Self-Medication with Over-the-Counter Drugs and Antibiotics in Romanian Consumers: A Qualitative Study

ABSTRACTSelf-medication with antibiotics, irrational prescribing and use of over-the-counter medicines and antibiotics represent a global concern, with implications for antibiotic resistance, clinical outcomes and costs of health care.This paper set out. to make an in-depth exploration of the factors that, influence self-medication in Romania. Specifically, this study investigated the factors prompting self-medication, knowledge about, the side effects of medicines and antibiotic resistance and the practice of prescribing and dispensing antibiotics. The phenomenon of self-medication was delineated by interviewing individuals that, self-medicate, physicians and pharmacists. Semi-structured individual interviews were conducted with 7 men and 13 women, aged 24 to 59 years old. The data set. was analyzed using thematic analysis. Findings show that, the complex phenomenon of self-medication is an individual health management, habit. , influenced mainly by health related education and sources of information, medical experience, beliefs about, medicines atrd the quality of the relationships with the health-care providers. This practice is consolidated by consumers ' social circle and enabled by factors related to the health-care system, such as medical insurance, co-payments and informal payments.KEYWORDS: self-medication, antibiotics, over-the-counter drugs, thematic annalysis"Self-medication involves the use of medicinal products by the consumer to treat self-recognized disorders or symptoms" (WHO, 2000, p.9). Medicines intended for self-medication are called over-the-counter and are available without a physician's prescription.Self-care behaviors, particularly self-medication, have potential benefits on the health-care system and individuals. They allow patients to take responsibility and actively manage their health, thereby promoting self-empowerment. Self-medication offers an increased flexibility through more frequent options to healthcare access (e.g., method of delivery, time, location). However, not "everyone sees the importance of taking on more responsibility for their health, especially where that involves 'becoming informed' outside of the traditional medical encounter" (Henwood, Wyatt, Hart, & Smith, 2003, p. 598). From physicians' perspective, responsible self-medication reduces the pressure put upon medical services and the costs of health-care by avoiding unnecessary consultations (Al-Motassen, A-Bakri, Bustanji, & Wazaify, 2008). By decreasing consultations for minor illnesses or symptoms, doctors have more time to devote to cost-effective interventions, especially when health services are limited.On the other hand, inappropriate self-medication patterns may emerge, such as: unnecessary use of antibiotics for the wrong ailments; inadequate dosage and/or frequency; delayed antibiotics therapy in critical patients; the antibiotic spectrum being either too broad or too narrow; receiving antibiotics from various sources, without consulting specialists. Individuals may wrongfully make self-diagnoses, diagnoses, with consequences such as failure to treat the disease, failure to recognize symptoms, which may be a manifestation of another disease. Patients can exposure themselves to antibiotic risks when an infection is not present in the body. When individuals take medicines without medical supervision, there is an increased risk of side effects and drug interactions.Irrational prescribing of drugs and self-medication with antibiotics represent a global concern. Numerous studies, in developed and developing countries, describe patterns of polypharmacy, use of drugs unrelated to the diagnosis, inappropriate use of antibiotics and irrational self-medication (Hogerzeil, 1995). Sturm and colleagues (1997) found that even when antibiotics were acquired by prescription, they were misused, the duration of treatment varying between 1 day and 40 days, 44% of individuals using antibiotics for a period exceeding 14 days, and in 18% of cases until the patient felt better (Sturm, van der Pol, Smits, van Hellenmondt, Mouton, Jamil et al. …