Self‐medication among children and adolescents in Germany: results of the National Health Survey for Children and Adolescents (KiGGS)
Authors: Du Yong , Knopf Hildtraud 
Published: June 2009

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Common paediatric over‐the‐counter medications, such as cough and cold medicines (CCM) and antipyretic analgesics, can lead even to serious adverse drug effects among self‐medicating children and adolescents.

• The U.S. Food and Drug Administration and the UK Medicines and Healthcare Products Regulatory Agency recently again reviewed the safety of CCM use in children.

• Despite the widespread use of self‐medication among the child population and the potential harm it can do, up‐to‐date epidemiological data on self‐medication are sparse worldwide.

WHAT THIS STUDY ADDS

• One quarter of non‐institutionalized children and adolescents in Germany had used self‐medication during the previous week.

• Self‐medication accounted for nearly 40% of total medicine use and included all medication classes, particularly drugs acting on the respiratory system (32.1%), the alimentary tract and metabolism (21.6%), the skin (14.2%) and the nervous system (11.3%), as well as homoeopathic preparations (8.6%).

• Vitamin preparations were most frequently used with a weighted prevalence of 4.7%, followed by CCMs with 4.4% and analgesics 3.7%.

• Overall use of aspirin among children under 12 years of age was 0.3%; use of CCMs was substantial among children under the age of 6 years.

• Our results suggest that self‐medication use is highly prevalent in Germany, particularly among children and adolescents from families with a higher socioeconomic status.

AIMS

Despite the widespread use of self‐medication among the child population and the potential harm it can do, up‐to‐date epidemiological data on self‐medication are sparse worldwide. The aim was to investigate the prevalence and correlates of self‐medication use among non‐institutionalized children in Germany, focusing on the paediatric self‐medications that are most frequently used.

METHODS

All cases of last‐week medicine use were recorded among 17 450 children aged 0–17 years who participated in the 2003‐2006 German Health Interview and Examination Survey for Children and Adolescents. Self‐medication was defined as the use of medicines that had either been bought over the counter or obtained from other sources (OS). The complex sample method was used to estimate the prevalence of, and factors associated with self‐medication use.

RESULTS

During the previous week 25.2% of participants had used self‐medication (17.0% used over‐the‐counter drugs and 9.9% other‐sources drugs). Self‐medication accounted for 38.5% of total medicine use and included all medication classes. These clustered among drugs acting on the respiratory system (32.1%), alimentary tract and metabolism (21.6%), skin (14.2%) and nervous system (11.3%), as well as homoeopathic preparations (8.6%). Vitamin preparations were most frequently used with a weighted user prevalence of 4.7% (5.2% vs. 4.1%, P < 0.001, boys vs. girls), followed by cough and cold medicines (CCMs) 4.4% (4.3 vs. 4.5, P > 0.05) and analgesics 3.7% (3.0% vs. 4.4%, P < 0.001, both boys vs. girls). Overall use of aspirin among children <12 years old was 0.3%; use of CCMs was substantial (4.4%), particularly among children <6 years old. Use of self‐medication was closely related to older adolescent ages of between 14 and 17 years (odds ratio 1.16; 95% confidence interval 1.00, 1.33), children with a poor health status (1.29; 1.10, 1.52), with no immigration background (1.55; 1.33, 1.80), from families with a higher household income (1.23; 1.06, 1.42) and with mothers with a higher educational level (1.37; 1.19, 1.57).

CONCLUSIONS

Self‐medication use is highly prevalent in Germany, particularly among children and adolescents from families with a higher socioeconomic status. Self‐medication in younger children using such drugs as CCMs and aspirin suggested inappropriate drug use and potential risks. This should be closely monitored and warrants an education programme for parents in Germany.