Abstract
Background: Self-medication refers to the use of medication without medical supervision. This can involve either taking a prescribed drug for chronic or recurring conditions or symptoms or using over-the-counter medications to treat self-diagnosed issues. Older adults are especially susceptible to self-medication, as they may have multiple health conditions and be taking several medications.
Objective: This systematic review aims to identify the prevalence, types of medicines, factors, and causes associated with self-medication among older adults.
Methods: The databases searched included PubMed platform, and the step was further repeated at other databases such as Scopus, Science Direct, Taylor and Francis Online, and Google Scholar. Original research articles reporting the prevalence, types of medicines, factors, and causes associated with the practice of self-medication by elderly, which was available as full text, published in English language between the years 2011 and 2022 were included in the review. Commentaries, letters to editor, and conference proceedings were excluded.
Results: A total of 11 articles were included. The data generated four main subtitles: (1) prevalence of self-medication among older adults, (2) types of medicines for self-medications, (iii) factors influencing elderly to self-medications, and (4) causes of elderly practice self-medications.
Conclusion: The incidence of self-medication among older adults varies across countries and years of research. Brazil reported the highest rate of 85.5% in 2013, while Spain had the lowest rate at 7.8%. Analgesics are the most used medicines, followed by antipyretics and vitamins. Factors such as urgency for treatment, past effectiveness of care, symptom intensity, and medication safety impact the decision to self-medicate. Poor health and sleep problems had also been linked to self-medication. While the elderly primarily makes the choice of self-medication medication, friends, relatives, and neighbors may also influence the decision.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Abdu N, Mosazghi A, Teweldemedhin S, Asfaha L, Teshale M, Kibreab M, Anand IS, Tesfamariam EH, Russom M. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Usage and co-prescription with other potentially interacting drugs in elderly: A cross-sectional study. PLoS One. 2020;15 https://doi.org/10.1371/journal.pone.0238868.
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 https://doi.org/10.1111/ijpp.12334.
Alhomoud F, Aljamea Z, Almahasnah R, Alkhalifah K, Basalelah L, Alhomoud FK. Self-medication and self-prescription with antibiotics in the Middle East – do they really happen? A systematic review of the prevalence, possible reasons, and outcomes. Int J Infect Dis. 2017; https://doi.org/10.1016/j.ijid.2017.01.014.
Aslam A, Gajdács M, Zin CS, Rahman NSA, Ahmed SI, Zafar MZ, Jamshed S. Evidence of the practice of self-medication with antibiotics among the lay public in low-and middle-income countries: A sco** review. Antibiotics. 2020; https://doi.org/10.3390/antibiotics9090597.
Booker S, Herr K, Tripp-Reimer T. Patterns and perceptions of self-management for osteoarthritis pain in African American older adults. Pain Med (United States). 2019;20 https://doi.org/10.1093/pm/pny260.
Brandão GR, Teixeira L, Araújo L, Paúl C, Ribeiro O. Self-medication in older European adults: prevalence and predictive factors. Arch Gerontol Geriatr. 2020;91 https://doi.org/10.1016/j.archger.2020.104189.
Chautrakarn S, Khumros W, Phutrakool P. Self-medication with over-the-counter medicines among the working age population in metropolitan areas of Thailand. Front Pharmacol. 2021;12 https://doi.org/10.3389/fphar.2021.726643.
Cybulski M, Cybulski L, Krajewska-Kulak E, Orzechowska M, Cwalina U. Preferences and attitudes of older adults of Bialystok, Poland toward the use of over-the-counter drugs. Clin Interv Aging. 2018;13 https://doi.org/10.2147/CIA.S158501.
da Silva Dal Pizzol, T., Fontanella, A.T., Ferreira, M.B.C., Bertoldi, A.D., Borges, R.B., Mengue, S.S, 2020. Erratum: Analgesic use among the Brazilian population: results from the national survey on access, use and promotion of rational use of medicines (PNAUM) (PLoS ONE (2019) 14:3 (e0214329). https://doi.org/10.1371/journal.pone.0214329). PLoS One. https://doi.org/10.1371/journal.pone.0229039.
de Oliveira SBV, Barroso SCC, Bicalho MAC, Reis AMM. Profile of drugs used for self-medication by elderly attended at a referral center. Einstein (Sao Paulo). 2018;16. https://doi.org/10.31744/einstein_journal/2018AO4372
dehvan F, Ghorbani M, Ghanei Gheshlagh R, Dalvand S, Moradi B, Faramarzi P, Moradi M. Evaluation of self-medication and related factors in elderly population of Sanandaj. Iran. 2019;4:46–57.
