Authors

1 Social Factors in Health Promotion Research Center, Hormozgan Health Research Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

2 Department of Health Information Technology, Faculty of Paramedicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

3 Department of Midwifery, Nursing and Midwifery School, Jiroft University of Medical Sciences, Jiroft, Iran

4 Endocrinology and Metabolism Research Center, Hormozgan Univesity of Medical Sciences, Bandar Abbas, Iran

5 Department of Nursing, Nursing and Midwifery School, Jiroft University of Medical Sciences, Jiroft, Iran

Abstract

BACKGROUND: Self‑medication is the use of unprescribed drugs to treat a disease. Elderly
self‑medication can be more dangerous compared to other age groups because of changes in organ
functions that occur due to senescence. This study aimed to estimate the prevalence of self‑medication
in the elderly, its related factors, and common drugs used in this regard.
MATERIALS AND METHODS: Electronic databases such as PubMed, Scopus, and Web of Science
were searched between January 2016 and June 2021. The search strategy was built on two core
concepts: “self‑medication” and “aged”. The search was limited to original articles in the English
language. A random effect model was used to estimate the pooled prevalence of self‑medication.
Heterogeneity among studies was assessed using both the I2
 statistic and the χ2
 test. Also, a
meta‑regression model was used to investigate the potential sources of heterogeneity of the studies.
RESULTS: Out of 520 non‑duplicate studies, 38 were included in the meta‑analysis. Self‑medication
in the elderly ranged from 0.3% to 82%. The pooled proportion of self‑medication was 36% (95%
CI: 27%–45%). The result of the χ2
 test and the I2
 index (P < 0.001, I2 = 99.90%) revealed notable
heterogeneity among the included studies in the meta‑analysis. The meta‑regression showed a
significant association between the sample size (adjusted β = −0.01; P = 0.043) and the pooled
proportion of self‑medication.
CONCLUSION: The prevalence of self‑medication in the elderly is high. Education through mass
media to raise awareness about the dangers of self‑medication can help solve this problem.

