Self-treatment among students at the Public Health Faculty of the

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HEALTH AND WELLNESS 4/2014
WELLNESS AND SOCIETY
CHAPTER X
Emergency Medicine
Department of Child Neurosurgery and Emergency Medicine Clinic
Public Health Faculty, Medical University of Silesia in Katowice
ul. Piekarska 18, 41-902 Bytom
Zakład Medycyny Ratunkowej
Katedry Neurochirurgii Dziecięcej i Medycyny Ratunkowej
Wydział Zdrowia Publicznego, Śląski Uniwersytet Medyczny w Katowicach
*Department of Basic Medical Sciences Public Health Faculty
Medical University of Silesia in Katowice
ul. Piekarska 18, 41-902 Bytom
Katedra i Zakład Podstawowych Nauk Medycznych
Wydział Zdrowia Publicznego
Śląski Uniwersytet Medyczny w Katowicach
JOANNA MAKARSKA, DARIUSZ MYRCIK,
MAGDALENA TRZEPIZUR, KAROLINA WALAS*,
KATARZYNA CHOJNACKA*, TOMASZ STĘPIEŃ,
ARKADIUSZ NICZYPORUK, BOGUSŁAW BUCKI,
MAREK MANDERA
Self-treatment among students
at the Public Health Faculty
of the Medical University of Silesia
Zjawisko „samoleczenia” wśród studentów
Wydziału Zdrowia Publicznego Śląskiego
Uniwersytetu Medycznego w Katowicach
Key words: self-treatment, students
Słowa kluczowe: samoleczenie, studenci
INTRODUCTION
Suffering and pain form an inseparable part of human existence. Illnesses, persistent complaints and malaise make it difficult to function in everyday life. Therefore,
Wellness and society
as soon as first symptoms of a physical – as well as a mental discomfort occur, you
instinctively try to cope with your health problem. There are two groups of people
who deal with such situations in a different way. In order to manage their persistent
complaints, people from the first group consult a physician. The second group, however, includes individuals who take pharmaceuticals and parapharmaceuticals available at pharmacies and in herbal shops. The pharmaceutical market offers a large
variety of products that relief everyday complaints, such as pain, cold, allergy, and
insomnia.
The term ‘self-treatment’ is ambiguous. It may be understood in a general meaning as ‘self-care’, or in a more specific meaning as ‘self-medication’ [3]. According
to the World Health Organization, self-treatment should be understood as taking
pharmaceuticals in order to treat illnesses or symptoms recognised without any medical consultation. In a broader sense, self-treatment means all activities demonstrating conscious decisions leading to the maintenance and improvement of one’s
health. Self-treatment may also refer to a broadly understood lifestyle based on
avoiding health risks and defending one’s health. Therefore, self-treatment also
means being physically active and taking care for proper nutrition.
Recently, there has been an increased interest in preventive medications, including OTC-drugs. Independent application of OTC-medications in the case of nonserious diseases and complaints has turned into a common phenomenon. There are
two categories of OTC-drugs applied by individuals without any consultation of
a physician. The first group includes medications that are defined, registered and
acknowledged by the Polish legal system as drugs. The second category involves
other OTC-products, such as: paramedical products, supplementing parapharmaceuticals, cosmetics, and medical materials. Self-treatment does not only concern pharmaceutical products. Phytotherapy (treatment based mainly on herbal extracts),
homeopathy, and alternative medicine are also part of the idea [1, 3, 4].
The aim of this study is to assess the phenomenon of self-treatment in students
of the Public Health Faculty of the Medical University of Silesia in Katowice. The
research and discussion focuse mainly on the frequency of occurrence of the phenomenon of self-treatment, the reasons of taking drugs without medical consultation,
the types of applied drugs as well as the sources of information about OTC-drugs to
which students most often refer.
