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DOI:10.4172/2329-6631.1000173

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ISSN: 2329-6631 Drugs

Research Article Open Access

Self-Medication Trends in Children by their Parents

Umar Farooq Gohar1, Sadia Khubaib1 and Asad Mehmood2
1
Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore Pakistan
2
University of New South Wales, Sydney 2033, Australia

Abstract
The aim of present study was to determine the self-medication trends in children by their parents, knowledge of self-
medication and their attitude towards this practice. Factors that enforced them to do this practice were also determined
along with their source of information about drug use. Total 400 parents were randomly selected and interviewed.
It was observed that self-medication prevalence in children by their parents was 77.25% with male and female ratio
49% and 51%. Self-medication awareness was 66% among total parents and this practice was more in children of
age 1-5 years i.e., 47%. Most common conditions for self-medication were fever, cough, flu, vomiting, diarrhoea and
allergies. Frequently used drug groups include antipyretics, cough and cold preparation, antimicrobials, antiemetics and
antiallergy. It was also observed that 45% of parents practiced self-medication 3-4 times per year and the main reasons
behind this practice were perception of illness, previous experience, lack of time, financial constraint and leftover
medicines. Old prescriptions, family members, friends and medical stores were common source of self-medication.
This study also revealed that 57% of parents reported recovery after self-medication. It was also observed that 63% of
parents informed physician about self-medication in their children and 18% reported that their child became sicker after
self-medication. Out of total 56% participants were agreed that self-medication is unsafe for their children.

Keywords: Self-medication; Drug interactions; Analgesics; Anti- susceptible to different diseases [9]. It is observed that in developed
inflammatory agents countries people practice self-medication predominantly with non-
prescription over the counter drugs whereas most developing countries
Introduction have a high burden of irrational drug use. The reason behind is the
Drug utilization in children is of great concern worldwide [1]. poorly enforced drug utilization policies due to which individuals have
Many drugs for this group of population are used in outpatient settings access to both prescription and non-prescription medications [10].
[2]. Parents generally give drugs to treat their child sickness. The trend Children are given medications by their parents [11]. When children
of using drugs on their own that is self-medication has been increasing become sick the first response by most of the parents is to self-medicate
in developing countries as well as in developed countries in recent them [12]. Majority of the parents in both developed and developing
years [1]. Drugs use without consulting any physician or health care countries prefer to treat their child’s common ailments like fever, cough/
provider for treating or preventing the ailments is self-medication [3]. cold and diarrhoea without consulting a physician [10]. Analgesics,
According to World Health Organization self-medication is the antipyretics, anti-inflammatory agents, cough and cold preparations are
use and selection of medicines by individuals to treat self-recognized amongst the commonly practiced self-medications [9].
illnesses or symptoms. The International Pharmaceutical Federation Different studies conducted to evaluate the patterns of self-
(IPF) has defined self-medication as non-prescription drugs use by medication in children have shown that self-medication prevalence is
individuals on their own initiative [4]. Drugs purchase and use without quite high among children. These studies also show that self-medication
an authorized prescription or using previous prescription also comes patterns are not appropriate enough and parents do not have sufficient
under self-medication. It also included the use of leftover medicines and appropriate knowledge about the drug use in children [13].
which are stored at home and medicines advised by family members Worldwide practice of self-medication has been reported to increase
or friends [5]. day by day. The studies which were conducted in developed countries
Primary responsibility for the use of self-medication products revealed high prevalence among parents like in Germany 25.2% [11],
comes not only to the individual but also on all people involved in France 96% [14], China 62% [15], Italy 69.2% [16].
self-medication. Therefore, all people must be aware of the benefits Likewise, in developing countries prevalence rate is quite high. In,
and risks associated with the self-use of medicines [6]. Self-medication Pakistan the prevalence was found to be 51.3% [17], 59% in India [18]
associated risks include inappropriate diagnosis, drug interactions, and in Brazil about 56.6% [19,20]. Among underdeveloped countries
drug resistance and adverse drug reactions, inappropriate drug studies showed the prevalence as 60% in Yemen [21], 95.75% in Sudan
choice and augmented polypharmacy. Risk of drug dependency and [13] and 30.1% in Uganda [10]. In, Nigeria many studies were also
abuse are also associated with self-medication [4,7]. Others may also
include inadequate dosage, excessive prolonged drug use and double
medication as individuals could not be able to identify that same drug
has already been taken with another brand name which may lead to *Corresponding author: Asad Mehmood, University of New South Wales, Sydney
2033, Australia, Tel: +61293851000; E-mail: [email protected]
serious consequences [8]. Unjustified and absurd self-medication
consequence is the wastage of healthcare resources and may also lead Received August 04, 2017; Accepted August 07, 2017; Published August 14, 2017
to hospital admissions [4]. Citation: Gohar UF, Khubaib S, Mehmood A (2017) Self-Medication Trends in
Children by their Parents. J Develop Drugs 6: 173. doi:10.4172/2329-6631.1000173
Self-medication practices are of great concern in case of children
as children are considered to be more vulnerable regarding the use Copyright: © 2017 Gohar UF, et al. This is an open-access article distributed un-
der the terms of the Creative Commons Attribution License, which permits unre-
of medicines. In developing countries children constitute a large stricted use, distribution, and reproduction in any medium, provided the original
percentage of the population and they are more vulnerable and author and source are credited.