Keywords

  1. Mortazavi SS, Shati M, Khankeh HR, Ahmadi F, Mehravaran S,
    Malakouti SK. Self‑medication among the elderly in Iran:
    A content analysis study. BMC Geriatr 2017;17:1‑12.
    2. Da Silva MGC, Soares MCF, Muccillo‑Baisch AL. Self‑medication
    in university students from the city of Rio Grande, Brazil. BMC
    Public Health 2012;12:1‑7.
    3. World Health Organization (WHO). WHO supports
    s c i e n t i f i c a l l y ‑ p r o v e n t r a d i t i o n a l m e d i c i n e . 2 0 2 0 .
    Available from: https://www. Afro.who.int/news/
    who‑supports‑scientifically‑proven‑traditional‑medicine. [Last
    accessed on 20/05/2020].
    4. Chouhan K, Prasad SB. Self‑medication and their consequences:
    A challenge to health professional. Asian J Pharm Clin Res
    2016;9:314‑7.
    5. Loyola Filho Aid, Lima‑Costa MF, Uchôa E. Bambuí project:
    A qualitative approach to self‑medication. Cad Saude Publica
    2004;20:1661‑9.
    6. Sadio AJ, Gbeasor‑Komlanvi FA, Konu RY, Bakoubayi AW,
    Tchankoni MK, Bitty‑Anderson AM, et al. Assessment of
    self‑medication practices in the context of the COVID‑19 outbreak
    in Togo. BMC Public Health 2021;21:1‑9.
    7. Niclós G, Olivar T, Rodilla V. Factors associated with selfmedication in Spain: A cross-sectional study in different age
    groups. Int J Pharm Practice 2018;26:258‑66.
  2. 8. Balbuena FR, Aranda AB, Figueras A. Self‑medication in older
    urban uropean. Drugs Aging 2009;26:51‑60.
    9. Ahmad A, Patel I, Mohanta G, Balkrishnan R. Evaluation of self
    medication practices in rural area of town Sahaswan at Northern
    India. Ann Med Health Sci Res 2014;4:S73‑8.
    10. Li J, Feng XL. Health care-seeking behaviours and health
    expenditures in adults aged 45 years and older in China, 2011–
    2013. Trop Med Int Health 2017;22:638‑54.
    11. Babatunde OA, Fadare JO, Ojo OJ, Durowade KA, Atoyebi OA,
    Ajayi PO, et al. Self‑medication among health workers in a tertiary
    institution in South‑West Nigeria. Pan Afr Med J 2016;24. Doi:
    10.11604/pamj.2016.24.312.8146.
    12. Nakhaee M, Vatankhah S. Prevalence and cause of self‑medication
    in Iran: A systematic review and meta‑analysis on health center
    based studies. J Biochem Tech 2019;2:90‑105.
    13. Kassie AD, Bifftu BB, Mekonnen HS. Self‑medication practice
    and associated factors among adult household members in
    Meket district, Northeast Ethiopia, 2017. BMC Pharmacol Toxicol
    2018;19:15.
    14. Skliros E, Merkouris P, Papazafiropoulou A, Gikas A,
    MatzouranisG, Papafragos C, et al. Self‑medication with antibiotics
    in rural population in Greece: A cross‑sectional multicenter study.
    BMC Fam Pract 2010;11:1‑3. Doi: 10.1186/1471‑2296‑11‑58.
    15. Saba H, Shivananda K, Jayan M, Hussain C. Prevalence of
    self‑medication practices and its associated factors in rural
    Bengaluru, Karnataka, India. Int J Commun Med Public Health
    2017;3:1481‑6.
    16. Bogale AA, Amhare AF, Chang J, Bogale HA, Betaw ST,
    Gebrehiwot NT, et al. Knowledge, attitude, and practice of
    self‑medication with antibiotics among community residents in
    Addis Ababa, Ethiopia. Expert Rev Anti Infect Ther 2019;17:459‑66.
    17. ZhuX, PanH, YangZ, CuiB, ZhangD, Ba‑TheinW. Self‑medication
    practices with antibiotics among Chinese university students.
    Public Health 2016;130:78‑83.
    18. Rezaei S, Hajizadeh M, Ahmadi S, Ebrahimi M, Matin BK.
    Socioeconomic inequality in self‑medication in Iran:
    Cross‑sectional analyses at the national and subnational levels.
    Clinicoecon Outcomes Res 2020;12:411‑21.
    19. Ellison D, White D, Farrar FC. Aging population. Nurs Clin
    2015;50:185‑213.
    20. Vali L, Pourreza A, Foroushani AR, Sari AA, Pharm DHH. An
    investigation on inappropriate medication applied among elderly
    patients. World Appl Sci J 2012;16:819‑25.
    21. Meranius MS, Hammar LM. How does the healthcare system
