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Published in: BMC Geriatrics 1/2017

Open Access 01-12-2017 | Research Article

Self-medication among the elderly in Iran: a content analysis study

Authors: Seyede Salehe Mortazavi, Mohsen Shati, Hamid Reza Khankeh, Fazlollah Ahmadi, Shiva Mehravaran, Seyed Kazem Malakouti

Published in: BMC Geriatrics | Issue 1/2017

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Abstract

Background

Self-medication is described as the use of drugs without a physician’s prescription to treat self-recognized illness or symptoms, and an important health issue among the elderly. Despite the wide range of different definitions, recognizing all forms of self-medication among older adults, particularly, in developing countries, help healthcare professionals and providers to reduce harmful effects of self-medication. The purpose of this study is to describe the practice of self-medication and its related factors among elderly people in Iran based on the experiences of people who are involved in this phenomenon.

Methods

This qualitative study was conducted using content analysis. Purposive sampling was used to select the participants and continued until saturation. The participants were the elderly, their care-givers, physicians, and pharmacists. Data was collected using semi-structured interviews, and analysis was done using an inductive approach. The theory of planned behavior was used as a framework to explain the role of the emerged factors in the occurrence of self-medication behavior.

Results

Based on the expressed experiences of the participants, factors related to the practice of self- medication among the elderly in Iran fit in these 5 categories: “patient’s attitudes towards disease, treatment, and physicians”, “living with disease”, “unfriendly environments”, “enabling health system”, and “influential others”.

