Self-medication in the context of COVID-19, the dangers of the practice and associated factors
DOI:
https://doi.org/10.33448/rsd-v12i6.42039Keywords:
Self Medication; COVID-19; Drug-related side effects and adverse reactions.Abstract
Introduction: With the advancement of the COVID-19 pandemic, many people sought treatment or prevention alternatives for the disease and adhered to self-medication, without taking into account the possible risks of this practice. Objective: To characterize the practice of self-medication in the context of the COVID-19 pandemic, it’s dangers and associated factors. Methodology: An integrative literature review was carried out, with searches in the Virtual Health Library (VHL) databases, using the following Health Sciences Descriptors (DeCS): “COVID-19” and “self-medication” and the Boolean operator “AND”, searching for full articles published free of charge in the last five years in English, Portuguese or Spanish. A total of 57 articles were found, of which 10 were selected for full reading in order to answer the following guiding question: “What are the dangers, associated factors and characteristics of self-medication during the COVID-19 pandemic?”. Results: Self-medication was practiced by, on average, one third of the population during the pandemic. Health professionals, medical students and women self-medicated more compared to the rest of the population. The most used medications were antibiotics, ivermectin, antimalarials, NSAIDs and paracetamol, in addition to dietary supplements such as zinc, vitamin C and multivitamin complexes. Study participants had easy access to these medications. Traditional therapies have also been reported. Conclusion: Self-medication was very present, with heterogeneous characteristics of population distribution. Most medications were used without indication, and some may pose considerable health risks. More studies need to be carried out on the subject.
References
Abd‐Elsalam, S., Noor, R. A., Badawi, R., Khalaf, M., Esmail, E. S., Soliman, S., Abd El Ghafar, M. S., Elbahnasawy, M., Moustafa, E. F., Hassany, S. M., Medhat, M. A., Ramadan, H. K., Eldeen, M. A. S., Alboraie, M., Cordie, A., & Esmat, G. (2021). Clinical study evaluating the efficacy of ivermectin in COVID‐19 treatment: A randomized controlled study. Journal of Medical Virology, 93(10), 5833–5838. https://doi.org/10.1002/jmv.27122
Alexander, J., Tinkov, A., Strand, T. A., Alehagen, U., Skalny, A., & Aaseth, J. (2020). Early Nutritional Interventions with Zinc, Selenium and Vitamin D for Raising Anti-Viral Resistance Against Progressive COVID-19. Nutrients, 12(8), 2358. https://doi.org/10.3390/nu12082358
AlShoaibi, N. A., Maghrabi, K., Alanazi, H., Harbi, M. Al, & Alghamdi, S. (2020). Saudi Heart Rhythm Society Task Force on Management of Potential Arrhythmogenicity Associated with Pharmacotherapy for COVID-19. Annals of Saudi Medicine, 40(5), 365–372. https://doi.org/10.5144/0256-4947.2020.365
Arias, F., Izquierdo-Condoy, J. S., Naranjo-Lara, P., Alarcón, V., Bonilla, P., Erazo, E., Carrington, S. J., & Ortiz-Prado, E. (2022). A Cross-Sectional Analysis of Self-Medication Patterns during the COVID-19 Pandemic in Ecuador. Medicina (Kaunas, Lithuania), 58(11). https://doi.org/10.3390/medicina58111678
Becker, M. L., Snijders, D., van Gemeren, C. W., Kingma, H. J., van Lelyveld, S. F. L., & Giezen, T. J. (2021). QTc Prolongation in COVID-19 Patients Using Chloroquine. Cardiovascular Toxicology, 21(4), 314–321. https://doi.org/10.1007/s12012-020-09621-2
Behzadifar, M., Behzadifar, M., Aryankhesal, A., Ravaghi, H., Baradaran, H. R., Sajadi, H. S., Khaksarian, M., & Bragazzi, N. L. (2020). Prevalence of self-medication in university students: systematic review and meta-analysis. Eastern Mediterranean Health Journal, 26(7), 846–857. https://doi.org/10.26719/emhj.20.052
Bhimraj, A., Morgan, R. L., Hirsch Shumaker, A., Baden, L., Chi-Chung Cheng, V., Edwards, K. M., Gallagher, J. C., Gandhi, R. T., Muller, W. J., Nakamura, M. M., O, J. C., Shafer, R. W., Shoham, S., Hassan Mu-rad, M., Mustafa, R. A., Sultan, S., & Falck-Ytter, Y. (2023). Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. www.idsociety.org/COVID19guidelines.