MATERIAL AND METHOD
The research was conducted from the 1st of October 2012 until the 31st of January 2013, involving 700 students of the Public Health Faculty of the Medical University of Silesia in Katowice. The group included 466 female- and 234 male intramural and extramural students aged 19 to 26 who specialised in dietetics and public
health. The students were asked to complete an anonymous questionnaire prepared
by the author of the research. The questionnaire consisted of two parts. The first part
of the questionnaire included general questions concerning gender, age, place of
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Joanna Makarska, Dariusz Myrcik, Magdalena Trzepizur, Karolina Walas,
Katarzyna Chojnacka, Tomasz Stępień, Arkadiusz Niczyporuk, Bogusław Bucki,
Marek Mandera
Self-treatment among students at the Public Health Faculty
living, as well as type (intramural, extramural) and year of studies. The second part
of the questionnaire involved questions leading to the assessment of the phenomenon of self-treatment, such as questions referring to frequency of application of
OTC-drugs, reasons of application of such drugs and the type of most frequently
bought medical products. All information provided by the respondents has been used
exclusively for the purposes of this research. The results of the research have been
illustrated in tables and pictures. In order to analyse statistical data, Microsoft Excel
has been used.
RESULTS
A vast majority of respondents consisted of young individuals aged 25 or under
(97%). There were 452 women (65%) in 679 students in this group. One third of the
group was composed of men (227 male students). There were only 21 respondents
aged over 25. These 21 individuals formed 3% of all interviewed. To add to this,
2% out of the 3% were female students (14). Male students aged over 25 constituted
only 1% of the group (7 students).In the group of 466 female respondents, 348 students declared application of OTC-products, whereas the other 118 women mentioned that they bought medicaments after medical consultation and having received
a prescription. One hundred forty five male respondents preferred self-treatment.
The smallest group of students consisted of 85 male respondents who declared buying drugs after having consulted a physician. A detailed analysis of the frequency of
application of prescription medicines and OTC-drugs in the group of students of the
Public Health Faculty of the Medical University of Silesia in Katowice with regard
to gender has been presented in the picture no. 1.
60%
50%
50%
40%
Women
30%
20%
21%
17%
Men
12%
10%
0%
prescription
OTC-drugs
medicines
Picture 1. The frequency of application of prescription medicines and OTC-drugs in
the group of students of the Public Health Faculty of the Medical University of Silesia in Katowice with regard to gender
147
The largest number of respondents (582 individuals, 83%) explained that the reason why they preferred to buy OTS-medications was lack of time to consult a physician. Another reason provided by 58 students (8%) was difficulty in consulting a
physician resulting either from a long waiting time for a specialist consultation, or
difficult access to a physician because of a distant place of living. Finally, 60 interviewed (9%) ticked the answer “other”, providing us with further possible reasons,
such as: higher costs of treatment when taking prescription medicines, lack of trust
to the physician, trust in natural methods of treatment and aversion to antibiotics.
The most frequent reasons of purchasing OTC-drugs provided by the students of the
Public Health Faculty of the Medical University of Silesia in Katowice with regard
to their gender have been presented in the picture no. 2.
70%
64%
60%
50%
40%
30%
20%
20%
10%
5%
4%
3%
4%
0%
Women
Men
Lack of time difficulty in consulting a physician
Other
Picture 2: The reasons of purchasing OTC-drugs in the group of student of the Public Health Faculty of the Medical University of Silesia in Katowice with regard to
gender
Almost half of the interviewed (336 individuals) decided to take OTC-drugs because of such complaints as headache, sinus pain, toothache, pain in the bones- and
joints system, and period pain. The second most frequent type of OTC-drugs bought
by students were medicines against flu and cold (133 students). Another 70 respondents bought OTC-medicaments against gastrointestinal disorders, whereas in case of
56 students the reason why they purchased drugs without prescription was allergy.
