1. Self-medicating behavior of urban Pakistani population towards psychotropic agents and its correlates Fayaz Hashmi* 1, Hassaan A. Rathore 1, Munavvar Zubaid Abdul Sattar 1, Furqan Khurshid Hashmi 1 School of Pharmaceutical Sciences Universiti Sains Malaysia

2. Introduction Self-medication A form of self-care, includes acquiring medicines without prescription, resubmitting old prescription to get medicines, sharing medicines with relatives or members of one's social circle or using residual medicines It is an important initial response to illness and is affected by socio-demographic and socio-economic factors[1]. Although, most self-medications result in the desired outcome but mishaps are not uncommon [2]

3. Self medication in Pakistan In Pakistan, national data on self-medication is not available; however, some studies revealed that it is varying from 6.3% to 51.3% [2, 3, and 4] Surprisingly, people have access to controlled drugs due to pharmacy malpractices such as sales of medicine without any prescription, poor drug regulation, running of medical stores/chemist shops/pharmacies by persons registered in categories B and C due flaws in the Drug Act 1976 [5].

4. Methodology A randomized, cross-sectional, questionnaire-based, multi-center study for the prevalence of self-medication was performed in some areas of Lahore, Pakistan A self designed, validated, questionnaire was designed to evaluate current knowledge of self medication among general population. A pre-liminary questionnaire was presented to a panel of experts for content validation. The questionnaire was finalized after several meetings The study design contained the following five portions. 1. The patient’s preference over the allopathic and other sources of therapy. 2. Diseases most commonly encountered and the drugs obtained for these diseases. 3. Reasons behind self-medication trends existing in the community. 4. Respondent’s suggestions to restrict self-medication. 5. Respondents using psychoactive agents A questionnaire was distributed to the general community at schools, colleges, universities, factories and residential areas, hence, the participants were students, factory workers, house wives and elderly people with different educational backgrounds

5. RESULTS Education level and socio-demographic data of respondents VariablesNo of participants% PopulationPsychoactive drugs % Psychoactive drugs Gender Male 60 54.55% 16 14.55% Female 50 45.45% 13 11.82% Education Illiterate 2 1.82% 2 Primary 15 13.64% 5 4.55% Secondary 38 34.55% 6 5.45% Higher Secondary 18 16.36% 8 7.27% University 37 33.64% 8 7.27%

6. Education levelVisit doctorPreferred allopathic medicine Other sources are better Consult doctor in emergency Always self- medicate Illiterate 1.82% 0% 1.82% 0% Primary 7.27% 9.09% 6.36% 9.09% 0.91% Secondary 33.64% 30.91% 10% 17.27% 4.55% Higher secondary 15.64% 11.82% 6.36% 10% 0% University 28.18% 29.09% 10.91% 17.27% 3.64% Society’s behaviour toward self-medication

7. Education Level common cold, headache, sore throat stomach indigestion joint and muscle pain vitamin deficiency analgesics /pain killers antibioticsMulti vitamins Male 70% 20%17.27% 2.73% 43.64% 13.64% 8.18% Female 71.82% 15.45% 10% 5.45%36.36% 8.18% 4.55% Illiterate 1.82% 0% 1.82% 0% 1.82% 0.91% Primary 17.27% 8.18% 6.36% 0% 11.82% 2.73% 1.82% Secondar y 60% 6.36% 10.91% 0.91% 24.55% 7.27% 4.55% Higher secondary 23.64% 5.45% 8.51% 0% 12.73% 4.55% 0.91% University 68.18% 15.45% 13.64% 9.09% 29.09% 6.36% Most commonly occurring diseases and self-medicated OTC drugs

8. Educational level Poor health care system nearest hospital is far Economical issue Disease is mild Previous experience of prescribed medicine Awareness level Illiterate 0.91% 0% 0.91% 1.82% Primary 2.73% 5.45% 3.64% 4.55% 9.09% Secondary 10% 4.55% 13.64% 21.82% 29.09% Higher secondary 6.36% 2.73% 5.45% 10.91% 12.73% University 6.36% 1.82% 21.82% 20% 30% Beyond self medication

9. Suggestions given by the respondents belonging to various groups Educational levelIncreasing number of hospitals Educational campaigns and seminars No sale without prescription Increasing community pharmacist Illiterate 1.82% 0.00% Primary 4.55% 0.91% Secondary 9.09% 10.91% 4.55% 1.82% Higher secondary 3.64% 5.45% 2.73% 4.55% University 8.18% 17.27% 13.64% 5.45%

10. Discussion In the present study, educated people were found to be self-medicating themselves. These results are confirmed by another study carried in Karachi University, Karachi, Pakistan, indicating the use of pain killers, fever relieving agents, antibiotic and multivitamin as self-medication [4] The possible reason associated to this behaviour can be attributed to information of public about most commonly used drugs. Additionally, they saved money by not consulting the doctor. The self- medication behaviour is predominant in men than the women

11. Conclusion It is concluded from the present study that there is as increasing trend of self-medication in educated people and the inclination is existing in both the genders. People have easy access to psychoactive drugs because these can be purchase without any prescription. The self-medication can be decreased by increasing healthcare facilities, implementing health insurance and discouraging unethical drug promotional activities through electronic and print media

12. References 1. Tenaw A.,Tsige G. M. (2004).Self-medication practices in Addis Ababa: A prospective study. Ethiop J Health Sci, 14, 1-11. http://www.ejhs.ju.edu.et/ejhs_journal/2004/volume14issue1.phphttp://www.ejhs.ju.edu.et/ejhs_journal/2004/volume14issue1.php 2.Butt ZA, Gilani A H, Nanan D, Sheikh AL, White F. (2005). Quality of pharmacies in Pakistan: a cross-sectional survey. International Journal for quality in Health care, 17 (4), 307-313. DOI: 10.1093/intqhc/mzi049 3.Haider S, Thaver IH. (1995). Self-medication or self-care: implications for primary health care strategies. J Pak Med Assoc, 45, 297-298. http://dx.doi.org/10.1016/0277-9536(92)90147-I http://link.springer.com/article/10.2165/00002018-200124140-00002 http://www.indianjmedsci.org/article.asp?issn=00195359;year=1997;volume=51;issue=3 spage=93;epage=96;aulast=Deshpande

13. References 4. Sturm AW, Van der Pol R, Smits AJ, et al. (1997).Over-the-counter availability of antimicrobial agents, self-medication and patterns of resistance in Karachi, Pakistan. J Antimicrob Chemother, 39, 543-547. DOI:10.1093/jac/39.4.543 5.Hussain K, Hashmi FK. (2011). Unlawful and Unjustified Collection of Enrolment Fee from Pharmacy Students. Archives of Pharmacy Practice, 2(4) 141-142.