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The epidemiology of self-medication in Colombia: A systematic literature review and meta-analysis
Epidemiología de la automedicación en Colombia: revisión sistemática de la literatura y metanálisis
A epidemiologia da automedicação na Colômbia: revisão sistemática da literatura e metanálise
DOI:
https://doi.org/10.15446/rcciquifa.v52n3.110393Keywords:
Self-medication, Prevalence, Colombia, Systematic Review, Meta-analysis (en)Automedicación, Prevalencia, Colombia, Revisión sistemática, Metanálisis (es)
Automedicação, Prevalência, Colômbia, Revisão sistemática, Metanálise (pt)
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Objectives: The reported frequency of self-medication in Colombia ranges from 32.3% to 84.7%, depending on the study sample and time frame. This study aimed to estimate a pooled prevalence of self-medication and its associated factors in Colombian youth and adults. Method: A comprehensive systematic literature review and meta-analysis of the studies on self-medication in Colombia published from January 2000 - June 2022 was conducted. Results: Twelve studies (n=5,668) from urban areas were included, and a pooled prevalence of self-medication of 64.2% (95% confidence interval [CI] 50.8%-77.5%) was found. However, the prevalence was lower when self-medication was assessed during the last 30 days (32.3%; 95%CI 25.4%-39.3%) than when longer time frames were used. Female university students had a higher frequency of self-medication (OR= 1.72; 95% CI 1.17-2.53) than males. The most common medications were analgesics (37.7%), anti-inflammatories (33.2%), antihistamines (14.8%), and antibiotics/antiparasitics (12.1%). Lack of time and delays in medical care were reported in 35.2% (95% CI 25.6%-44.7%) of the cases. Conclusions: The reported frequency of self-medication in urban areas of Colombia changed across the studies depending on the time frame used; therefore, this should be considered when conducting and comparing studies on selfmedication prevalence. Although over-the-counter drugs were the most frequently involved (85.7%), the reported use of prescription drugs such as antibiotics/antiparasitics was 12.1%. Considering that lacking time and delays in medical care were reported in a third of cases of self-medication, shortening the long waiting times for healthcare services might contribute to the proper use of medications.
Objetivos: La frecuencia reportada de automedicación en Colombia oscila entre 32,3% y 84,7%, según la muestra de estudio y el marco temporal utilizado. Este estudio tuvo como objetivo estimar la prevalencia agrupada de la automedicación y sus factores asociados en jóvenes y adultos colombianos. Método: Se realizó una revisión sistemática de la literatura y un metanálisis de los estudios sobre automedicación en Colombia publicados entre enero de 2000 y junio de 2022. Resultados: Se incluyeron 12 estudios (n=5.668) realizados en áreas urbanas y se encontró una prevalencia combinada de automedicación de 64,2 % (intervalo de confianza [IC] del 95 % 50,8 %-77,5 %). Sin embargo, la prevalencia fue menor cuando se evaluó la automedicación durante los últimos 30 días (32,3%; IC95% 25,4%-39,3%) que cuando se utilizaron marcos de tiempo más prolongados. Las mujeres universitarias presentaron mayor frecuencia de automedicación (OR= 1,72; IC 95% 1,17-2,53) que los hombres. Los medicamentos más comunes fueron analgésicos (37,7%), antiinflamatorios (33,2%), antihistamínicos (14,8%) y antibióticos/antiparasitarios (12,1%). La falta de tiempo y las demoras en la atención médica se reportaron en el 35,2% (IC 95% 25,6%-44,7%) de los casos. Conclusiones: La frecuencia reportada de automedicación en áreas urbanas de Colombia cambió entre los estudios dependiendo del marco de tiempo utilizado; por lo tanto, esto debe tenerse en cuenta al realizar y comparar estudios sobre la prevalencia de la automedicación. Aunque los medicamentos de venta libre fueron los más frecuentemente involucrados (85,7%), el uso informado de medicamentos de prescripción como antibióticos/antiparasitarios fue 12,1%. Además, considerando que la falta de tiempo y las demoras en la atención médica fueron informadas en un tercio de los casos de automedicación, la reducción de los largos tiempos de espera en los servicios de salud podría contribuir al uso adecuado de los medicamentos.