Fabricant SJ, Hirschhorn N. Deranged distribution, perverse prescription, unprotected use: the irrationality of pharmaceuticals in the develo** world. Health Policy Plan. 1987;2 https://doi.org/10.1093/heapol/2.3.204.
Gualano MR, Bert F, Passi S, Stillo M, Galis V, Manzoli L, Siliquini R. Use of self-medication among adolescents: a systematic review and meta-analysis. Eur J Pub Health. 2015;25 https://doi.org/10.1093/eurpub/cku207.
Hughes CM, McElnay JC, Fleming GF. Benefits and risks of self medication. Drug Saf. 2001; https://doi.org/10.2165/00002018-200124140-00002.
Jafari F, Khatony A, Rahmani E. Prevalence of self-medication among the elderly in Kermanshah-Iran. Global J Health Sci. 2015;7 https://doi.org/10.5539/gjhs.v7n2p360.
Karimy M, Rezaee-Momtaz M, Tavousi M, Montazeri A, Araban M. Risk factors associated with self-medication among women in Iran. BMC Public Health. 2019;19 https://doi.org/10.1186/s12889-019-7302-3.
Kazemioula G, Golestani S, Alavi SMA, Taheri F, Gheshlagh RG, Lotfalizadeh MH. Prevalence of self-medication during COVID-19 pandemic: a systematic review and meta-analysis. Front Public Health. 2022;10 https://doi.org/10.3389/fpubh.2022.1041695.
Limaye D, Limaye V, Krause G, Fortwenge G. A systematic review of the literature to assess self-medication practices. Ann Med Health Sci Res. 2017;7
Limaye D, Pitani RS, Limaye V, Sydymanov A, Otzipka C, Ziesenis P, Fortwengel G. Development of a quantitative scoring method for STROBE checklist. Acta Pol Pharm Drug Res. 2018;75 https://doi.org/10.32383/appdr/84804.
Locquet M, Honvo G, Rabenda V, van Hees T, Petermans J, Reginster JY, Bruyère O. Adverse health events related to self-medication practices among elderly: a systematic review. Drugs Aging. 2017; https://doi.org/10.1007/s40266-017-0445-y.
Makowska M, Boguszewski R, Nowakowski M, Podkowińska M. Self-medication-related behaviors and Poland’s Covid-19 lockdown. Int J Environ Res Public Health. 2020;17 https://doi.org/10.3390/ijerph17228344.
Maust DT, Solway E, Clark SJ, Kirch M, Singer DC, Malani P. Prescription and nonprescription sleep product use among older adults in the United States. Am J Geriatr Psychiatr. 2019;27 https://doi.org/10.1016/j.jagp.2018.09.004.
McDonald DD. Predictors of gastrointestinal bleeding in older persons taking nonsteroidal anti-inflammatory drugs: Results from the FDA adverse events reporting system. J Am Assoc Nurse Pract. 2019;31 https://doi.org/10.1097/JXX.0000000000000130.
Mortazavi S, salehe, Shati, M, Khankeh HR, Ahmadi F, Mehravaran S, Malakouti SK. Self-medication among the elderly in Iran: a content analysis study. BMC Geriatr. 2017;17:198. https://doi.org/10.1186/s12877-017-0596-z.
Naoum V, Nomikos N, Naoum P, Athanasakis K, Kyriopoulos J. Self-medication in Greece: the financial impact from expanding the OTC market. Int J Pharm Pract. 2021;29 https://doi.org/10.1093/ijpp/riab066.
Neves SJF, de Oliveira Marques AP, Leal MCC, da Silva Diniz A, Medeiros TS, de Arruda IKG. Epidemiology of medication use among the elderly in an urban area of northeastern Brazil. Rev Saude Publica. 2013;47 https://doi.org/10.1590/S0034-8910.2013047003768.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10:89. https://doi.org/10.1186/s13643-021-01626-4.
