BACKGROUND: Antibiotic self-medication is a global public health concern contributing to antibiotic resistance. This systematic review and meta-analysis aim to assess the prevalence of antibiotic self-medication and its associated factors in Ethiopia.
METHODS: A comprehensive search of electronic databases was conducted from MEDLINE (PubMed), Scopus, Google Scholar and Web of Science to identify relevant studies published between 2000 and 2024. Adult households, undergraduate university students and health care professionals who had taken antibiotics without a prescription in the household setting were included in this review. The primary outcome of this review is antibiotic self- medication. The random-effects model was used to estimate pooled prevalence rates. The outcome measure was analyzed with STATA version 17 software.
RESULTS: A total of nine studies were included in the Meta-analysis, comprising a sample size of 5908 participants. The pooled prevalence of antibiotic self-medication among Ethiopians was found to be 46.14 with 95% Confidence Interval [35.71, 56.57]. The most frequently used classes of self-medicated antibiotics were penicillins, followed by tetracyclines. Community pharmacies were the source of information that individuals utilized. The most common reported reasons for antibiotic self-medication include previous experience of treating a similar illness, to save cost, lack of time and avoiding waiting time for medical services. Participants having less than high school educational level was the most commonly reported factor associated with self-medication antibiotics.
CONCLUSIONS: Antibiotic self-medication is a prevalent practice in Ethiopia. This underscores the need for targeted interventions such as educating people about the risks associated with using antibiotics without medical guidance, which results in a reduction in antibiotic resistance.

BACKGROUND: Self-medication practice among pregnant women is a global concern. However, its understanding in the Indian context is limited due to a lack of comprehensive studies.
OBJECTIVE: This study aimed to comprehensively assess the prevalence of self-medication, the medications used for self-medication, diseases/conditions associated with self-medication, and the reasons for self-medication among Indian pregnant women.
METHODS: This study was carried out following the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A thorough search was done in PubMed, Embase, and Google Scholar to find articles that were published up until May 2023. Inclusion criteria comprised observational studies reporting self-medication prevalence among pregnant women in India. Data were extracted using a standardized sheet, and a random-effects model was applied to determine the overall prevalence of self-medication using R software. The I2 statistic was employed to assess the heterogeneity among the studies.
RESULTS: This study analyzed eight studies with a collective sample size of 2208 pregnant women. The pooled prevalence of self-medication among pregnant Indian women was 19.3% (95% CI: 7.5%-41.3%; I2 = 99%; p < 0.01). Common self-treated conditions were cold, cough, fever, headache, and stomach disorders. Antipyretics, analgesics, antihistamines, and antacids were frequently used for self-medication. The perception of mild ailment, immediate alleviation, convenience, time savings, and advice from family, friends, or the media were all reasons for self-medication. Local pharmacies were the most usual source for obtaining drugs, and pharmacists, family, friends, and past prescriptions were common sources of medicine information.
CONCLUSIONS: A low yet substantial number of pregnant women in India are engaged in self-medication practices. Appropriate strategies need to be planned to reduce self-medication practices to attain sustainable developmental goals for maternal health in India.

Self-medication during pregnancy is of great interest. The use of drugs during pregnancy requires a careful reflection on the benefits to the mother and the risks to the fetus. Selecting a drug or drugs for treating pregnant women can be difficult for clinicians owing to the various pharmacokinetic and physiological changes encountered during pregnancy. This systematic review and meta-analysis aimed to estimate the pooled prevalence of self-medication and associated factors among women during pregnancy.
Searches were carried out at PubMed, Science Direct, Web of Science, and Google Scholar. The quality of the studies and the risk of bias were analyzed using the Joanna Briggs Critical Appraisal Checklist for Analytical Cross-Sectional Studies instrument. The extracted data were tabulated and analyzed qualitatively and quantitatively through meta-analysis.
The overall prevalence of self-medication among pregnant women was 44.50% (95% CI: 38.92-50.23). Subgroup analyses showed differences in self-medication prevalence influenced by region, county income, and study design. The Heterogeneity, assessed by the statistical test I2 varied from 96 to 99% and was statistically significant. The result of this funnel plot showed that the funnel plot was symmetry with p-value = 0.36, and there is no publication bias.
The results obtained from this study showed that the prevalence of self-medication among pregnant women is relatively high. This requires effective measures and interventions to reduce self-medication.
ID =  CRD42022312333 .