Objetivos: A frequência relatada de automedicação na Colômbia varia de 32,3% a 84,7%, dependendo da amostra do estudo e do período de tempo utilizado. Este estudo teve como objetivo estimar a prevalência da automedicação e seus fatores associados em jovens e adultos colombianos. Método: Foi realizada uma revisão sistemática e exaustiva da literatura e uma metanálise dos estudos sobre automedicação na Colômbia publicados entre janeiro de 2000 e junho de 2022. Resultados: Um total de 12 estudos (n=5668) realizados em áreas urbanas foram incluídos e encontraram uma prevalência agrupada de automedicação de 64,2% (intervalo de confiança [IC] de 95%: 50,8-77,5%). No entanto, a prevalência foi menor quando se avaliou a automedicação nos últimos 30 dias (32,3%; IC 95% 25,4%-39,3%) do que quando foram utilizados intervalos de tempo mais longos. As mulheres universitárias apresentaram maior frequência de automedicação (OR= 1,72; IC 95% 1,17 2,53) do que os homens. Os medicamentos mais comuns foram analgésicos (37,7%), anti-inflamatórios (33,2%), anti-histamínicos (14,8%) e antibióticos/antiparasitários (12,1%). Falta de tempo e demora no atendimento médico foram relatados em 35,2% (IC 95% 25,6%-44,7%) dos casos. Conclusões: A frequência relatada de automedicação em áreas urbanas da Colômbia variou entre os estudos, dependendo do período de tempo usado; portanto, isso deve ser levado em consideração na condução e comparação de estudos sobre a prevalência da automedicação. Embora os medicamentos de venda livre tenham sido os mais frequentemente envolvidos (85,7%), o uso relatado de medicamentos prescritos como antibióticos/antiparasitários foi de 12,1%. Além disso, considerando que a falta de tempo e a demora no atendimento médico foram relatadas em um terço dos casos de automedicação, a redução do longo tempo de espera nos serviços de saúde pode contribuir para o uso adequado dos medicamentos.
References
World Health Organization, WHO guidelines for the regulatory assessment of medicinal products for use in self-medication: general information, WHO Drug Inf 2000 141 18-26, 2000. URL: https://apps.who.int/iris/handle/10665/57624
World Health Organization, The Role of the pharmacist in self-care and self-medication: report of the 4th WHO Consultative Group on the Role of the Pharmacist, 1998. URL: https://apps.who.int/iris/handle/10665/65860, accessed: Oct 28, 2022.
A.M. Ruiz-Sternberg, A.M. Pérez-Acosta, Automedicación y términos relacionados: una reflexión conceptual, Rev. Cienc. Salud, 9(1), 83–97 (2011).
I.A. Rather, B.-C. Kim, V.K. Bajpai, Y.-H. Park, Self-medication and antibiotic resistance: Crisis, current challenges, and prevention, Saudi J. Biol. Sci., 24(4), 808–812 (2017).
S. Ghasemyani, M.R. Benis, H. Hosseinifard, R. Jahangiri, A. Aryankhesal, H. Shabaninejad, et al., Global, WHO regional, and continental prevalence of selfmedication from 2000 to 2018: A systematic review and meta-analysis, Ann. Public Health, 1, 585 (2022).
F. Villegas-Cardona, K.M. Nasner-Posso, D.P. Buitrago-Gómez, S. Cruz-Calderón, S.R. Restrepo, J.E. Bedoya-Arias, et al., Patrón de automedicación en la zona urbana de la ciudad de Pereira (Colombia) en el trimestre marzo-mayo 2013, Investig. Andina, 16(29), 1073–1085 (2014).
C.P. Ortiz, O.D. Fúnez-David, H. Rubiano-Daza, C.L. García-Rojas, C.A. Calderón-Ospina, D.R. Delgado, Automedicación en estudiantes de la Sede Neiva de la Universidad Cooperativa de Colombia, Rev. Colomb. Cienc. Quím. Farm., 48(1), 128–144 (2019).
A. Liberati, D.G. Altman, J. Tetzlaff, C. Mulrow, P.C. Gøtzsche, J.P.A. Ioannidis, et al., The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration, PLoS Med., 6(7), e1000100 (2009).
Z. Munn, S. Moola, K. Lisy, D. Riitano, C. Tufanaru, Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data, Int. J. Evid. Based Healthc., 13(3), 147–153 (2015).
D. Hoy, P. Brooks, A. Woolf, F. Blyth, L. March, C. Bain, et al., Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement, J. Clin. Epidemiol., 65(9), 934–939 (2012).
J. Castro-Espinosa, J.F.A. Arboleda-Geovo, P. Samboni-Novoa, Prevalencia y determinantes de automedicación con antibióticos en una comuna de Santiago de Cali, Colombia, Rev. Cubana Farm., 48(1), 43–54 (2014).