J Develop Drugs
ISSN: 2329-6631 JDD an open access journal Volume 6 • Issue 2 • 1000173
Citation: Gohar UF, Khubaib S, Mehmood A (2017) Self-Medication Trends in Children by their Parents. J Develop Drugs 6: 173. doi:10.4172/2329-
6631.1000173

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conducted for parental self-medication evaluation in children and July 2017. Parents having at least one child of age less than 16 years
infants. These studies revealed self-medication prevalence as 53.4% in were included in this study. There was no limitation of age, level of
children [22] and 47.62% in infants [23]. education, economic status and gender of participants. Data of total
400 participants was collected.
Mostly parents get advice from family, friends or use previous
prescription to manage the ailments [9]. In some cases, parents get The design of present study based on random sampling technique
information from medicine information leaflets, internet, social which was questionnaire based and cross sectional. The questionnaire
media and pharmacies to manage the child’s condition [16]. Most of was prepared in English language and consisted of three sections. First
the parents take the illness as of mild nature that does not need the section was related to basic demographic information of participants
service of any physician [16]. Studies also show that old prescriptions like name, gender, age, education status, monthly income, number of
are commonly used for treating the similar complaints [21]. Similar children and child age for self-medication. In second section, there
complaints are not always the indication of previous disease thus the were twelve basic questions related to self-medication, conditions
practice of using previous prescriptions to treat the current illness is for which parents usually preferred to self-medicate, medicines used
not considered to be safe [9]. Similarly, parents are also not aware of to treat illness and reasons for self-medication. It also included self-
the generic and brand name of drugs [9] which may lead to serious medication information source, duration of self-medication, recovery
consequences especially when one drug is given at the same time related question and general perception of participants about child
having two different brand names. A study in France shows about 21% self-medication either they considered it safe or not. The last section
of parents combine two brands of paracetamol at the same time [14]. was related to consent.
Generally, it is observed that parents have a lot of misunderstanding Verbal consent of parents was taken prior to interview by
about antibiotics. They think that antibiotics can cure all type of explaining them the objective of study. During interview, each question
diseases caused by even viruses [1]. In majority of the cases ailments was properly explained to the participants in the language which he/
like cold, flu, respiratory tract infections and diarrhoea are viral and she could understand easily. For each participant data was collected on
usually self-limiting [15]. Emergence of antimicrobial resistance is individual questionnaire. Data of each questionnaire was transferred
a major issue throughout the world that is mainly due to the wrong on excel sheets and results were compiled in the form of frequencies
use of antimicrobials. This affects not only to the individuals but to and percentages. Results were then analysed by chi square test using
the whole society [24]. Consequences of drug resistance may lead SPSS version 20.
to treatment failure, prolonged hospitalization, drug toxicity and
increased treatment cost [1]. Results
Studies showed that self-medication is increasing day by day and In, order to determine self-medication trends in children 400
many number of factors are accounted for this practice. Among them parents were interviewed. Gender distribution of participants was
socioeconomic status, easy availability of medicines, personal high 49% male and 51% females (Figure 1). Among total participants
potential for disease management and lifestyle are common [25]. 50% belonged to age group 25-34 years and 36.25% were graduated
Other important factors influencing self-medication are long waiting (Figures 2 and 3). As far as the monthly income was concerned 36% of
hours in clinics/hospitals, high drugs prices, demographic factors like participants belonged to group having income between 30,000-60,000
education, gender and age. High consultation fee is also another reason PKR (Figure 4). Participants having two or three children were 34.25%
observed for self-medication especially in economically poor deprived and 21.5% respectively (Figure 5). Self-medication was found to be
communities [26]. 77.25% among total participants (Figure 6). It was observed that 47%
of participants were practised self-medication in children between age
In, Germany higher socioeconomic position and higher level 1-5 years and 33% in age between 5-12 years as shown in Figure 7.
of mother’s education were reported as the main factors associated
with self-medication [11]. Taking the illness as of mild nature, time In present study, trend of preferred therapies among parents who
restraints and previous experience are also among the main reasons practiced self-medication for their child’s ailments were also observed.
of self-medication [27]. Advertisements, financial problems, easy drug Most of the participants preferred allopathy as a first choice. Among
accessibility due to poor drug regulations and long time needed to 309 participants who self-medicate their child, 177(57.3%) preferred
consult physician are the other reasons [28]. allopathy and 84(27.2%) participants preferred allopathy along with
other therapies at the same time. Figure 8 clearly shows the results of
Self-medication is also a common practice in Pakistan like other preferred therapy distribution among participants.
developing countries. Self-medication practices are of great concern
in case of children as children are considered to be more vulnerable
regarding the use of medicines. In Pakistan children also constitute
a large percentage of the population and they are more vulnerable
and susceptible to different diseases. Present study was designed
and conducted with the purpose to determine the self-medication
prevalence in paediatric population. Main aims of present study were
to determine self-medication trends in children by parents, their
knowledge and attitude towards self-medication. The conditions for
which parents usually self-medicate their children, reasons for self-
medication and information sources were also determined.