Self-medication is a widespread public health issue that has continued to grow without ever reaching a level, both in wealthy and underdeveloped countries. Residents of Port Harcourt, Nigeria, have faced danger to their health from malaria, and because they have limited access to healthcare, the majority of them turn to self-medication to treat the disease. The study\'s goal was to ascertain how well-informed Port Harcourt citizens were of the negative effects of self-medication for malaria on their health. Self-medication was a common practice among the research population. However, their understanding of how self-medication for malaria affects health is not particularly strong. The findings and explanations show that this is reflected in their attitude and behavior regarding self-medicating behaviors. The vast majority of people think they can treat their cases of malaria by using symptoms, prior experiences, and a suitable diagnostic laboratory test to confirm the disease. The two biggest causes of self-medication were low income and a lack of health insurance, while other minor factors included a lack of healthcare facilities, high medicine prices, an inability to pay for medical bills, being near a hospital, and having a negative attitude towards physicians. The findings show that self-medication is continuing to rise and that it will continue to have an influence on malaria prevention and treatment in the study region unless the government and other people in positions of authority do something about it.
L\'automédication est un problème de santé publique répandu qui n\'a cessé de croître, tant dans les pays riches que dans les pays en développement. Les habitants de Port Harcourt, au Nigeria, sont confrontés à un danger pour leur santé en raison du paludisme et, en raison de leur accès limité aux soins de santé, la majorité d\'entre eux ont recours à l\'automédication pour traiter la maladie. L\'objectif de l\'étude était de déterminer dans quelle mesure les habitants de Port Harcourt étaient informés des effets négatifs de l\'automédication pour le paludisme sur leur santé. L\'automédication était une pratique courante parmi la population étudiée. Cependant, leur compréhension de la manière dont l\'automédication pour le paludisme affecte la santé n\'est pas particulièrement solide. Les résultats et les explications montrent que cela se reflète dans leur attitude et leur comportement en ce qui concerne les comportements d\'automédication. La grande majorité des personnes pensent qu\'elles peuvent traiter leurs cas de paludisme en utilisant les symptômes, les expériences antérieures et un test de laboratoire de diagnostic approprié pour confirmer la maladie. Les deux principales causes de l\'automédication étaient le faible revenu et le manque d\'assurance maladie, tandis que d\'autres facteurs mineurs comprenaient le manque d\'infrastructures de santé, le coût élevé des médicaments, l\'incapacité à payer les factures médicales, la proximité d\'un hôpital et une attitude négative envers les médecins. Les résultats montrent que l\'automédication continue de progresser et qu\'elle continuera d\'avoir une influence sur la prévention et le traitement du paludisme dans la région étudiée, à moins que le gouvernement et d\'autres personnes en position d\'autorité ne fassent quelque chose à ce sujet. Mots-clés: Attitude et comportement, absence d\'assurance maladie, faible revenu, santé publique.

Decreasing the prevalence of antibiotic self-medication among the public requires proper understanding of the risk factors involved. However, the determinants of antibiotic self-medication are not well defined.
To identify patient and health system-related determinants of antibiotic self-medication among the public.
A systematic review of quantitative observational studies and qualitative studies was undertaken. PubMed, Embase, and Web of Science were searched to identify studies on determinants of antibiotic self-medication. The data were analyzed using meta-analysis, descriptive analysis, and thematic analysis.
Sixty-eight studies were included in the review. From meta-analyses, male sex (pooled odds ratio [POR]: 1.52, 95% confidence interval [CI]: 1.19-1.75), lack of satisfaction with healthcare services/physicians (POR: 3.53, 95% CI: 2.26-4.75) were associated with antibiotic self-medication. In subgroup analysis, lower age was directly associated with self-medication in high-income countries (POR: 1.61, 95% CI: 1.10-2.36). In low- and middle-income countries, people with greater knowledge of antibiotics were less likely to self-medicate (POR: 0.2, 95% CI: 0.08-0.47). Patient-related determinants identified from descriptive and qualitative studies included previous experience with antibiotics and similar symptoms, perceived low severity of disease, intention to save time and get better quickly, cultural beliefs about curative power of antibiotics, advice from family/friends, and having home stock of antibiotics. Health system-related determinants included high cost of consulting physicians and low cost of self-medication, lack of access to physician/medical care, lack of trust/confidence in physicians, greater trust in pharmacists, long distance of physicians/healthcare facilities, long waiting time at healthcare facilities, easy access to antibiotics from pharmacies, and convenience associated with self-medication.
Patient and health system-related determinants are associated with antibiotic self-medication. Interventions to decrease antibiotic self-medication should incorporate community programs along with appropriate policies and healthcare reforms targeting these determinants with specific attention to population at high risk of self-medication.