Finally, a group of 105 interviewed declared taking other medicines than could not
be selected in the questionnaire. People in this group enumerated vitamin products,
dietary supplements, herbal products, soporific drugs and tranquilisers. A detailed
analysis of this aspect of the problem has been illustrated in the picture no. 3.
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Marek Mandera
60%
50%
48%
40%
30%
19%
20%
10%
15%
10%
8%
Gastrointestinal
disorders
Allergy
0%
Pain
Cold/Flu
Other
Picture 3. The reasons of the application of OTC-drugs in the group of student of the
Public Health Faculty of the Medical University of Silesia in Katowice
The most popular drugs among the students of the Public Health Faculty of the
Medical University of Silesia in Katowice were non-steroidal anti-inflammatory
drugs (NSAIDs). This group of medicaments was chosen by 420 (60%) interviewed
students. The second most popular group of drugs among the respondents included
vitamin- and mineral products as well as products boosting the immune system.
These products were chosen by 133 (19%) interviewed. OTC- antihistamine
medicaments applied in the treatment of allergies was bought by 42 (6%) respondents without having consulted a physician. Another 49 (7%) students purchased
OTC-gastric acid secretion inhibitors, H2 receptors antagonists or proton pump
inhibitors. Finally, 56 (8%) respondents decided to take drugs from other groups,
such as tranquilisers, weight-loss products and products helping to quit smoking. A
detailed analysis of the frequency of application of the specific groups of OTC-drugs
in the group of student of the Public Health Faculty of the Medical University of
Silesia in Katowice has been presented in pictures no. 4 and picture no. 5.
149
7%
8%
6%
19%
60%
NLPZ
leki p/bólowe, p/zapalne i p/gorączkowe
NSAIDs
Vitamin/mineral
system boosting products
Witaminy,
minerały,products/immune
preparaty na odporność
Antihistamine medicaments
Alergia
Gastric
acid secretion
inhibitors
Leki
na problemy
żołądkowe
Other
Inne
Picture 4. The frequency of application of the specific groups of OTC-drugs in the
group of student of the Public Health Faculty of the Medical University of Silesia in
Katowice
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Marek Mandera
100%
Procentowy udział
80%
60%
42%
40%
18%
20%
12%
3%
4%
5%
7%
3%
3%
3%
0%
kobiety
mężczyźni
NLPZ
leki p/bólowe, p/zapalne i p/gorączkowe
NSAIDs
Witaminy,
minerały, preparaty na
odporność
Vitamin/mineral/immune
system
boosting products
Alergia
Antihistamine medicaments
Inne
LekiGastric
na problemy
acid żołądkowe
secretion inhibitors
Other
Picture 5. The frequency of application of the specific groups of OTC-drugs in the
group of student of the Public Health Faculty of the Medical University of Silesia in
Katowice with regard to their gender
The most popular among OTC-medicaments was Ibuprom that was mentioned
by 273 (39%) respondents. Another very common drug was Apap that was chosen
by 238 (34%) students. The third of the top positions was held by Gripex that was
indicated by 133 (19%) interviewed. The least popular OTC-medicament mentioned
by only 56 (8%) participants of the research was Rutinoscorbin (picture no. 6)
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8%
19%
39%
34%
Ibuprom
Apap
Gripex
Rutinoskorbin
Picture 6. The most popular among OTC-medicaments drugs in the group of student
of the Public Health Faculty of the Medical University of Silesia in Katowice
The respondents indicated various factors that had had an impact on their choice
of the drug. Firstly, according to 400 (57%) respondents, their decisions on the medicament were influenced by the pharmacist’s recommendation. Secondly, 182
(26%) interviewed students bought drugs following the opinion of their families or
friends. Thirdly, 97 (14%) respondents chose medicaments under the influence of
advertisements. Other factors having an impact on the choice of OTC-medicaments
mentioned by the students were price, amount of pills in a packet and being used to
a certain drug (21 individuals; 3%). A detailed analysis of factors that had an impact
on the choice of the drug in the group of student of the Public Health Faculty of the
Medical University of Silesia in Katowice has been presented in pictures no. 7.