    affect medication self-management among older adults with
    multimorbidity? Scand J Caring Sci 2016;30:91‑8.
    22. Ayalew MB. Self‑medication practice in Ethiopia: A systematic
    review. Patient Prefer Adherence 2017;11:401‑13.
    23. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A,
    Petticrew M, et al. Preferred reporting items for systematic review
    and meta‑analysis protocols (PRISMA‑P) 2015 statement. Syst Rev
    2015;4:1‑9.
    24. Poorolajal J, Hooshmand E, Mahjub H, Esmailnasab N, Jenabi E.
    Survival rate of AIDS disease and mortality in HIV‑infected
    patients: A meta‑analysis. Public Health 2016;139:3‑12.
    25. Nikolić G, Stojanović NM, Randjelović PJ, Manojlović S,
    Radulović NS. An epidemiological study on herbal product
    self‑medication practice among psychotic outpatients from Serbia:
    A cross‑sectional study. Saudi Pharm J 2018;26:335‑41.
    26. Oliveira SBVd, Barroso SCC, Bicalho MAC, Reis AMM. Profile of
    drugs used for self‑medication by elderly attended at a referral
    center. Einstein (São Paulo) 2018;16.
    27. Secoli SR, Marquesini EA, Fabretti SdC, Corona LP,
    Romano‑Lieber NS. Self‑medication practice trend among the
    Brazilian elderly between 2006 and 2010: SABE study. Rev Bras
    Epidemiol 2019;21:e180007. Doi: 10.1590/1980‑549720180007.supl. 2
    28. Urrunaga‑Pastor D, Benites‑Zapata VA, Mezones‑Holguín E.
    Factors associated with self‑medication in users of drugstores
    and pharmacies in Peru: An analysis of the national survey on
    user satisfaction of health services, ENSUSALUD 2015. F1000Res
    2019;8:23. Doi: 10.12688/f1000research.17578.2.
    29. Asiri S, Mahmoudi F, Pasha A, Kazemnezhad Leyli E. Drug use
    pattern among elderly people referred to the retirement centers.
    Shiraz E Med J 2018;19. Doi: 10.5812/semj.68694.
    30. da Costa IHF, e Silva RM, de Oliveira Carlos J, Silva MCA,
    Pinheiro MKC, Martins BCC, et al. Potentially inappropriate
    medications in older kidney transplant recipients: A Brazilian
    prevalence study. Int J Clin Pharmacy 2019;41:888‑94.
    31. Makarewicz‑Wujec M, Janas E, Kozłowska‑Wojciechowska M.
    Health behaviour of elderly patients with heart failure in Poland
    associated with pharmacotherapy and non‑pharmacological
    treatment. Acta Pol Pharm Drug Res 2019;76:367‑74.
    32. Mehuys E, Crombez G, Paemeleire K, Adriaens E, Van Hees T,
    Demarche S, et al. Self‑medication with over‑the‑counter
    analgesics: A survey of patient characteristics and concerns about
    pain medication. J Pain 2019;20:215‑23.
    33. Monteiro C, Miranda C, Brito F, Fonseca C, Araujo AR.
    Consumption patterns of NSAIDs in central Portugal and the
    role of pharmacy professionals in promoting their rational use.
    Drugs Ther Perspect 2017;33:32‑40.
    34. Pons EdS, Knauth DR, Vigo Á, Group PR, Mengue SS.
    Predisposing factors to the practice of self‑medication in Brazil:
    Results from the national survey on access, use and promotion of
    rational use of medicines (PNAUM). PloS One 2017;12:e0189098.
    35. Gupta N, Vashist P, TandonR, Gupta SK, Kalaivani M, Dwivedi S.
    Use of traditional eye medicine and self‑medication in rural India:
    A population‑based study. PloS One 2017;12:e0183461.
    36. Heidari M, Borujeni MG, Ghafourifard M, Sheikhi RA. The
    evaluation of the awareness, attitude and practice of the elderly
    toward self‑medication: A cross‑sectional study. Drug research
    2018;68:475‑80.
    37. Hernández‑Vásquez A, Alarcon‑Ruiz CA, Díaz‑Seijas D,
    Magallanes‑Quevedo L, Rosselli D. Purchase of medications
    without prescription in Peru: A cross‑sectional population‑based
    study. F1000Res 2018;7.
    38. Eugenia RP, Roberts BS, Burns A, Goodlet KJ, Chapman A,
    Cyphers R, et al. Prevalence and dental professional awareness
    of antibiotic self-medication among older adults: Implications for
    dental education. J Dent Educ 2020;84:1126‑35.