To evaluate the prevalence, influencing factors, and behavior rules of self-medication in children. Articles on self-medication in children from various electronic databases (PubMed, Cochrane Library, Web of Science, the WHO website (https://www.who.int/), ABI, CNKI, and Wanfang), were searched to August 2022. The single-group meta-analyses of the prevalence, influencing factors, and behavior rules of self-medication in children were performed using Revman 5.3 and Stata 16.0. The overall pooled prevalence of self-medication in children was 57% (95% CI: 0.39-0.75, I² = 100%, P < .00001 Z = 6.22). The pooled prevalence for main influencing factors, in terms of caregivers, was: 73% (95% CI: 0.72-0.75, I² = 100%, P < .00001, Z = 111.18) for those in rural areas; 55% (95% CI: 0.51-0.59, P = .04, Z = 26.92, I² = 68%, P < .00001) for females; 75% (95% CI: 0.74-0.76, I² = 68%, P < .00001, Z = 106.66) for those whose income was less than 716 dollars; 77% (95% CI: 0.75-0.79, I² = 99%, P < .000001, Z = 92.59) for the middle-aged and elderly; and 72% (95% CI: 0.58-87, I² = 99%, P < .00001, Z = 9.82) for those with a degree below bachelor. In the process of self-medication for children, 19% (95% CI: 0.06-0.32, I² = 99%, P < .00001, Z = 2.82) of the caregivers did not read the instructions, 28% (95% CI: -0.03-0.60, I² = 100%, P < .000001, Z = 1.77) neglected adverse effects, 49% (95% CI: 0.11-0.87, I² = 100%, P = .01, Z = 2.51) spontaneously increased or decreased the dosages, 49% (95% CI: 0.48-0.55, I² = 65%, P < .00001, Z = 16.51) had an awareness of over-the-counter (OTC) drugs, and 41% (95% CI: 0.18-0.64, I² = 99%, P < .00001, Z = 3.49) misrecognized the antibiotics. Self-medication for children was common, although the overall prevalence was not very high. The prevalence of self-medication in children was relatively higher among those caregivers who were female, rural, had low-income, were elder, or had a degree below bachelor. Common behaviors during self-medication in children included spontaneous dose increase or decrease, a lack of awareness of OTC drugs, and misconception of antibiotics. Government departments should formulate corresponding policies to provide quality health education resources for the caregivers of children.

This study estimates the prevalence of self-medication and provides an understanding of the reasons for self-medication in Ghana through the synthesis of relevant literature.
A comprehensive search was conducted in PubMed, Science Direct and African Journals Online to identify observational studies published from inception to March 2022. Google scholar and institutional websites were searched for grey literature. We included studies reporting primary data on the prevalence and/or reasons for self-medication in Ghana. Random-effects meta-analysis was used to estimate the prevalence of self-medication. Subgroup analysis was performed with the study population (pregnant women, patients and students), geopolitical zone (coastal, middle and northern) and study setting (rural and urban). Using inductive thematic analysis, reasons for self-medication were classified and tallied under key themes.
Thirty studies involving 9271 participants were included in this review. The pooled prevalence of self-medication in Ghana was 53.7% (95% CI 46.2% to 61.0%; I²=98.51%, p<0.001). Prevalence of self-medication was highest among pregnant women (65.5%; 95% CI 58.1% to 72.5%; I2=88%), in the middle belt of the country (62.1%; 95% CI 40.9% to 82.0%; I²=98%; p<0.001) and in rural settings (61.2%; 95% CI 36.5% to 84.5%; I²=98%; p<0.001). The most cited reasons for self-medication included long waiting time at health facilities (73.3%), previous use of drugs (66.7%) and the perceived unseriousness of diseases (53.3%).
This study has revealed that self-medication is still an unresolved public health challenge in Ghana, with a high prevalence estimate. Self-medication is influenced by inconveniences associated with accessing healthcare coupled with poor health seeking behaviours. There is the need for improved access to quality healthcare and the promotion of appropriate health-seeking behaviours.