D.M. Feria-Mejía, G.A. Romero-Martínez, K.J. Carrascal-García, Caracterización de la práctica de la automedicación en adultos beneficiarios de un centro de desarrollo integral de la Comuna Ocho de la Cuidad de Sincelejo, Sucre en 2020, College Thesis, Universidad de Sucre, Sincelejo, Colombia, 2021. URL:: https://repositorio.unisucre.edu.co/bitstream/handle/001/1136/T615.856%20F356.pdf?sequence=1&isAllowed=y
M. Peñuela, A. De la Espriella, E. Escobar, M.V. Velásquez, J. Sánchez, A. Arango, et al., Factores socioeconómicos y culturales asociados a la autoformulación en expendios de medicamentos en la ciudad de Barranquilla, Salud Uninorte, 16, 30–38 (2002).
M. Del Toro-Rubio, A. Díaz-Pérez, Z. Barrios-Puerta, I.Y. Castillo-Avila, Automedicación y creencias en torno a su práctica en Cartagena, Colombia, Revista Cuidarte, 8(1), 1509 (2017).
M. Macías-Vidal, Factores asociados a la automedicación con productos farmacéuticos de venta libre, adquiridos en tiendas, por personas mayores de 18 años de cuatro municipios del departamento del Atlántico en el 2014, Master Thesis, Universidad del Norte, Barranquilla, Colombia, 2015. URL: https://manglar.uninorte.edu.co/bitstream/handle/10584/10023/Mac%c3%adas%20Vidal. pdf?sequence=1&isAllowed=y
H. Oviedo-Córdoba, C.E. Cortina-Navarro, J.A. Osorio-Coronel, S.M. Romero-Torres, Realidades de la práctica de la automedicación en estudiantes de la Universidad del Magdalena, Enfermería Global, 62, 531–543 (2021).
J.E. Machado-Alba, L.F. Echeverri-Cataño, M.J. Londoño-Builes, P.A. Moreno- Gutiérrez, S.A. Ochoa-Orozco, J.O. Ruiz-Villa, Social, cultural and economic factors associated with self-medication, Biomedica, 34(4), 580–588 (2014).
J.J. López, R. Dennis, S.M. Moscoso, Estudio sobre la Automedicación en una Localidad de Bogotá, Rev. Salud Pública, 11(3), 432–442 (2009).
A.L. Fajardo-Zapata, F.J. Méndez-Casallas, J.F. Hernández-Niño, L.H. Molina, A.M. Tarazona, C. Nossa, et al., La automedicación de antibióticos: un problema de salud pública, Salud Uninorte, 29(2), 226–235 (2013).
K. Bravo, E Espinel, A. Pardo, A. Robles, Automedicación en estudiantes de medicina de la Universidad de Ciencias Aplicadas y Ambientales UDCA en el segundo semestre de 2017, College Thesis, Universidad de Ciencias Aplicadas y Ambientales, Bogotá, 2017. URL: https://repository.udca.edu.co/bitstream/handle/11158/830/28-10-2017%20AUTOMEDICACION%20final.pdf?sequence=1&isAllowed=y
C.A. López-Cabra, J.M. Gálvez-Bermúdez, C. Domínguez-Domínguez, A. Urbina-Bonilla, C.A. Calderón-Ospina, A. Vallejos-Narváez, Automedicación en estudiantes de medicina de la Universidad del Rosario en Bogotá D. C., Colombia, Rev. Colomb. Cienc. Quím. Farm., 45(3), 374–384 (2016).
Departamento Administrativo Nacional de Estadística (DANE), DANE - ¿Dónde estamos?, 2023. URL: https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/censo-nacional-de-poblacion-yvivenda-2018/donde-estamos, accessed: Aug 28, 2023.
D. Baracaldo-Santamaría, M.J. Trujillo-Moreno, A.M. Pérez-Acosta, J.E. Feliciano- Alfonso, C.A. Calderon-Ospina, F. Soler, Definition of self-medication: A scoping review, Ther. Adv. Drug Saf., 13, 20420986221127501 (2022).
P.H.F. Domingues, T.F. Galvão, K.R.C. de Andrade, P.T.T. de Sá, M.T. Silva, M.G. Pereira, Prevalence of self-medication in the adult population of Brazil: A systematic review, Rev. Saude Publica, 49, 36 (2015).
M.C.X. Pinto, F. Ferré, M.L.P. Pinheiro, Potentially inappropriate medication use in a city of Southeast Brazil, Braz. J. Pharm. Sci., 48(1), 79–86 (2012).
