Self-medication in older urban mexicans : an observational, descriptive, cross-sectional study.
BACKGROUND
Self-medication in older adults can be problematic, especially if remedies taken without prescription interact with prescribed medications or if they produce adverse effects. Before designing interventions to improve self-medication, it is important to characterize patterns of self-medicating in local populations. This can be easily achieved through the conduct of simple surveys.


OBJECTIVE
To quantify and describe the demographic, socioeconomic and pharmacological characteristics of self-medication among a geriatric urban population in Chiapas, Mexico.


METHODS
An observational, descriptive, cross-sectional study was conducted, using a conglomerate sampling technique. A total of 245 older (aged > or =65 years) residents in the downtown area of Tuxtla Gutierrez (Chiapas, Mexico) participated in the study. Information on self-medication and demographic and socioeconomic variables was obtained from a specific structured interview that was conducted by a single specially trained physician.


RESULTS
More than half of the 245 interviewed older adults (131 [53.5%; 95% CI 47.2, 59.7]) reported taking a medicine without prescription during the last 30 days. Self-medication was significantly more frequent among older adults who lived alone compared with married people (p = 0.0274) and among the illiterate or those with a low level of education compared with people with secondary and high-school degrees (p = 0.0036). NSAIDs (36.2% of medications) and antihistamines (12.6%) were the most frequent drugs taken as self-medication. The most frequently cited reasons for self-medicating were muscle and joint pain (19.9% of medications), upper respiratory tract problems (15.9%) and cough (7.3%). However, 13% of people who self-medicated took a remedy for hypertension (11% of all medications) without medical supervision. Previous prescriptions could have served as the basis for future self-medication in 33 (25.2%) patients. Finally, 35 (26.7%) patients who self-medicated reported that they had experienced adverse effects from the drug they were taking.


CONCLUSIONS
Self-medication in older adults is a problem that should be carefully addressed in public health policies. Surveys such as the present one are easy to carry out (and could conveniently be conducted in primary care settings), rapidly yield information about the true nature of self-medication in local populations, and provide a basis on which to design future interventions. Factors associated with self-medication in this study, including both socioeconomic characteristics (e.g. most self-medicators were poorly educated or lived alone) and therapeutic considerations (e.g. substantial proportions of patients self-medicated for hypertension, used previous prescriptions as the basis for self-medication, or reported adverse effects of self-medication), are vital clues to the design of effective and appropriately targeted interventions in the future.
Balbuena
Fernando Ruiz
FR
Post-degree Department, Universidad de Ciencias y Artes de Chiapas (UNICACH), Tuxtla Gutiérrez, Chiapas, México.
Aranda
Alfredo Briones
AB
Figueras
Albert
A
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018771:Arthralgia / Q000188:drug therapy; D003371:Cough / Q000188:drug therapy; D003430:Cross-Sectional Studies; D004358:Drug Therapy / Q000706:statistics & numerical data*; D017723:Drug Utilization Review / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008800:Mexico; D015999:Multivariate Analysis; D009135:Muscular Diseases / Q000188:drug therapy; D012140:Respiratory Tract Diseases / Q000188:drug therapy; D012651:Self Medication / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D012923:Social Class; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D006633:Histamine Antagonists