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COVID-19 pushes self-medication up

Doctors warn practice can result in improper treatment or cause new illness

Kampala, Uganda | PATRICIA AKANKWATSA | More Ugandans are treating themselves without first seeking medical adviceas the COVID-19 pandemic rages.

The Council of Pharmaceutical Society of Uganda made the revelation in a recent statement.

“With the surge of the COVID-19 cases in the past months, many people decided to use medicines such as Dexamethasone and azithromycin in the management of COVID-19 without the advice of a health professional,” the council said.

The practice, medically called self-medication, involves sharing medication with relatives/family members or using leftover medications for the treatment of self-recognised illnesses or resubmitting old prescriptions at the pharmacy.

“With the outbreak of COVID-19, people have increasingly turned to self-medication because there is no cure,” says Dr. Ekwaro Obuku a physician and health policy expert, “They use whatever helps to relieve the pain.”

He says that COVID-19 and the measures to curb it like lockdowns have left many people jobless and penniless. This has led them to change the way they live.

The Council of Pharmaceutical Society of Uganda, which is responsible for ensuring standards in the practice of pharmacy, says the country is grappling with self-medication that claims to be able to cure COVID-19.

The increase in self-medication is driven by the increasing levels of poverty, poor health services, the ever-mushrooming drug shops with varying degrees of quality.

The most widely self-medicated substances are Over-The-Counter (OTC) drugs and dietary supplements, which are used to treat common health issues at home. The OTC drugs being used include pain relievers, cough and cold medicines. They are mainly used for self-medication because they are easily accessible at pharmacies without the doctor’s prescription.

However, due to regulation challenges, self-medication may be practicedusing Prescription-Only Medications (POMs).

Dr. Obuku says the unregulated access to both POMs and OTC drugs is likely to increase the prevalence of complications linked to self-medication.

“This practice can result in improper treatment of symptoms and conditions as well as potentially cause new conditions, such as substance use disorders or addiction,” Obuku says.

Dr. Nehemiah Katusiime the Executive Director Kawempe General Hospital says self-medication using OTC drugs may be safe and acceptable if the consumer has adequate knowledge of the drug and the illness.

“When practiced properly among the knowledgeable populations, self-medication can reduce the time spent waiting on physicians and some health expenses like the doctor’s consultation fees,” he told The Independent.

“However, POMs and OTC drugs are often considered unsafe when used irrationally leading to different drug interactions and eventually increase disease burden in a population due to resistance,” he adds.

Dr. Apollo Odeke Epuwatt, a Physician at Mulago National Referral Hospital in Kampala, says that self-medication can lead to wastage of resources, delay in diagnosis of problems and provision of appropriate treatments. It can also lead to serious health hazards and adverse drug reactions.

Epuwatt warns that although self-medication is a form of self-care commonly used to manage symptoms of minor illnesses or injuries, the practice of self-treatment for serious health conditions, such as mental health conditions, has many risks.

Self-medication could lead to incorrect self-diagnosis, delays in seeking appropriate medical advice and proper treatment ,potential adverse reactions, worsening of the condition the individual is trying to self-treat, dangerous drug interaction, masking of severe diseases and risk of dependence and abuse

“Drugs should therefore be taken under the supervision of a qualified health practitioner in order to minimise the risks of inaccurate self-diagnosis, incorrect choice of therapy, inadequate or excessive dosage, food and drug interaction,” Epuwatt adds.

People may practice self-medication for a variety of reasons, including the availability of drugs in establishments other than pharmacies.

In appropriately functioning health systems, essential medications are planned to be available in sufficient amounts, in the proper dosage forms, in assured quality and adequate information, and at prices the individual and the community can afford and at intended times.

But people may resort to self-medication if the cost of medical treatment, including doctor visits and medications, is high.  Some fear to seek treatment due to perceived negative stigmas; they may wish to hide or deny a condition. Some may have used inefficient medications in the past. Self-medication can also because of attitudes towards health care, gender, education, insurance policies, cost savings, convenience and age.

The urge for self-care, sympathy for family members in sickness, lack of health services, poverty, ignorance, misbelief, and excessive advertisements of drugs are also factors.

Dr. Obuku says that many Ugandans who suffer from more serious health conditions, particularly mental health conditions, turn to self-medication.

“Rather than consulting a doctor to receive a proper diagnosis and medical treatment, many people use supplements and other substances, sometimes drugs and alcohol, to try to cope with the symptoms they are experiencing.

He says because of COVID-19, many people have ended up depressed and stressed.

Dr. Katusiime says self-medication is a worldwide health problem with serious public health implications such as public health risks. It can lead to drug resistance, organ damage and contributes 2.9% to 3.7% of the deaths in the world, mainly due to drug–drug interactions.

In 2010, the National Drug Authority (NDA) estimated that eight in every 10 people self-medicate or buy drugs over the counter. NDA attributes this to the increased number of pharmacies and drug shops, expensive treatment from clinics and long distances to health facilities.

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