Beograd, 27. 9. 2009 Self-medication in general practice in Slovenia 1

Marija Petek ŠterJanko Kersnik

Beograd, september 2009

Beograd, 27. 9. 2009 Self-medication in general practice in Slovenia 2

Background - definitionMost health care takes place outside the

formal health care systemSelf-medication describes treatment that is

initiated and managed by individual rather than prescribed by a health care professional

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Background-epidemilogyDifferent methods for self-medication were used in 20-

70% of population (herbs, vitamins, OTC, homeopatic drugs...)

Slovenia: 72% of poupulation use herbs, 83,6% of population sometimes or regularly use OTC

Self medication is more frequently used in elderly, chronicaly ill patients (eg. patients with cancer) and patinets belong to higher socio-economical classes

More than half of the patients don’t discuss about the self medication use with their general practitioner

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Background –benefits/riskBenefits of self-medicationAutonomy and empowerment Free to set priorities, use resources, control

treatment. Improved adherence.Self-monitoring and self-medication may

affect outcomes in: hypertensiondiabetesasthma anti-coagulation therapy

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Background –benefits/riskRisks of self-medicationHarm from adverse effectsDrug-drug interactionsRisk in older patients Multiple co-morbidityPoly-pharmacyPhysicians unaware of the OTC or CAMIncreasing costs from self-medicationOTC medication may a reduce visitsReduce use of prescription drugs

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Research questionsWe would like to know: the prevalence the reasons for self- medication recognise the characteristics of patients who

use self-medication

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MethodsStudy population: 38 tutors in general practice collect

data about use of self-medication for 564 consecutive attainders ( pysicinas didn’t report that any of the attaninders refuse participation in the study)

Methods: During the 17th Bled course the participants developed the qestionnaire about self-medication. We adapted and translated the questionnaire into Slovene. Patients fulfill a questionnaire by themselves

The questions were about: the use of self-medication by themselves reasons for use of unprescribed drugs or remedies their attitudes about efficacy and safety of self-

medication their knowledge on self-medication

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Results - prevalence The mean age of patients was 49.5 years,

63.4 % of patients were female 71.8 % of patients used self-medication (in

average 1.4 different self-medicines)The most popular self-medicines were herbal

tea in 59.3 % and OTC medicines in 35.8 % of those who use self medicines

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Results – who reccomendedfamily members or friends in 46.9 % pharmacist in 22.2 % physicians in 20.2 % media in 14.8 %,other health care professionals in 6.9 %11.6 % of patients decided for self-

medication by themselves

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Results - reasonsThe most frequent answers:it is more natural than medical treatment -

37.8 % traditional - 21.0 %,safer than conventional medicine - 7.2 % more convenient in 4.2 %

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Results-would you like to know more?53.5 % of patients who use self-medication

would like to know more70.9 % they thought that a physician would

be the best person to advice them

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Results – predictors of self-medicationfemale sex (OR=1.73, 95 % CI 1.14-2.64) higher level of education (OR=1.91, 95 % CI

1.54-2.37) the presence of psychiatric disorders

(OR=2.34, 95 % CI 1.02-5.34).

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DiscussionThe questionnaire need some clarification

(eg. unclear definitions of OTC, unclear questione about the potential risks of self-medication)

Fulfilment of the questionaire: Patients alone or an interview leaded by the nurse or physician?

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ConclusionsPeople in Slovenia frequently use self-

medication because they believe that self-medication is more natural than prescribed medication

More than a half would like to know more about the self-medicines they use and they thought physicians are the most suitable persons for advice