Conclusions

Based on the results of this study, self-medication of the elderly in Iran has commonalities with many countries in regard to over-the-counter medications and complementary and alternative medicine; however, self-medication is also seen with drugs that require a prescription but can easily be obtained from pharmacies. Contributing factors, apart from the elderly themselves, include their families, caregivers, and social circle, the physical environment where they live, and the health system from which they receive services.
Literature
1.
go back to reference World Health Organization. Guidelines for the regulatory assessment of Medicinal Products for use in self-medication. Geneva: World Health Organization; 2000. World Health Organization. Guidelines for the regulatory assessment of Medicinal Products for use in self-medication. Geneva: World Health Organization; 2000.
2.
go back to reference da Silva MGC, Soares MCF, Muccillo-Baisch AL. Self-medication in university students from the city of Rio Grande, Brazil. BMC Public Health. 2012;12(1):1.CrossRef da Silva MGC, Soares MCF, Muccillo-Baisch AL. Self-medication in university students from the city of Rio Grande, Brazil. BMC Public Health. 2012;12(1):1.CrossRef
3.
go back to reference AId LF, Lima-Costa MF, Uchôa E. Bambuí project: a qualitative approach to self-medication. Cad de Saúde Pública. 2004;20(6):1661–9.CrossRef AId LF, Lima-Costa MF, Uchôa E. Bambuí project: a qualitative approach to self-medication. Cad de Saúde Pública. 2004;20(6):1661–9.CrossRef
4.
go back to reference Prasad SB. Self medication and their consequences: a challenge to health professional. Asian J Pharm Clini Res. 2016;9(2):314–7. Prasad SB. Self medication and their consequences: a challenge to health professional. Asian J Pharm Clini Res. 2016;9(2):314–7.
5.
go back to reference Hughes CM, McElnay JC, Fleming GF. Benefits and risks of self medication. Drug Saf. 2001;24(14):1027–37.CrossRefPubMed Hughes CM, McElnay JC, Fleming GF. Benefits and risks of self medication. Drug Saf. 2001;24(14):1027–37.CrossRefPubMed
6.
go back to reference Wen Y, Lieber E, Wan D, Hong Y. A qualitative study about self-medication in the community among market vendors in Fuzhou, China. Health Soc Care Community. 2011;19(5):504–13.CrossRefPubMed Wen Y, Lieber E, Wan D, Hong Y. A qualitative study about self-medication in the community among market vendors in Fuzhou, China. Health Soc Care Community. 2011;19(5):504–13.CrossRefPubMed
7.
go back to reference Abdarzadeh N, Ezzatabadi MR, Rafiei S, Shafiei M, Tafti AD, Saghafi F, et al. Self-Medication and Contributing Factors: A Questionnaire Survey Among Iranian Households. 2016; 5(3):17. Abdarzadeh N, Ezzatabadi MR, Rafiei S, Shafiei M, Tafti AD, Saghafi F, et al. Self-Medication and Contributing Factors: A Questionnaire Survey Among Iranian Households. 2016; 5(3):17.
8.
go back to reference Ellison D, White D, Farrar FC. Aging population. Nurs Clin N Am. 2015;50(1):185–213.CrossRef Ellison D, White D, Farrar FC. Aging population. Nurs Clin N Am. 2015;50(1):185–213.CrossRef
9.
go back to reference Vali L, Pourreza A, Foroushani AR, Sari AA, Pharm DHH. An investigation on inappropriate medication applied among elderly patients. World Appl Sci J. 2012;16(6):819–25. Vali L, Pourreza A, Foroushani AR, Sari AA, Pharm DHH. An investigation on inappropriate medication applied among elderly patients. World Appl Sci J. 2012;16(6):819–25.
10.
go back to reference Meranius MS, Hammar LM. How does the healthcare system affect medication self-management among older adults with multimorbidity? Scand J Caring Sci. 2016;30(1):91–8.CrossRefPubMed Meranius MS, Hammar LM. How does the healthcare system affect medication self-management among older adults with multimorbidity? Scand J Caring Sci. 2016;30(1):91–8.CrossRefPubMed
11.
go back to reference Shaghaghi A, Asadi M, Allahverdipour H. Predictors of self-medication behavior: a systematic review. Iran J Public Health. 2014;43(2):136–46.PubMedPubMedCentral Shaghaghi A, Asadi M, Allahverdipour H. Predictors of self-medication behavior: a systematic review. Iran J Public Health. 2014;43(2):136–46.PubMedPubMedCentral
12.
go back to reference Maddigan SL, Farris KB, Keating N, Wiens CA, Johnson JA. Predictors of older adults’ capacity for medication Management in a Self-Medication Program a Retrospective Chart Review. J Aging Health. 2003;15(2):332–52.CrossRefPubMed Maddigan SL, Farris KB, Keating N, Wiens CA, Johnson JA. Predictors of older adults’ capacity for medication Management in a Self-Medication Program a Retrospective Chart Review. J Aging Health. 2003;15(2):332–52.CrossRefPubMed
14.
go back to reference Sahebi L, Vahidi RG. Self-medication and storage of drugs at home among the clients of drugstores in Tabriz. Curr Drug Saf. 2009;4(2):107–12.CrossRefPubMed Sahebi L, Vahidi RG. Self-medication and storage of drugs at home among the clients of drugstores in Tabriz. Curr Drug Saf. 2009;4(2):107–12.CrossRefPubMed
15.
go back to reference Sarahroodi S, Maleki-Jamshid A, Sawalha AF, Mikaili P, Safaeian L. Pattern of self-medication with analgesics among Iranian university students in central Iran. J Fam Community Med. 2012;19(2):125.CrossRef Sarahroodi S, Maleki-Jamshid A, Sawalha AF, Mikaili P, Safaeian L. Pattern of self-medication with analgesics among Iranian university students in central Iran. J Fam Community Med. 2012;19(2):125.CrossRef
