No matter what medication you are taking, whether it is prescription or over-the-counter, medicines should always be taken with care. Many of us are guilty of using self-determined medicines that require a physician's prescription due to their indications or risks.

The World Health Organization defines self-medication as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms . It may include the use of herbs, the retention and re-use of prescription drugs or the direct purchase of prescription-only drugs without medical prescription.

The practice of self-medication is common worldwide in both developed and developing countries and may even be more common than the use of prescribed medication.

The practice of self-medication has received considerable attention as a major public health challenge in low-income and middle-income countries (LMICs). According to several studies, the average prevalence of self-medication is estimated to be 55.7% in Africa. Also, the WHO estimates that 20%–50% of all antibiotics in LMICs are inappropriately used. Most of the drugs commonly used for self-medication in Africa are anti-malaria, antibacterial, and analgesics/pain medication. The high prevalence of self-medication in poor countries is mainly due to many different reasons.

A Rwandan researcher in the College of Medicine and Health Sciences showed self-medication in Rwanda was at 77.9% of surveyed parents/caregivers of children under ten years. Among them, 50.8% used modern medications, 15.8% used traditional medicines, and 33.3% used both.

Paracetamol and local herbs were the most commonly used self-prescription drugs. Parents using modern medicines had more confidence in self-medicating and cited barriers to medical consultations as a key reason. Factors such as having multiple young children, being over 30 years old, and living in Kigali were linked to a preference for modern self-medication. This study highlights the widespread nature of self-medication in Rwanda across various socio-demographic groups.

Despite the risks associated with especially inappropriate self-medication, people still practice it frequently. People usually use it as a first line of treatment when they fall ill. Research shows that some people continue to self-medicate for various mild to serious ailments despite being aware of the dangers or consequences associated with it.

During the Covid-19 pandemic, there was a notable increase in self-medication with antibiotics or other medications due to impaired access to healthcare services. One of the common negative outcomes of the practice of self-medication is the impact of the irrational use of antibiotics.

Patients self-medicate for various reasons, including having medication information, previous experience, easy access to medicine, lack of time, limited access to medical staff, the cost of doctor visits, inadequate respect for patient privacy, pharmaceutical advertising, and an overload of information.

Sometimes pharmacists out to make quick cash also provide and sell all types of medicines without demanding a doctor’s note. Given these factors and the risks associated with self-medication, health policymakers should enforce stricter regulations on pharmacies selling drugs without a prescription and provide educational courses on the dangers of self-medication, especially for the more affluent members of society with education.

The importance of self-medication as a phenomenon has attracted the interest of health professionals including physicians and policymakers, especially when drugs become deregulated and change from prescription status to be sold over-the-counter (OTC).

Generally, it is accepted that self-medication may have an important role in the care of minor illnesses. In some particular instances, self-medication for very minor conditions can create a significant aspect of healthcare, offering benefits for both individuals and the healthcare system.

It can provide an affordable, quick, and convenient solution for minor illnesses or minor conditions, alleviating pressure on the healthcare system and preventing it from becoming overwhelmed. Self-medication can reduce waiting times for patients to see a doctor and conserve limited medical resources for more serious conditions. However, irrational self-medication practices will ultimately increase health risks for individuals with negative health impacts.

The is also a growing problem of non-medical use of prescription drugs. Such usage can be defined as the taking of prescription drugs, whether obtained by prescription or otherwise, other than in the manner or for the reasons or time period prescribed, or by a person for whom the drug was not prescribed.

In some cases medicines for medical and scientific purposes are taken by individuals for other reasons. Most cases include use of medications containing narcotic or psychotropic properties as drugs of choice for many drug users.

Self-medication is a global phenomenon and a significant contributor to the development of antibiotic resistance in humans. The effects of self-medication are influenced by community practices and strategies employed to mitigate it. Regular and unsupervised use of medications without professional healthcare guidance can result in drug resistance, improper drug use, delays in appropriate medical treatment, and increased mortality rates.

Dr Vincent Mutabazi is an applied epidemiologist.

X: @VkneeM