152
Marek Mandera
3%
26%
57%
14%
Pharmacist’s farmaceuty
recommendation
Wskazanie
Reklama,
ulotka
Advertisements
Wskazanie
otoczenia
Friends recommendation
Inne
Other
Picture 7. Factors that had an impact on the choice of the drug in the group of student of the Public Health Faculty of the Medical University of Silesia in Katowice
DISCUSSION
There has been an increase in the interest in self-treatment in the recent years.
This increase may be related to the fact that self-treatment is becoming a more and
more common way of taking care of one’s health. The tendency may result from an
increased consciousness, maturity of patients, as well as from the progress of civilisation. Knowledge development and social education constitute an obvious basis of
the development of self-treatment.
According to Krajewski-Siuda [3], the progress in the phenomenon of selftreatment is unavoidable. Self-treatment is a result of the progress of civilisation. It
is expected that after some time, the structure of the healthcare system in Poland will
be reorganised as a consequence of the demographic changes (ageing of population)
and the creation of alternative healthcare systems (such as one day clinics). What is
more, increasing limitations of access to a physician’s consultation (especially a
specialist’s) will automatically encourage the development of self-treatment.
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A quite interesting aspect of self-treatment that has been developing recently is
the so called ‘self-management’. Owing to a developed health education of patients,
the number of unnecessary medical consultations and interventions has been limited,
costs of treatment have decreased, and the living standards of the patients have been
improved. Such organisation of healthcare and treatment involving patient enables
physicians who are part of the healthcare system to treat a higher number of patients
even without any changes in the system of national healthcare financing [6]. Contemporary understanding of self-treatment also involves a continuation of the treatment commenced by the physician in case of chronic diseases. There have also been
cases of preventive treatment based on OTC-drugs that have been consulted with
physicians at first, and after that have been successfully applied by the patients
themselves.
Self-treatment, however, may also involve the aspect of self-medication that can
be understood as the application of drugs with no medical consultation. The most
serious potential risk of self-medication is polypharmacy. Nevertheless, it should be
differentiated between the phenomenon of polypharmacy and polytherapy. While
the term ‘polypharmacy’ stands for a simultaneous application of a set of drugs
without being fully aware of the effects and potential interactions of the drugs with
each other, whereas the term ‘polytherapy’ means a treatment combining a couple of
drugs but under control of a physician.
A negative effect of self-treatment is also postponing medical consultations,
which may lead to late recognition of diseases and, as a consequence, late specialised treatment [6].
Our research conducted last year concerned a group of 700 intramural and extramural students who specialised in dietetics and public health at the Public Health
Faculty of the Medical University of Silesia in Katowice. The results of the research
have indicated that the respondents frequently applied OTC-drugs. The analysis of
the material has illustrated that a majority (two third) of interviewed declared selfmedication, and only one third bought medical products after having consulted a
physician.
Similarly, the results of the research by Pączkowska (an analysis under the auspices of The Department of Research and Sociological Analyses conducted from
April 2007 until April 2008) have shown that more than 75% of Poles buy OTCdrugs [4]. In 1996, 48% of respondents declared to have used home methods of
treatment. There has been no significant change in the next two years as in 1998,
there was an increase to 52% of interviewed. A more visible change in percentage
can be observed in patients who consult a physician and follow his or her prescriptions (31% in 1996 and 56% in 1998). Moreover, a comparison and contrast analysis
of the results in 1996 and 1998 with the results of a survey conducted after a decade
indicate a significant increase of the importance of OTC-drugs applied in home
treatment. The reasons of such an increase may be a better access to OTC-drugs, a
higher amount of products of this type on the pharmaceutical market, and
a considerable change in Poles’ awareness of the responsibility for their own health
[3, 4].