Methodology
The study was conducted in Lahore from the parents visiting
health care facilities. Study duration was from December 2016 to Figure 1: Gender distribution of participants.

J Develop Drugs
ISSN: 2329-6631 JDD an open access journal Volume 6 • Issue 2 • 1000173
Citation: Gohar UF, Khubaib S, Mehmood A (2017) Self-Medication Trends in Children by their Parents. J Develop Drugs 6: 173. doi:10.4172/2329-
6631.1000173

Page 3 of 7

also noted. It was observed that 45% of participants self-medicate their

children three to four times per year (Figure 11). Main reasons that
enforced the parents to self-medicate their child were perception of
illness 35% and lack of time 24% (Figure 12).
How the people get information about the use of medicine for
different ailments was also an important part of present study. Main
sources that parents used to get information about the medicine
were shown in Figure 13. Participants in group-1 were 24% who
acquired information from family members or friends. About 50% of
participants used last prescription or previous experience, 24% from
family members or friends and 23% from medical stores.

AG-1=18-24 years, AG-2=25-34 years, AG-3=35-44 years, AG-4=45 years Parents’ attitude towards self-medication was also assessed in
or above. present study. The attitude of participants towards the recovery after
Figure 2: Age group distribution of participants.

NG-1=One child, NG-2=Two children, NG-3=Three children, NG-4=Four

EG-1=Illiterate, EG-2=Primary, EG-3=Secondary, EG-4=Intermediate, EG- children, NG-5=More than four children.
5=Graduation, EG-6=Post graduate. Figure 5: Group distribution on the basis of number of children.
Figure 3: Education based group distribution of participants.

MIG-1=Less than 30,000 PKR, MIG-2=30,000-60,000 PKR, MIG- SG-1=Participants who self-medicate, SG-2=Participants who never self-
3=Above 60,000 PKR, MIG-4=Refusal. medicate.
Figure 4: Income based group distribution of participants. Figure 6: Self-medication prevalence groups.

Common ailments for which participants preferred to self-

medicate their children were also noted. The distribution of self-
medication conditions among participants is shown in Figure 9. It was
observed that the most common illness for which parents preferred
self-medication was fever (94%). Other common conditions for which
self-medication was practices in routine included cough, flu and cold,
vomiting and diarrhoea.
Among drugs used for children antipyretics were at the top i.e.,
94% then cough and cold preparations 60%, antimicrobials 34% and
antiemetics 32%. These were followed by analgesics 25%, antiallergy
21%, ophthalmic preparations 9%, topical preparations 5% and ear CAG-1=less than 1 month, CAG-2=1-12 months, CAG-3=1-5 years, CAG-
preparation 3% as shown in Figure 10. 4=5-12 years, CAG-5=12-16 years.
Figure 7: Group distribution of participants on the basis of child age.
Self-medication frequency in previous year among children was

J Develop Drugs
ISSN: 2329-6631 JDD an open access journal Volume 6 • Issue 2 • 1000173
Citation: Gohar UF, Khubaib S, Mehmood A (2017) Self-Medication Trends in Children by their Parents. J Develop Drugs 6: 173. doi:10.4172/2329-
6631.1000173

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ALP=Allopathy, HMP=Homeopathy, HRB=Herbal, HMR=Home remedies,

THEO=Theo-therapy, COM=Combination therapies.
Figure 8: Distribution of preferred therapy among participants.

