few or no other options. The World Health Organization (WHO) has pointed out that responsible self-medication can help prevent and treat ailments that do not require medical consultation and provides a cheaper alternative for treating common illnesses. It is therefore necessary to develop tools in every environment to evaluate the appropriateness of self medication.8, 9The challenge and opportunity for governments, healthcare professionals, and providers of self-medication products all over the world and in developing nations particularly, then, is to have a responsible framework in place for self-medication as a practice.

1.2 Statement of the problem
Self-medication is becoming an increasingly important component of health care in both developing and developed countries, 10 unlike other aspects of self-care, it involves the use of drugs, which have the potential to do good as well as cause harm. Several studies on the subject indicate that there are risks such as misdiagnosis, drug resistance, use of drugs in excessive amounts, use of expired drugs, prolonged duration of use, drug interactions, poly-pharmacy; and other toxicological and pharmacological risks associated with improper use of non-prescription medicines.

In some parts of the world, particularly in the more privileged, developed countries, the high prevalence of self-medication is a reason for optimism, as it demonstrates the continuous growth of consumers’ self-awareness and self-reliance and their escape from the dependency and alienation brought about by “medicalization” of health care. 12 This however cannot be said about self-medication in developing countries where it is not an escape from “medicalization” but rather the appearance of a more subtle and less visible form of it. Truly, self-medication may be very common in the industrialized world, but it is hardly, equivalent to that in developing countries both in a quantitative and qualitative sense.12

Nigeria stands out among the few countries of the world where drugs are freely displayed for sale in unauthorized places such as markets, shops, roadside stalls, motor parks and other public places by individuals not duly licensed. This indiscriminate use of drugs cuts across all categories of people and it could be for medical, social or recreational purposes. 13Several literature reveal a high incidence of self medication with over-the-counter, complementary and sometimes prescriptions medicines in a range of 15.0 - 81.5% in different localities.14, 18, 27 The common reasons given for practicing self-medication include long delays in the health centres, previous experience of medical treatment of the same symptoms, illness being considered too trivial and health centres not being socially accessible. However some people may engage in the practice due to ignorance, poverty and non-availability of health facilities.

It is widely believed that human behaviour such as inadequate dosing, incomplete courses and indiscriminate drug use have contributed to the emergence and spread of resistance to certain drugs in the country over the past few years.15 The consequences include the loss of relatively cheap drugs, and their replacement by new drugs which are more expensive (as in the case of replacement of chloroquine with the arthemether combination drugs), and may lead to poor drug-compliance.15 Furthermore, presently in Nigeria, drugs such as antibiotics, analgesics hormonal drugs and anti-hypertensives which must be prescribed by a physician before purchase over-the-counter in developed countries find their way into the hands of consumers without a prescription. It is known that the patent medicine sellers go as far as dispensing the drugs as opposed to the stated regulation which instructs that 0TCs are to be sold manufacturers pack only.

1.3 Specific Objectives of the Study
1. To determine the knowledge and attitude of elderly persons in Ikeja Local Government Area on the benefits and risks of self-medication

2. To identify the drugs commonly used and conditions for which elderly persons in Ikeja Local Government Area practice self medication.

3. To identify the determinants of self-medication amongst elderly persons in Ikeja Local Government Area.

1.4 Research Questions

1. What is the knowledge and attitude of elderly persons in Ikeja Local Government Area on the benefits and risks of self-medication?

2. What are the drugs commonly used and conditions for which elderly persons in Ikeja Local Government Area practice self medication.

3. What are the determinants of self-medication amongst elderly persons in Ikeja Local Government Area.

1.5 Significance for the Study

Individual self-care is shaped in the social environment- it is a major determinant of the type, quality and amount of healthcare used.17 Self medication is very common among individuals in many developing countries, and despite the growing research interest on the topic, not much is known about its major determinants.18, 19, 20, 21 Certain studies 8 on self-medication done in developing countries show that it is influenced by many factors, such as education, family, society, law, availability of drugs and exposure to advertisements. A high level of education and professional status particularly has been mentioned as predictive factors for self-medication.8, 22 The reasons for self-medication include mild illness, previous experience of treating similar illness, economic considerations and a lack of availability of healthcare personnel with most common medications used for self-medication been analgesics and antimicrobials.5, 23

Conversely, there are peculiarities in the self medication profile of Nigeria. First, there are few who will consider visiting or consulting a physician at the outset of an ailment.7, 24 Secondly, conventional drugs may not be as affordable to the low-income earners. Thirdly, traditional herbal medicines whose dosages are not known constitute up to 50% of the drugs used for treatment by the general population for self-medication and continue to gain grounds through vigorous media publicity.7, 24Lastly, the social system in existent makes it easy for an individual who was cured of an ailment following the use of a particular drug to become an authority whenever a friend, relation or close associate presents with similar symptoms without necessarily suffering from the same or associated ailment7. As a result, minor illnesses are treated with the wrong doses of antimicrobials, antispasmodics and analgesics which have a potential to harm the individual as well as the society at large.24

Self-medication is no doubt an area where governments and health authorities need to ensure that things are done in a responsible manner, with well enforced policies taking care of safety issues as it concerns the age of the user, pregnancy, underlying disease conditions and potential drug allergies and interactions amongst others.25 Although the Federal Ministry of Health published in its National Drug Policy of 2005 a number of steps to be taken towards obtaining the benefits of self-medication while avoiding its risk, there are still occurrences of health hazards amongst the populace resulting from inappropriate drug use.

There is a therefore a need to identify the factors which influence the pattern and mode of practice in Ikeja Local Government area(LGA) in order to adequately inform the public on the limits and acceptable attitudes and practices towards self care via self medication even as the health authorities and pharmaceutical companies put in place more guided safety measures. This survey was undertaken with the general aim of determining the Knowledge, attitudes and practices amongst residents in the Ikeja local government area towards self medication.

1.6 Limitations
This study was largely constrained by time which prevented the use of a larger sample size. Another limitation of this study was the reliance on self-reported data about self medication from the respondents coupled with inability to ascertain drugs used, and their dosages. The inability to establish the occurrence of side effects following drug use could also have limited the study.

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