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Marek Mandera
The reasons why Poles tend to buy medications without any medical consultation
needs a further investigation. According to Krajewski-Siuda et al. [3], the most frequent complaints that make Poles decide on a self-treatment with the use of OTCdrugs are such complaints as different types of pain, as well as cold and flu (76% of
interviewed in total). Similarly in our research, a majority of students most often
applied OTC-drugs to treat pain (48%), cold and flu (19%). However, in the research by Krajewski-Siuda et al. [3], gastrointestinal complaints were the most often
provided reason of buying OTC-drugs in only 2%, whereas in our research, gastric
complaints were the most frequent reason of OTC-treatment for 8% of interviewed.
Taking into account that a majority of students participating in the later research
were students of dietetics, the high percentage of respondents declaring the application of OTC-drugs as a result of digestive problems seems quite interesting.
From a group of OTC-drugs, students most frequently selected non-steroidal anti-inflammatory drugs (67% of respondents). A similar phenomenon has been observed by Rogulska [5]. In her analysis, there has been 65% of interviewed who
declared the application of NSAIDs available without prescription. A slightly lower
percentage of respondents (57%) stated that they bought OTC-painkillers without
medical consultation in the research by Pączkowska [4].
The second most popular group of products among the group of students involved in our research were vitamin products, minerals, dietary supplements and
immune system boosters (19% of respondents). Moreover, a corresponding group in
the research by Pączkowska [4] included a slightly lower number of individuals
(13%). Surprisingly, the analysis by Rogulska [5] indicates that vitamin products
and dietary supplements were applied by as much as 44% of participant of her research. The considerable difference in the results of each analysis may derive from
the differences in the interviewed populations. In other words, our research involved
a specific group of individuals, a majority of them being students of dietetics, who
understood the importance of vitamins and minerals being a part of a properly balanced diet.
The most popular medicaments among students of the Public Health Faculty
were Ibuprom, Apap and Gripex. Our observations have confirmed the results of
other authors’ research: ibuprofen and paracetamol, being known on the market
under various trade names, have been the most often purchased OTC-drugs [1, 2, 5,
7]. According to Szalonka et al. [7], 38% of interviewed asked to provide a name of
an OTC-painkiller mentioned Ibuprom and Apap. The popularity of these two products may indicate that they are well promoted on the media and thus generally
known to Poles. The impact of advertisements and media has not been confirmed in
our research, where only 14 % respondents declared to have been influenced by the
media when deciding on a medication.
The main factor influencing the decision making process concerning OTC-drugs
in our group of respondents was pharmacist consultation (57% of students), whereas
26% of students followed the opinion of their friends and relatives. According to the
155
research by the Polish Research Institute of Public Opinion, each ten individual has
confirmed that it is usually the pharmacist who has the greatest impact on his or her
decision on a drug [8].
The influence of advertisements on the decision which medication to buy has
been mentioned by a very low percentage of respondents [4, 5, 10]. To illustrate, in
the research by Szalonka et al. [7], only 2% of interviewed pointed out to advertisement as the source of their decisions on a medication. However, a low percentage of respondents who declared the influence of the media on their decision making
with regard to drugs may derive from the fact that the perception of advertisements
is often subconscious and the recipients are often not aware of the impact of the
media on their decisions. This hypothesis has been confirmed by WaszczykNowaczyk et al. [9]. They have interviewed pharmacists who have pointed out that,
in their opinion, advertisement has a great impact on the decisions of patients at
a pharmacy.
CONCLUSION
1. The phenomenon of self-treatment among students of the Public Health Faculty
of the Medical University of Silesia in Katowice has been assessed as common.
The application of methods of self-treatment has been declared by 75% femaleand 64% male students.
2. The reason of applying methods of self-treatment provided by a majority of
respondents has been lack of time for a medical consultation.
3. Pain has been the most often reason why the interviewed students have decided
on OTC-medicaments. The most frequently bought drugs have been non-steroid
anti-inflammatory drugs.