SFG-1=Who self-medicate 1-2 times, SFG-2=Who self-medicate 3-4 times,

SFG-3=Who self-medicate 5-6 times, SFG-4=Who self-medicate many times.
Figure 11: Participants’ distribution based on self-medication frequency.

Hd=Headache, Fv=Fever, Vmt=Vomiting, Diar=Diarrhea, Cons=Constipation,

Ab=Abdominal pain, Cof=Cough, Flu=Flu and cold, S.th=Sore throat, Ey=Eye
infection, Er=Ear problem, T.ach=Toothache, M.ul=Mouth ulcers, Alrg=Allergy,
Sk=Skin problems, Oth=Others (Not mentioned above).
Figure 9: Self-medication based on clinical conditions among participants.

SRG-1=Unavailability/inaccessibility to medical professionals, SRG-

2=Non-cooperative attitude of medical staff, SRG-3=Perception of illness,
SRG-4=Lack of time, SRG-5=Economical constraint, SRG-6=Others (Not
mentioned above).
Figure 12: Distribution of participants based on self-medication reasons/factors.

ANP=Antipyretics, ANL=Analgesics, ANM=Antimicrobials, ANE=Antiemetics,

CCP=Cough & cold preparations, ANA=Antiallergy, OPH=Ophthalmic
preparations, OTIC=Otic preparations, TOP=Topical preparations.
Figure 10: Commonly self-medicated drug groups.

self-medication, duration of self-medication, worsening of child

condition after self-medication and intimation of self-medication to
physician are shown in Figures 14-17.
Self-medication is either safe or not is a worldwide issue. In
present study, it was also enquired from the participants. Among
SIG-1=Family/friends, SIG-2=Last prescription/ previous experience, SIG-
309 participants who practiced self-medication 56% considered 3=Medical stores/pharmacy, SIG-4=Social media (TV, newspapers, internet),
self-medication safe for their children whereas 43% agreed that it SIG-5=Others (Not mentioned above).
was not safe as they have no knowledge of diseases and medicine Figure 13: Source of information used by participants for self-medication.
(Figure 18).

J Develop Drugs
ISSN: 2329-6631 JDD an open access journal Volume 6 • Issue 2 • 1000173
Citation: Gohar UF, Khubaib S, Mehmood A (2017) Self-Medication Trends in Children by their Parents. J Develop Drugs 6: 173. doi:10.4172/2329-
6631.1000173

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IPG-1=Informed physician, IPG-2=Did not informed physician, IPG-

3=Informed physician at times, IPG-4=No experience.
CRG-1=Yes, CRG-2=No, CRG-3=Sometimes.
Figure 17: Distribution of participants based on self-medication intimation
Figure 14: Distribution of participants based on child recovery after self- to physician.
medication.

SDG-1=Until recovery, SDG-2=No recovery move to next self-medication, SSG-1=Self-medication is safe, SSG-2=Self-medication is not safe, SSG-
SDG-3=No recovery or become critical move to physician /hospital. 3=No opinion.

Figure 15: Distribution of participants based on duration of self-medication. Figure 18: Self-medication safety distribution among total participants.

Discussion
Total 400 parents were participated in present study. Among them
51% were mothers and 49% were fathers which show that both parents
were almost equally involved while dealing with different issues of child
health. Major participants were of age group 25-34 years with 55%
females and 45% males. This might be due to the fact that participants
in this age group were considered to be more active and showed more
concerns to get information and knowledge about their child’s health.
Self-medication prevalence among parents was 77.25% which was
high as compared to the study conducted in 1995 in Karachi that was
58% [17]. Different studies were also documented extremely variable
rates of self-medication in children by parents ranging from 43% to
95.7% [9]. The reasons for this variation might be due to different
methods of data collection, availability of free medical for children in
some countries, parents’ concern about the safety of medicine and high
cost of medical care. At times parents did not reveal about the self-use
CWG-1=Child’s condition worsens after self-medication, CWG-2=Child’s of medicine in children that may also lead to variation [9].
condition never worsen after self-medication.
Figure 16: Distribution of participants based on worsen condition. It was observed that educated parents practiced self-medication
more as compared to less educated and illiterate. In a study conducted in