    39. Kumar S, Burney IA, Saparamadu P, de Silva C. Disseminated
    Kaposi’s sarcoma in an immunosuppressed patient after
    long‑term inhaled and systemic steroid therapy. J Coll Physicians
    Surg Pak 2016;26:S135‑6.
    40. Santos TRA, Silveira EA, Pereira LV, Provin MP, Lima DM,
    Amaral RG. Potential drug–drug interactions in older adults:
    A population-based study. Geriatr Gerontol Int 2017;17:2336‑46.
    41. Tajvar M, Yaseri M, Karami B, Mohammadi M. Pattern of
    outpatient health service utilization by older people in Iran. Iran
    J Ageing 2021;15:410‑27.
    42. Verulava T, Jorbenadze R, Dangadze B, Eliava E. Access to
    ambulatory medicines for the elderly in Georgia. Home Health
    Care Manag Pract 2019;31:107‑12.
    43. Xu W, Li Z, Pan Z, He R, Zhang L. Prevalence and associated
    factors of self‑treatment behaviour among different elder
    subgroups in rural China: A cross‑sectional study. Int J Equity
    Health 2020;19:1‑12.
    44. Abraham O, Schleiden LJ, Brothers AL, Albert SM. Managing
    sleep problems using non‑prescription medications and the role
    of community pharmacists: Older adults’ perspectives. Int J Pharm
    Pract 2017;25:438‑46.
    45. Brandão GR, TeixeiraL, Araújo L, Paúl C, RibeiroO. Self‑medication
    in older uropean adults: Prevalence and predictive factors.
    Arch Gerontol Geriatr 2020;91:104189. Doi: 10.1016/j.archger.
    2020.104189.
  3. 46. Carmona-Torres JM, Cobo-Cuenca AI, Recio-Andrade B,
    Laredo-Aguilera JA, Martins MM, Rodríguez-Borrego MA.
    Prevalence and factors associated with polypharmacy in the older
    people: 2006–2014. J Clin Nurs 2018;27:2942‑52.
    47. Lutz BH, Miranda VIA, Bertoldi AD. Potentially inappropriate
    medications among older adults in Pelotas, Southern Brazil. Rev de
    Saude Publica 2017;51:52. Doi: 10.1590/S1518‑8787.2017051006556.
    48. Gao Z, Xu L, Qin W, Zhang J, Zhou J, Hu F, et al. Prevalence
    and associated factors of self‑treatment among the elderly—a
    comparative study between empty and non‑empty nesters in
    Shandong, China. Int J Environ Res Public Health 2020;17:7880.
    Doi: 10.3390/ijerph 17217880.
    49. Gbeasor‑Komlanvi FA, Zida‑Compaore WI, Dare IH, Diallo A,
    Darre TP, Potchoo Y, et al. Medication consumption patterns
    and polypharmacy among community‑dwelling elderly in
    lomé (Togo) in 2017. Curr Gerontol Geriatr Res 2020;2020:4346035.
    Doi: 10.1155/2020/4346035.
    50. Prado MAMBd, Francisco PMSB, Bastos TF, Barros MbdA. Use
    of prescription drugs and self‑medication among men. Rev Bras
    Epidemiol 2016;19:594‑608.
    51. Siddiqui MT, Bilal M, Singh A, Olivier-Cabrera S, Lebovics E,
    Schorr-Lesnick B, et al. Prevalence of cannabis use has
    significantly increased in patients with cyclic vomiting syndrome.
    Neurogastroenterol Motil 2020;32:e13806. Doi: 10.1111/nmo.
    13806.
    52. Smiley K, Malhotra R, Peche W, Langell JT. Unresectable
    pancreatic adenocarcinoma: Eight years later. World J Oncol
    2016;7:17‑20.
    53. Gangavalli A, Malige A, Terres G, Rehman S, Nwachuku C.
    Misuse of opioids in orthopaedic postoperative patients. J Orthop
    Trauma 2017;31:e103‑9.
    54. Andreoli DC, Whittier WL. Reset osmostat: The result of chronic
    desmopressin abuse? Am J Kidney Dis 2017;69:853‑7.
    55. Bozung AK, Ko AC, Gallo RA, Rong AJ. Persistent basal cell
    carcinoma following self‑treatment with a “natural cure,”
    Sanguinaria canadensis. Ophthalmic Plast Reconstr Surg
    2021;37:e71‑3.
    56. Laskey D, Tran M. Facial eschar following a single application of
    black salve. Clin Toxicol 2017;55:676‑7.
    57. Moreira TdA, Alvares‑Teodoro J, Barbosa MM, Guerra AA,
    Acurcio FdA. Use of medicines by adults in primary care: Survey
    on health services in Minas Gerais, Brazil. Rev Bras Epidemiol
    2020;23:e200025. Doi: 10.1590/1980‑549720200025.
    58. Baldin TigumanGM, SilvaMT, GalvaoTF. Use and self‑medication
