Stricter rules needed to curb self-medicating patients, research shows

AJMAN// Stricter regulation is needed to rein in self-medicating patients and pharmacists who freely sell antibiotics to treat minor ailments.

Cost-cutting and convenience are key drivers behind an epidemic of self-medicating in the UAE that could be putting patients at risk, according to a research paper published by the Ajman University of Science and Technology.

Researchers said pharmacists are playing a growing role in keeping the nation’s health in check, with more patients saving cash and time by avoiding visits to doctors.

Problems include misuse of antibiotics, misdiagnoses and mistakenly taking combinations of drugs that could pose a health risk.

“There should be more public awareness programmes on the dangers of taking over the counter medications,” said Dr Zeeshan Khan, an internal medicine specialist in Dubai.

“Most countries have certain rules and regulations over administering over-the-counter medications. Unfortunately, this isn’t the case in the UAE.

“In this country, particularly in Dubai, some people are not insured for medicine, so it is costly to pay for a consultation and then also medication.

“The most important thing to consider here is that the antibiotic policy is not very restrictive.”

Dr Khan said greater control over who is offered antibiotics is an area that needs to be improved.

“The short-term effect can be good for the patient, but the damage to the wider population can be much worse,” he said.

“The UAE and some developing countries are the few places where they can be purchased without a prescription. Some patients really press me for antibiotics, so I try to educate them about why it can be a problem.”

The objective of university researchers in Ajman was to assess self-medication patterns among different populations to find influencing factors, and explore public attitudes, beliefs and level of knowledge concerning self-medication.

Researchers took a qualitative approach through face to-face interviews to investigate participants’ behaviours and attitudes.

Three themes emerged from the data. Reasons for self-medication were costs of visiting a doctor, convenience in visiting a pharmacy and perception of simplicity of the condition.

Researchers also found pharmacists were the main source of diagnosis, in addition to medication leaflets, family and previous use of medicines.

They concluded that self-medication behaviours are common in the UAE, and that inappropriate self-medication is compromising patient care.

Researchers also said pharmacists are playing a vital role in intervening to optimise the use of medications and patient education regarding self-care.

Dr Yasmin Maher, a director at Medeor 24x7 hospital in Al Ain, said pharmacists are not qualified to make an accurate diagnosis, and supports tighter drug controls.

“Health Authority Abu Dhabi is working on a new antibiotic stewardship programme that will restrict prescriptions of antibiotics without a full justification,” she said.

“If antibiotics are dispensed from a pharmacy and they are not required, it creates bacterial infection resistance.

“Doctors are now being monitored by the health authority to ensure antibiotics are not being used unnecessarily.”

Self-treatment is an important aspect of self care and one of the vital issues under debate in health care.

Commonly-used drugs like paracetamol and aspirin are often taken to treat similar ailments but can react differently to prescription medicines.

Other over-the-counter drugs that can be dangerous include anti-inflammatories, Voltaren and ibuprofen, which can lead to kidney problems, ulcers and internal bleeding.

“Doctors are the only people who should be making decisions on what drugs to use based on a full diagnosis, lab investigation or other tests,” Dr Maher said.

“Drug use can vary greatly between patients, depending in age and symptoms, so care must be taken. Pharmacists will not be aware of a patient’s history or any other medication that may be taken.

“People should always give their bodies the chance to fight disease naturally before turning to medication, but not everyone does.”