16.
go back to reference Azami-Aghdash S, Mohseni M, Etemadi M, Royani S, Moosavi A, Nakhaee M. Prevalence and cause of self-medication in Iran: a systematic review and meta-analysis article. Iran J Public Health. 2015;44(12):1580.PubMedPubMedCentral Azami-Aghdash S, Mohseni M, Etemadi M, Royani S, Moosavi A, Nakhaee M. Prevalence and cause of self-medication in Iran: a systematic review and meta-analysis article. Iran J Public Health. 2015;44(12):1580.PubMedPubMedCentral
17.
go back to reference Zargarzadeh AH, Minaeiyan M, Torabi A. Prescription and nonprescription drug use in Isfahan, Iran: an observational, cross-sectional study. Curr Ther Res. 2008;69(1):76–87.CrossRefPubMedPubMedCentral Zargarzadeh AH, Minaeiyan M, Torabi A. Prescription and nonprescription drug use in Isfahan, Iran: an observational, cross-sectional study. Curr Ther Res. 2008;69(1):76–87.CrossRefPubMedPubMedCentral
18.
go back to reference Zargarzadeh AH, Tavakoli N, Hassanzadeh A. A survey on the extent of medication storage and wastage in urban Iranian households. Clin Ther. 2005;27(6):970–8.CrossRefPubMed Zargarzadeh AH, Tavakoli N, Hassanzadeh A. A survey on the extent of medication storage and wastage in urban Iranian households. Clin Ther. 2005;27(6):970–8.CrossRefPubMed
19.
go back to reference Mehrdad R. Health system in Iran. JMAJ. 2009;52(1):69–73. Mehrdad R. Health system in Iran. JMAJ. 2009;52(1):69–73.
20.
go back to reference Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRefPubMed Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRefPubMed
22.
go back to reference Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice. 4TH ed. United States of America: Jossey-Bass A Wiley Imprint; 2008. Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice. 4TH ed. United States of America: Jossey-Bass A Wiley Imprint; 2008.
23.
go back to reference Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative. Fifth ed. Printed in China: Wolters Kluwer Health / Lippincott Williams & Wilkins; 2011. Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative. Fifth ed. Printed in China: Wolters Kluwer Health / Lippincott Williams & Wilkins; 2011.
24.
go back to reference Schwandt TA, Lincoln YS, Guba EG. Judging interpretations: but is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. N Dir Eval. 2007;2007(114):11–25.CrossRef Schwandt TA, Lincoln YS, Guba EG. Judging interpretations: but is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. N Dir Eval. 2007;2007(114):11–25.CrossRef
26.
go back to reference Widayati A, Suryawati S, Cd C, Hiller JE. Beliefs about the use of nonprescribed antibiotics among people in Yogyakarta City, Indonesia: a qualitative study based on the theory of planned behavior. Asia Pac J Public Health. 2015;27(2):NP402–13.CrossRefPubMed Widayati A, Suryawati S, Cd C, Hiller JE. Beliefs about the use of nonprescribed antibiotics among people in Yogyakarta City, Indonesia: a qualitative study based on the theory of planned behavior. Asia Pac J Public Health. 2015;27(2):NP402–13.CrossRefPubMed
28.
go back to reference Reisi M, Javadzade SH, Mostafavi F, Sharifirad G, Radjati F, Hasanzade A. Relationship between health literacy, health status, and healthy behaviors among older adults in Isfahan, Iran. J Educ Health Promot. 2012;1(1):31.CrossRefPubMedPubMedCentral Reisi M, Javadzade SH, Mostafavi F, Sharifirad G, Radjati F, Hasanzade A. Relationship between health literacy, health status, and healthy behaviors among older adults in Isfahan, Iran. J Educ Health Promot. 2012;1(1):31.CrossRefPubMedPubMedCentral
29.
go back to reference Nader F, Mousavizadeh K, Ghafourifar P. Patient sources for drug information in Iran. A questionnaire-based survey. Pharm World Sci. 2008;30(6):764–7.CrossRefPubMed Nader F, Mousavizadeh K, Ghafourifar P. Patient sources for drug information in Iran. A questionnaire-based survey. Pharm World Sci. 2008;30(6):764–7.CrossRefPubMed
30.
go back to reference Sawalha AF. A descriptive study of self-medication practices among Palestinian medical and nonmedical university students. Res Soc Adm Pharm. 2008;4(2):164–72.CrossRef Sawalha AF. A descriptive study of self-medication practices among Palestinian medical and nonmedical university students. Res Soc Adm Pharm. 2008;4(2):164–72.CrossRef
31.
go back to reference Cicirelli VG. Fear of death in older adults predictions from terror management theory. J Gerontol Ser B Psychol Sci Soc Sci. 2002;57(4):P358–66.CrossRef Cicirelli VG. Fear of death in older adults predictions from terror management theory. J Gerontol Ser B Psychol Sci Soc Sci. 2002;57(4):P358–66.CrossRef
32.
go back to reference Major RJ, Whelton WJ, Schimel J, Sharpe D. Older adults and the fear of death: the protective function of Generativity. Can J Aging La Rev Can du Vieil. 2016;35(2):261–72.CrossRef Major RJ, Whelton WJ, Schimel J, Sharpe D. Older adults and the fear of death: the protective function of Generativity. Can J Aging La Rev Can du Vieil. 2016;35(2):261–72.CrossRef
33.
go back to reference Graham F, Clark D. WHO definition of palliative care. Medicine. 2008;2(36):64–6.CrossRef Graham F, Clark D. WHO definition of palliative care. Medicine. 2008;2(36):64–6.CrossRef
34.