W.A. Adedeji, M.D. Dairo, P.M. Nguku, A. Oyemakinde, F.A. Fehintola, Pattern and predictors of medication use among adults in southwestern Nigeria: A community- based cross-sectional study, Pharmacol. Res. Perspect., 11(1), e01017 (2023).
A. Althubaiti, Information bias in health research: Definition, pitfalls, and adjustment methods, J. Multidiscip. Healthc., 9, 211–217 (2016).
Z. Klemenc-Ketis, Z. Hladnik, J. Kersnik, A cross sectional study of sex differences in self-medication practices among university students in Slovenia, Coll. Antropol., 35(2), 329–334 (2011).
M. Sisay, G. Mengistu, D. Edessa, Epidemiology of self-medication in Ethiopia: A systematic review and meta-analysis of observational studies, BMC Pharmacol. Toxicol., 19, 56 (2018).
S. Azami-Aghdash, M. Mohseni, M. Etemadi, S. Royani, A. Moosavi, M. Nakhaee, Prevalence and cause of self-medication in Iran: A systematic review and meta-analysis article, Iran. J. Public Health, 44(12), 1580–1593 (2015).
Q. Zhang, C. Bal-dit-Sollier, L. Drouet, G. Simoneau, J.-C. Alvarez, S. Pruvot, et al., Interaction between acetaminophen and warfarin in adults receiving longterm oral anticoagulants: A randomized controlled trial, Eur. J. Clin. Pharmacol., 67(3), 309–314 (2011).
R. Gualtierotti, A. Zoppi, A. Mugellini, G. Derosa, A. D’Angelo, R. Fogari, Effect of naproxen and acetaminophen on blood pressure lowering by ramipril, valsartan and aliskiren in hypertensive patients, Expert Opin. Pharmacother., 14(14), 1875–1884 (2013).
I.M. MacIntyre, E.J. Turtle, T.E. Farrah, C. Graham, J.W. Dear, D.J. Webb, et al., Regular acetaminophen use and blood pressure in people with hypertension: The PATH-BP trial, Circulation, 145(6), 416–423 (2022).
Antimicrobial Resistance Collaborators, Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis, Lancet (Lond Engl.), 399(10325), 629–655 (2022).
M. Ocan, E.A. Obuku, F. Bwanga, D. Akena, S. Richard, J. Ogwal-Okeng, et al., Household antimicrobial self-medication: A systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries, BMC Public Health, 15(1), 742 (2015).
G. Nepal, S. Bhatta, Self-medication with antibiotics in WHO Southeast Asian Region: A systematic review, Cureus, 10(4), e2428 (2018).
G. Sulis, P. Adam, V. Nafade, G. Gore, B. Daniels, A. Daftary, et al., Antibiotic prescription practices in primary care in low- and middle-income countries: A systematic review and meta-analysis, PLoS Med., 17(6), e1003139 (2020).
N. Mallah, N. Orsini, A. Figueiras, B. Takkouche, Income level and antibiotic misuse: A systematic review and dose–response meta-analysis, Eur. J. Health Econ., 23(6), 1015–1035 (2022).
C.P. Vacca, C.Y. Niño, L. Reveiz, Restricción de la venta de antibióticos en farmacias de Bogotá, Colombia: estudio descriptivo, Rev. Panam. Salud Publica, 30(6), 586–591 (2011).
A. Shaghaghi, M. Asadi, H. Allahverdipour, Predictors of self-medication behavior: A systematic review, Iran. J. Public Health, 43(2), 136–146 (2014).
A.H.M.A. Faqihi, S.F. Sayed, Self-medication practice with analgesics (NSAIDs and acetaminophen), and antibiotics among nursing undergraduates in University College Farasan Campus, Jazan University, KSA, Ann. Pharm. Fr., 79(3), 275–285 (2021).
K. Tripković, A. Nešković, J. Janković, M. Odalović, Predictors of self-medication in Serbian adult population: cross-sectional study, Int. J. Clin. Pharm., 40(3), 627–634 (2018).
J. Aponte-González, A. González-Acuña, J. Lopez, P. Brown, J. Eslava-Schmalbach, Perceptions in the community about the use of antibiotics without a prescription: Exploring ideas behind this practice, Pharm. Pract., 17(1), 1394 (2019).
J. Aponte-González, P. Brown, J. Eslava-Schmalbach, Preferences based interventions to address the use of antibiotics without prescription: A discrete choice experiment, Pharm. Pract., 19(3), 2401 (2021).
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