    with antibiotics among adults in the Brazilian Amazon: A panel
    of two cross‑sectional studies, 2015 and 2019. Expert Rev Anti
    Infect Ther 2020;18:1263‑70.
    59. Costa CMFN, Silveira MR, Acurcio FdA, Guerra AA, Guibu IA,
    Costa KS, et al. Use of medicines by patients of the primary health
    care of the Brazilian unified health system. Rev Saúde Pública
    2017;51:18s. doi: 10.11606/S1518‑8787.2017051007144.
    60. Muniz IdAF, Campos DeS, Shinkai RSA, Trindade TGd,
    Cosme-Trindade DC. Case report of oral mucosa garlic burn
    during COVID-19 pandemic outbreak and role of teledentistry to
    manage oral health in an older adult woman. Spec Care Dentist
    2021;41:639‑43.
    61. de Paula ALT, Gonzaga WPF, Oliveira LM, Feibelmann TCM,
    Markus J. Exogenous intoxication by non‑prescribed use of
    vitamin D, a case report. BMC Geriatr 2020;20:1‑5. Doi: 10.1186/
    s12877‑020‑01614‑8
    62. Nagarajaiah B, Kishore M, NS SK, Panchakshari P. Prevalence and
    pattern of self‑medication practices among population of three
    districts of South Karnataka. Natl J Physiol Pharm Pharmacol
    2016;6:296‑300.
    63. Naing PA, Maung TM, Tripathy JP, Oo T, Wai KT, Thi A.
    Awareness of malaria and treatment‑seeking behaviour among
    persons with acute undifferentiated fever in the endemic regions
    of Myanmar. Trop Med Health 2017;45:1‑10. Doi: 10.1186/
    s41182‑017‑0070‑9.
    64. Tachi T, Yoshida A, Kanematsu Y, Sugita I, Noguchi Y, Osawa T,
    et al. Factors influencing the use of over‑the‑counter drugs and
    health foods/supplements. Pharmazie 2018;73:598‑604.
    65. Wang R, Ma C, Jiang K, Li M, Ma S. Descriptions of self‑treatment
    for the middle‑aged and elderly in Shanxi, China. PloS One
    2018;13:e0198554.
    66. Tripković K, Nešković A, Janković J, Odalović M. Predictors
    of self‑medication in Serbian adult population: Cross‑sectional
    study. Int J Clin Pharm 2018;40:627‑34.
    67. Volmer D, Raal A, Kalle R, Soukand R. The use of Panax ginseng
    and its analogues among pharmacy customers in Estonia:
    A cross‑sectional study. Acta Pol Pharm 2016;73:795‑802.
    68. Kajeguka DC, Moses E. Self‑medication practices and predictors
    for self‑medication with antibiotics and antimalarials among
    community in Mbeya City, Tanzania. Tanzania J Health Res
    2017;19.
    69. Horumpende PG, Said SH, Mazuguni FS, Antony ML,
    Kumburu HH, Sonda TB, et al. Prevalence, determinants and
    knowledge of antibacterial self‑medication: A cross sectional
    study in North‑eastern Tanzania. PloS One 2018;13:e0206623.
    70. Tiguman GMB, Silva MT, Galvao TF. Use and self‑medication
    with antibiotics among adults in the Brazilian Amazon: A panel
    of two cross‑sectional studies, 2015 and 2019. Expert Rev Anti
    Infect Ther 2020;18:1263‑70.
    71. Jerez‑Roig J, Medeiros LF, Silva VA, Bezerra CL, Cavalcante LA,
    Piuvezam G, et al. Prevalence of self‑medication and associated
    factors in an elderly population: A systematic review. Drugs
    Aging 2014;31:883‑96.
    72. Gualano MR, Bert F, Passi S, Stillo M, Galis V, Manzoli L, et al.
    Use of self‑medication among adolescents: A systematic review
    and meta‑analysis. Eur J Public Health 2015;25:444‑50.
    73. Domingues PHF, Galvão TF, Andrade KRCd, Sá PTTd, Silva MT,
    Pereira MG. Prevalence of self‑medication in the adult population
    of Brazil: A systematic review. Rev Saude Publica 2015;49. Doi:
    10.1590/s0034‑8910.2015049005709.
    74. OcanM, ObukuEA, BwangaF, AkenaD, RichardS, Ogwal‑OkengJ,
    et al. Household antimicrobial self‑medication: A systematic
    review and meta‑analysis of the burden, risk factors and outcomes
    in developing countries. BMC Public Health 2015;15:1‑11.
    75. SisayM, MengistuG, EdessaD. Epidemiology of self‑medication in
    Ethiopia: A systematic review and meta‑analysis of observational
    studies. BMC Pharmacol Toxicol 2018;19:1‑12.