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As often said, the most important thing
in medical practice is ‘Diagnosis’ of a
disease. Different diseases may have
similar symptoms and manifestations
with totally different cause which
need to be differentiated based on
laboratory tests for getting the right
medicine i.e. one which is highly
effective with minimum adverse
The physicians have
a professional, social and
moral responsibility to
provide the best available
treatment to their patients.
Similarly, patients also
have an equal responsibility
to use medicines as per
the doctor’s/pharmacist’s
instruction for best results.
However, the scenario is far from
desired. Several studies have revealed
that a good percentage of patients
fail to follow the instructions and
consume drugs as per their convenience
and belief towards the prescribed
Self medication can be
viewed from two angles:
Patient noncompliance is identifed as
a major factor in therapeutic failure in
routine practice. It is often assumed by
the doctors that patients will gratefully
or accurately follow what they are told,
but the assumption is wrong. The
patients adherence to the medical
advice and instructions may be partial,
erratic or nil.
This may be due to
several reasons:
The patient has not understood the
High frequency and complexity of
drug regimen
Multiple drugs
Willful noncompliance
Poor labeling on the containers
Poor patient doctor relationship
Failure to refll the medication
Some patients are over
enthusiastic to take the
drugs and may take more
drug than is prescribed.
This is generally because
of their belief that more
drug means faster and more
Appropriate steps can be
taken to improve the patient’s ability to
follow the instructions regarding drug
procurement, storage and usage and get
maximum beneft from the medicines
The other angle to self medication is
procuring and consuming drugs without
medical consultation or prescription.
The process is generally based on ones
judgment, observation, experience,
and confdence regarding the use of
medicine. Some consumers are able
to manage uncomplicated chronic
and recurrent illnesses after proper
medical diagnosis and occasional
professional advice. The individuals
are not willing to visit the doctor for
what they rightly feel they can manage
for themselves with their medical
knowledge and previous outcome with
the earlier use of medicine. However,
this is not recommended as it may
not give the desired therapeutic
effect. Moreover, it may sometimes
lead to worsening of the disease or
end up with severe and serious side
effects requiring hospitalization.
indiscriminate use of drugs,
particularly antimicrobials,
will increase the chances
of drug resistance and
therapeutic failure. It is
noteworthy that more than
fve per cent of the hospital
admissions are due to
adverse drug reactions.
Some of the factors that
promote and favor self
medication are:
Satisfactory previous experience
High physicians consultation fee
Lack of Time to visit the physician
Overconfdence about one’s
medical knowledge
Drug experience sharing with
relatives and friends
Easy availability of all sorts of
Freedom to start and stop the
Home storage
Drug information from internet
The most common
factor which promotes
self medication is the
information dissemination
by friends and relatives who
take pride in recommending
the medicine, which
has benefted them, to
anyone having similar
they consider it as their moral and
social responsibility to share such useful
information with others for the beneft
of one and all. They generally end up
giving incomplete information due to
ignorance which may prove dangerous if
accepted in good faith.
It is noteworthy that the successful
outcome of taking medicine without
prescription is the self–curing nature
of several illnesses which do not require
actually require any treatment which
gives encouragement and confdence
to the patient and he adopts the same
approach for serous diseases requiring
specifc medication. Moreover, patient’s
complaint being resolved is generally
considered as an achievement ignoring
the fact that the underlying disease
may be progressing well without the
alarming signs and symptoms. It must
be remembered that the effects of a
medicine show large interindividual
variation depending upon ethnicity,
age, Physiological status, smoking and
alcoholism, Pregnancy, presence of other
diseases, concomitant drugs etc. These
need to be taken into consideration
before popping a pill. Some of the drugs
called ‘over-the-counter’ are largely
available without prescription from the
pharmacies or via any retail outlet drugs
are generally considered safe which
is not the case and must be used with
In a nutshell, it is simply safe and
surely better to be in the hands
of a physician who prescribes
an evidence-based effective
treatment and gives proper
instructions for its use in a safe
and effective manner.
Modifying the instructions given
by the physician (Noncompliance)
and taking medicine as per the
Procuring and consuming
medicines without medical
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