J Develop Drugs
ISSN: 2329-6631 JDD an open access journal Volume 6 • Issue 2 • 1000173
Citation: Gohar UF, Khubaib S, Mehmood A (2017) Self-Medication Trends in Children by their Parents. J Develop Drugs 6: 173. doi:10.4172/2329-
6631.1000173

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Germany self-medication prevalence was also found to be high in educated It is also a common practice in our community that whenever a
mothers [11]. Present study reveals that parents with low to moderate child became sick parents seek advice from other family members or
monthly income (less than 30,000 and from 30,000 to 60,000 PKR) usually friends. Another common practice in our community is to directly
practiced more self-medication to their child. This might be due to high purchase the medicine from medical store /pharmacy by telling
consultation fee of physician and more family responsibilities. This finding symptoms of the ailment. This practice must be discouraged as it may
contrasts with that studied in Germany where self-medication practice was lead to misdiagnosis and lead to serious consequences. In present study
more in families with high income [11]. previous prescriptions were the commonly used source of information
for drug use i.e., 50%. This finding is similar to other studies conducted
Present study reveals that self-medication was high in children
by Ref. [1,31].
above one year of age. This was probably since majority of participants
were in opinion that it was safe to use the medicine in children above As far as the attitude of parents towards self-medication was
the age of one year. It was noted that most of the parents preferred concerned 54% of parents consulted physician in case of no recovery.
allopathy as the first choice of therapy. This is probably due to the That was a positive attitude in order to avoid serious consequences.
awareness among parents and their confidence on allopathy as more In this study 82% of parents respond that their child condition never
effective and reliable as compared to other therapies [13]. worsens after self-medication. This high response rate was probably due
Fever was found to be most common for which parents usually to the reason that participants were quite conscious about their child
self-medicate their children. First response of 94% of parents was health and in case of no recovery after self-medication they preferred to
to use antipyretic in case of fever. This high percentage was due to consult physician. This was a positive attitude. It was also observed that
the knowledge and awareness among parents regarding the use of 18% of respondents agreed that their child’s condition worsen after
antipyretics in fever. Cough, flu, vomiting and diarrhoea were also self-medication, the reason behind might be the wrong assessment of
among the common ailments. In other studies, above mentioned ailment, wrong medicine selection or inappropriate dose of medicine.
conditions were also reported as most common symptoms in children Intimation of self-medication to physician is very important as it
for which parents practiced self-medication [13,29]. Majority of helps the physician to make correct decision of medicine selection for
the medicines used by parents were antipyretics, cough and cold the properly diagnosed ailment. It was revealed that 63% of participants
preparations, antimicrobials and antiemetics. informed the physician about self-medication. This attitude was
Antimicrobials were mostly used to treat cough and cold, sore positive. On the other hand, 10% of participants were those who never
throat and diarrhoea. It was also documented in other studies that disclosed self-medication to the physician and 11% were those who at
these ailments are usually treated inappropriately with antimicrobials times informed the physician. This attitude was highly negative as it
[9]. Self-use of antimicrobials is alarming. Parents do not have might lead to serious consequences. Self-medication either safe or not
sufficient knowledge about the appropriate use of antimicrobials. The is a query worldwide. In this study, out of total 56% participants were
reason behind the frequent use is that antimicrobials can be easily agreed that self-medication is unsafe for their children.
purchased from the medical stores/pharmacies without prescription
Conclusions
and no polices are implemented for the sale of antimicrobials without
prescription. Results of present study showed that self-medication prevalence
in children by their parents is high i.e., 77.25%. It was observed that
Reasons that enforced parents to self-medicate their child were also
educated parents usually practiced it due to some knowledge of disease
investigated. The most common reason was found to be perception
and medicines. It was observed that out of total 400 parents 43%
of illness (35%) that might be due to previous experience of sickness
considered self-medication safe whereas 56% considered it unsafe for
or some knowledge. This practice may lead to misdiagnosis and may
their children. Child recovery after self-medication was reported by
prolong the child sickness. Perception of illness was also found among
57% of parents. Worsening of child sickness after self-medication was
main reasons in another study conducted in Vietnam [30]. Another
reported by 18% of parents.
common reason was lack of time, perhaps this might be due to working
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