Pietraszek A, Agrawal S, Dróżdż M, Makuch S, Domański I, Dudzik T, Dudek K, Sobieszczańska M. Sociodemographic and health-related factors influencing drug intake among the elderly population. Int J Environ Res Public Health. 2022;19 https://doi.org/10.3390/ijerph19148766.
Pons EDS, Knauth DR, Vigo Á, Mengue SS, Gadelha CAG, Costa KS, do Nascimento JM, Soeiro OM, Mengue SS, da Motta ML, de Carvalho ACC. 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 https://doi.org/10.1371/journal.pone.0189098.
Quispe-Cañari JF, Fidel-Rosales E, Manrique D, Mascaró-Zan J, Huamán-Castillón KM, Chamorro-Espinoza SE, Garayar-Peceros H, Ponce-López VL, Sifuentes-Rosales J, Alvarez-Risco A, Yáñez JA, Mejia CR. Self-medication practices during the COVID-19 pandemic among the adult population in Peru: a cross-sectional survey. Saudi Pharm J. 2021;29 https://doi.org/10.1016/j.jsps.2020.12.001.
Rahmani N, Salehi A, Molavi Vardanjani H, Marzban M, Behbood A. Using STROBE checklist to assess the reporting quality of observational studies affiliated with Shiraz University of Medical Sciences, and its correlates: a scientometric study from Iran. Scientometrics. 2020;122 https://doi.org/10.1007/s11192-019-03317-3.
Rashid M, Chhabra M, Kashyap A, Undela K, Gudi SK. Prevalence and predictors of self-medication practices in India: a systematic literature review and meta-analysis. Curr Clin Pharmacol. 2019;15 https://doi.org/10.2174/1574884714666191122103953.
Santos TRA, Lima DM, Nakatani AYK, Pereira LV, Leal GS, Amaral RG. Medicine use by the elderly in Goiania. Midwestern Brazil Rev Saude Publica. 2013;47 https://doi.org/10.1590/S0034-89102013000100013.
Secoli SR, Marquesini EA, Fabretti S. de C, Corona LP, Romano-Lieber NS. Self-medication practice trend among the Brazilian elderly between 2006 and 2010: SABE study. Rev Bras Epidemiol. 2018;21 https://doi.org/10.1590/1980-549720180007.supl.2.
Sisay M, Mengistu G, Edessa D. Epidemiology of self-medication in Ethiopia: a systematic review and meta-analysis of observational studies. BMC Pharmacol Toxicol. 2018;19 https://doi.org/10.1186/s40360-018-0248-8.
Tesfamariam S, Anand IS, Kaleab G, Berhane S, Woldai B, Tesfamariam E, Russom M. Self-medication with over the counter drugs, prevalence of risky practice and its associated factors in pharmacy outlets of Asmara, Eritrea. BMC Public Health. 2019;19 https://doi.org/10.1186/s12889-019-6470-5.
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(6):819–825.
Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M, Blettner M, Boffetta P, Brenner H, Chêne G, Cooper C, Davey-Smith G, Gagnon F, Greenland P, Greenland S, Infante-Rivard C, Ioannidis J, James A, Jones G, Ledergerber B, Little J, May M, Moher D, Momen H, Morabia A, Morgenstern H, Paccaud F, Röösli M, Rothenbacher D, Rothman K, Sabin C, Sauerbrei W, Say L, Sterne J, Syddall H, White I, Wieland S, Williams H, Zou GY. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg. 2014;12 https://doi.org/10.1016/j.ijsu.2014.07.014.
World Health Organization, 2000. Guidelines for the regulatory assessment of medicinal products for use in self-medication. Geneva.
World Health Organization, 2018. Ageing (WWW Document). World Health Organization. URL https://www.who.int/news-room/facts-in-pictures/detail/ageing. Accessed 2 Aug 23.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this entry
Cite this entry
Hussain, R., Loh, Z.C., Shakeel, S., Ong, S.C., Babar, ZUD. (2023). Self-Medication Among Elderly: Evidence Synthesis and a Systematic Review of the Literature. In: Babar, ZUD. (eds) Encyclopedia of Evidence in Pharmaceutical Public Health and Health Services Research in Pharmacy. Springer, Cham. https://doi.org/10.1007/978-3-030-64477-2_142
Download citation
DOI: https://doi.org/10.1007/978-3-030-64477-2_142
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-64476-5
Online ISBN: 978-3-030-64477-2
eBook Packages: MedicineReference Module Medicine