4. More than half of the students have bought an OTC-drug under the influence of a
pharmacist’s recommendation.
5. The most-frequently bought OTC-medication in the group of the interviewed
students has been Ibuprom.
REFERENCES
1. Bochenek T.: Medyczne, społeczne i ekonomiczne aspekty samoleczenia oraz
samoopieki. Samoleczenie a problematyka kosztów w systemie ochrony
zdrowia. W: Samoleczenie. Instytut Sobieskiego, Warszawa 2012, 99-120.
2. Cichońska M. et al.: Stosowanie leków przeciwbólowych i witamin dostępnych
bez recepty. Acta Scientifica Academiae Ostrovuensis. 2013; 1: 165-198.
3. Krajewski-Siuda K. et al.: Samoleczenie jako problem zdrowia publicznego. W:
Samoleczenie. Instytut Sobieskiego, Warszawa 2012, 31-97.
4. Pączkowska M.: Korzystanie z leków i ich dostępność. Wydział Badań i Analiz
Socjologicznych CISOZ, 2008.
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Marek Mandera
5. Rogulska B., Feliksiak M.: Stosowanie leków dostępnych bez recepty.
Warszawa: Centrum Badanie Opinii Społecznej, 2010.
6. Rybus-Potęba E., Marczewski K.: Samoleczenie - stare zagrożenia czy nowy
świat pomocy dla pacjenta. Zdr Publ. 2001, 111; 1: 31-36.
7. Szalonka K. et al.: Rola aptek a świadomość i racjonalność konsumpcji leków w
Polsce w świetle badań. PSZW. 2011; 54: 39-52.
8. Walus A. Informacja medyczna a zdrowie pacjenta. Instytut Globalizacji Gliwice
2006.
9. Waszyk-Nowaczyk M., Simon M.: Znaczenie porady farmaceuty w procesie
samoleczenia się pacjentów. Farm. Pol. 2009: 65: 772-774.
10. Zarzeczna-Baran M. et al.: Wpływ reklamy na zakup leków dostępnych bez
recepty. Ann. Acad. Med. Gedan. 2013; 43: 77-87.
ABSTRACT
The aim of this study is to assess the phenomenon of self-treatment in students of
the Public Health Faculty of the Medical University of Silesia in Katowice. The
research was conducted from October 2012 until January 2013, involving 700 students, 466 female- and 234 male, aged 19 to 26. The phenomenon of self-treatment
among students of the Public Health Faculty has been assessed as common. The
reason of self-treatment has been lack of time for a medical consultation. Pain has
been the most often reason why the interviewed students have decided on OTCmedicaments. The most frequently bought drugs have been NSAIDs. More than half
of the students have bought an OTC-drug under the influence of a pharmacist’s
recommendation. The most-frequently bought OTC-medication in the group of the
interviewed students has been Ibuprom.
STRESZCZENIE
Celem pracy jest ocena zjawiska „samoleczenia” wśród studentów Wydziału
Zdrowia Publicznego Śląskiego Uniwersytetu Medycznego w Katowicach. Badanie
przeprowadzono od 1 października 2012 roku do 31 stycznia 2013 roku wśród 700
studentów, 466 kobiet i 234 mężczyzn w wieku od 19 do 26 lat. Zjawisko samoleczenia w badanej grupie można uznać za powszechnie występujące. Większość
ankietowanych jako główną przyczynę leczenia się na własną rękę podaje brak czasu na skorzystanie z konsultacji medycznej. Najczęstszą przyczyną stosowanie leków dostępnych bez recepty są dolegliwości bólowe, a najczęściej kupowane leki
należą do grupy NLPZ. Ponad połowa ankietowanych dokonuje zakupu leku pod
wpływem opinii farmaceuty. Najczęściej kupowanym lekiem bez recepty w grupie
ankietowanych studentów jest Ibuprom.
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Self-treatment among students at the Public Health Faculty of the

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