go back to reference Asadi-Lari M, Madjd Z, Akbari ME. The need for palliative care services in Iran; an introductory commentary. Iran J Cancer Prev. 2012;1(1):1–4. Asadi-Lari M, Madjd Z, Akbari ME. The need for palliative care services in Iran; an introductory commentary. Iran J Cancer Prev. 2012;1(1):1–4.
35.
go back to reference Pineles LL, Parente R. Using the theory of planned behavior to predict self-medication with over-the-counter analgesics. J Health Psychol. 2013;18(12):1540–9.CrossRefPubMed Pineles LL, Parente R. Using the theory of planned behavior to predict self-medication with over-the-counter analgesics. J Health Psychol. 2013;18(12):1540–9.CrossRefPubMed
36.
go back to reference Corwin GS, Parker DM, Brown JR. Site of Treatment for Non-Urgent Conditions by Medicare Beneficiaries: Is There a Role for Urgent Care Centers?. Am J Med. 2016;129(9):966–73. Corwin GS, Parker DM, Brown JR. Site of Treatment for Non-Urgent Conditions by Medicare Beneficiaries: Is There a Role for Urgent Care Centers?. Am J Med. 2016;129(9):966–73.
37.
go back to reference Vik SA, Maxwell CJ, Hogan DB. Measurement, correlates, and health outcomes of medication adherence among seniors. Ann Pharmacother. 2004;38(2):303–12.CrossRefPubMed Vik SA, Maxwell CJ, Hogan DB. Measurement, correlates, and health outcomes of medication adherence among seniors. Ann Pharmacother. 2004;38(2):303–12.CrossRefPubMed
38.
go back to reference Putnam M. Linking aging theory and disability models: increasing the potential to explore aging with physical impairment. The Gerontologist. 2002;42(6):799–806.CrossRefPubMed Putnam M. Linking aging theory and disability models: increasing the potential to explore aging with physical impairment. The Gerontologist. 2002;42(6):799–806.CrossRefPubMed
39.
go back to reference Hayati H, Khosravi B, Kebriaeezadeh A, Khanizade M. Study of self-medication status among referring patients to Kashan pharmacies. J Pharmacoecon Pharm Manage. 2015;1(2):45–8. Hayati H, Khosravi B, Kebriaeezadeh A, Khanizade M. Study of self-medication status among referring patients to Kashan pharmacies. J Pharmacoecon Pharm Manage. 2015;1(2):45–8.
40.
go back to reference Nikfar S, Kebriaeezadeh A, Majdzadeh R, Abdollahi M. Monitoring of National Drug Policy (NDP) and its standardized indicators; conformity to decisions of the national drug selecting committee in Iran. BMC Int Health Hum Rights. 2005;5(1):1.CrossRef Nikfar S, Kebriaeezadeh A, Majdzadeh R, Abdollahi M. Monitoring of National Drug Policy (NDP) and its standardized indicators; conformity to decisions of the national drug selecting committee in Iran. BMC Int Health Hum Rights. 2005;5(1):1.CrossRef
41.
go back to reference Cheraghali A, Nikfar S, Behmanesh Y, Rahimi V, Habibipour F, Tirdad R, Asadi A, Bahrami A. Evaluation of availability, accessibility and prescribing pattern of medicines in the Islamic Republic of Iran. East Mediterr Health J. 2004;10(3):406–15. Cheraghali A, Nikfar S, Behmanesh Y, Rahimi V, Habibipour F, Tirdad R, Asadi A, Bahrami A. Evaluation of availability, accessibility and prescribing pattern of medicines in the Islamic Republic of Iran. East Mediterr Health J. 2004;10(3):406–15.
42.
go back to reference Sedighi B, Ghaderi-Sohi S, Emami S. Evaluation of self-medication prevalence, diagnosis and prescription in migraine in Kerman, Iran. Saudi Med J. 2006;27(3):377–80.PubMed Sedighi B, Ghaderi-Sohi S, Emami S. Evaluation of self-medication prevalence, diagnosis and prescription in migraine in Kerman, Iran. Saudi Med J. 2006;27(3):377–80.PubMed
43.
go back to reference Armitage CJ, Armitage CJ, Conner M, Loach J, Willetts D. Different perceptions of control: applying an extended theory of planned behavior to legal and illegal drug use. Basic Appl Soc Psychol. 1999;21(4):301–16.CrossRef Armitage CJ, Armitage CJ, Conner M, Loach J, Willetts D. Different perceptions of control: applying an extended theory of planned behavior to legal and illegal drug use. Basic Appl Soc Psychol. 1999;21(4):301–16.CrossRef
44.
go back to reference Sahebi L, Seydi A, Amini S, Mousa Khani M. Self-medication Status among referring patients to Tabriz pharmacies. Pharmaceutical sciences. 2009;14(4):174–181. Sahebi L, Seydi A, Amini S, Mousa Khani M. Self-medication Status among referring patients to Tabriz pharmacies. Pharmaceutical sciences. 2009;14(4):174–181.
45.
go back to reference Jain S, Malvi R, Purviya JK. Concept of self medication. A review. International Journal of Pharmaceutical & Biological Archive. 2011;2(3):831–36. Jain S, Malvi R, Purviya JK. Concept of self medication. A review. International Journal of Pharmaceutical & Biological Archive. 2011;2(3):831–36.
46.
go back to reference Afshary P, Mohammadi S, Koshteh S, Pajohideh SZ, Tabesh H. Survey on prevalence and causes of self-medication in women referring to health centers in Ahwaz, in 2013. ISMJ. 2015;18(5):1034–44. Afshary P, Mohammadi S, Koshteh S, Pajohideh SZ, Tabesh H. Survey on prevalence and causes of self-medication in women referring to health centers in Ahwaz, in 2013. ISMJ. 2015;18(5):1034–44.
Metadata
Title
Self-medication among the elderly in Iran: a content analysis study
Authors
Seyede Salehe Mortazavi
Mohsen Shati
Hamid Reza Khankeh
Fazlollah Ahmadi
Shiva Mehravaran
Seyed Kazem Malakouti
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2017
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-017-0596-z

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