Introduction: Patient information leaflets (PILs) of medicinal products are informative documents that accompany medicines and explain their components, modes of use, interactions with other medicines, and other relevant issues. When patients do not adequately understand the information in the leaflets, they may engage in behaviors that affect their health (e.g., self-medication). Objective: To identify patient-related factors and characteristics of PILs that can promote cognitive, emotional, and behavioral changes that lead to appropriate drug use practices. Additionally, we aimed to determine strategies that could be implemented to design leaflets that convey adequate information and are easier to understand. Method and Results: We evaluated scientific articles published in databases and containing information on PILs suitability to be used in a patient population. A total of 51 articles were selected as the sample. Certain leaflet factors that favored or hindered understanding were identified (e.g., format in which the leaflets are presented, their structure, their adaptation to the sociodemographic and linguistic characteristics of the population, their wording…). Similarly, we also identified patient factors, such as previous experience taking the drugs referred to in the leaflet; the type of emotions experienced when reading the leaflets; the emphasis on the adverse effects of the medications; sociodemographic variables (i.e., age or educational level); and degree of interest in their own healthcare. Conclusion: Patient and leaflet factors influence the comprehension of information in the PIL; hence, emphasis should be placed on these factors to increase treatment and medication adherence and to reduce health-risk behaviors.

Previous studies have assessed the prevalence and characteristics of self-medication in COVID-19. However, no systematic review has summarized their findings.
We conducted a systematic review to assess the prevalence of self-medication to prevent or manage COVID-19.
We used different keywords and searched studies published in PubMed, Scopus, Web of Science, Embase, two preprint repositories, Google, and Google Scholar. We included studies that reported original data and assessed self-medication to prevent or manage COVID-19. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) modified for cross-sectional studies.
We identified eight studies, all studies were cross-sectional, and only one detailed the question used to assess self-medication. The recall period was heterogeneous across studies. Of the eight studies, seven assessed self-medication without focusing on a specific symptom: four performed in the general population (self-medication prevalence ranged between <4% to 88.3%) and three in specific populations (range: 33.9% to 51.3%). In these seven studies, the most used medications varied widely, including antibiotics, chloroquine or hydroxychloroquine, acetaminophen, vitamins or supplements, ivermectin, and ibuprofen. The last study only assessed self-medication for fever due to COVID-19. Most studies had a risk of bias in the \"representativeness of the sample\" and \"assessment of outcome\" items of the NOS.
Studies that assessed self-medication for COVID-19 found heterogeneous results regarding self-medication prevalence and medications used. More well-designed and adequately reported studies are warranted to assess this topic.

Panic disorder is a debilitating psychiatric disorder that often co-occurs with substance use disorders. Given the current opioid epidemic, the high reported rates of comorbid panic disorder and opioid use disorder are particularly concerning. In this narrative review, we describe the literature on panic disorder and opioid use disorder co-occurrence.
86 studies, 26 reviews, 2 commentaries, and 5 guidelines pertaining to opioid use disorder, panic disorder, and their comorbidity were identified using all EBSCO databases, PubMed, and Google Scholar.
First, we review epidemiological literature on the prevalence of the comorbid condition above and beyond each disorder on its own. Additionally, we discuss the challenges that complicate the differential diagnosis of panic disorder and opioid use disorder and contribute to difficulties establishing rates of comorbidity. Second, we review three theoretical models that have been proposed to explain high rates of co-occurring panic disorder and opioid use disorder: the precipitation hypothesis, the self-medication hypothesis, and the shared vulnerability hypothesis. Third, we outline how co-occurring panic and opioid use disorder may impact treatment for each condition.
Based on findings in the field, we provide recommendations for future research as well as treatment considerations for co-occurring panic and opioid use disorders.