Corrao, S., Mallaci Bocchio, R., Lo Monaco, M., Natoli, G., Cavezzi, A., Troiani, E., & Argano, C. (2021). Does Evidence Exist to Blunt Inflammatory Response by Nutraceutical Supplementation during COVID-19 Pandemic? An Overview of Systematic Reviews of Vitamin D, Vitamin C, Melatonin, and Zinc. Nutrients, 13(4), 1261. https://doi.org/10.3390/nu13041261
DiGuilio, K. M., Rybakovsky, E., Abdavies, R., Chamoun, R., Flounders, C. A., Shepley-McTaggart, A., Harty, R. N., & Mullin, J. M. (2022). Micronutrient Improvement of Epithelial Barrier Function in Various Disease States: A Case for Adjuvant Therapy. International Journal of Molecular Sciences, 23(6), 2995. https://doi.org/10.3390/ijms23062995
Elham, A. S., Azam, K., Azam, J., Mostafa, L., Nasrin, B., & Marzieh, N. (2021). Serum vitamin D, calcium, and zinc levels in patients with COVID-19. Clinical Nutrition ESPEN, 43, 276–282. https://doi.org/10.1016/j.clnesp.2021.03.040
Furtado, R. H. M., Berwanger, O., Fonseca, H. A., Corrêa, T. D., Ferraz, L. R., Lapa, M. G., Zampieri, F. G., Veiga, V. C., Azevedo, L. C. P., Rosa, R. G., Lopes, R. D., Avezum, A., Manoel, A. L. O., Piza, F. M. T., Martins, P. A., Lisboa, T. C., Pereira, A. J., Olivato, G. B., Dantas, V. C. S., … Cavalcanti, A. B. (2020). Azithromycin in addition to standard of care versus standard of care alone in the treatment of patients admitted to the hospital with severe COVID-19 in Brazil (COALITION II): a randomised clinical trial. The Lancet, 396(10256), 959–967. https://doi.org/10.1016/S0140-6736(20)31862-6
Golabi, S., Adelipour, M., Mobarak, S., Piri, M., Seyedtabib, M., Bagheri, R., Suzuki, K., Ashtary-Larky, D., Maghsoudi, F., & Naghashpour, M. (2021). The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study. Nutrients, 13(10), 3368. https://doi.org/10.3390/nu13103368
Hinks, T. S. C., Cureton, L., Knight, R., Wang, A., Cane, J. L., Barber, V. S., Black, J., Dutton, S. J., Melhorn, J., Jabeen, M., Moss, P., Garlapati, R., Baron, T., Johnson, G., Cantle, F., Clarke, D., Elkhodair, S., Underwood, J., Lasserson, D., … Richards, D. (2021). Azithromycin versus standard care in patients with mild-to-moderate COVID-19 (ATOMIC2): an open-label, randomised trial. The Lancet Respiratory Medicine, 9(10), 1130–1140. https://doi.org/10.1016/S2213-2600(21)00263-0
Hsia, B. C., Greige, N., Quiroz, J. A., Khokhar, A. S., Daily, J., Di Biase, L., Ferrick, K. J., Fisher, J. D., & Krumerman, A. (2020). QT prolongation in a diverse, urban population of COVID-19 patients treated with hydroxychloroquine, chloroquine, or azithromycin. Journal of Interventional Cardiac Electrophysiology, 59(2), 337–345. https://doi.org/10.1007/s10840-020-00822-x
Islam, M. S., Ferdous, M. Z., Islam, U. S., Mosaddek, A. S. M., Potenza, M. N., & Pardhan, S. (2021). Treatment, persistent symptoms, and depression in people infected with covid-19 in bangladesh. International Journal of Environmental Research and Public Health, 18(4), 1–16. https://doi.org/10.3390/ijerph18041453
Jerez-Roig, J., Medeiros, L. F. B., Silva, V. A. B., Bezerra, C. L. P. A. M., Cavalcante, L. A. R., Piuvezam, G., & Souza, D. L. B. (2014). Prevalence of Self-Medication and Associated Factors in an Elderly Population: A Systematic Review. Drugs & Aging, 31(12), 883–896. https://doi.org/10.1007/s40266-014-0217-x
Kim, M. S., An, M. H., Kim, W. J., & Hwang, T.-H. (2020). Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: A systematic review and network meta-analysis. PLOS Medicine, 17(12), e1003501. https://doi.org/10.1371/journal.pmed.1003501
Lacerda, M. G. da C., Barbos, A. R. de M., & Dourado, C. S. de M. E. (2022). Acesso da população a medicamentos durante a pandemia do novo coronavírus. Revista Ciência Plural, 8(1). https://doi.org/10.21680/2446-7286.2022v8n1ID25630
Lam, S., Lombardi, A., & Ouanounou, A. (2020). COVID-19: A review of the proposed pharmacological treatments. European Journal of Pharmacology, 886, 173451. https://doi.org/10.1016/j.ejphar.2020.173451
López-Medina, E., López, P., Hurtado, I. C., Dávalos, D. M., Ramirez, O., Martínez, E., Díazgranados, J. A., Oñate, J. M., Chavarriaga, H., Herrera, S., Parra, B., Libreros, G., Jaramillo, R., Avendaño, A. C., Toro, D. F., Torres, M., Lesmes, M. C., Rios, C. A., & Caicedo, I. (2021). Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19. JAMA, 325(14), 1426. https://doi.org/10.1001/jama.2021.3071
Makowska, M., Boguszewski, R., Nowakowski, M., & Podkowińska, M. (2020). Self-medication-related behaviors and Poland’s Covid-19 lockdown. International Journal of Environmental Research and Public Health, 17(22), 1–19. https://doi.org/10.3390/ijerph17228344
Manea, E., Jipa, R., Milea, A., Roman, A., Neagu, G., & Hristea, A. (2021). Healthcare-associated Clostridioides difficile infection during the COVID-19 pandemic in a tertiary care hospital in Romania. Romanian Journal of Internal Medicine, 59(4), 409–415. https://doi.org/10.2478/rjim-2021-0020
Mohan, A., Tiwari, P., Suri, T., Patel, A., Jain, A., Kumar Das, U., Bopanna, T. K., Shelke, S., Rajan Singh, A., Bhatnagar, S., Masih Mahajan Imaging Shelly Mahajan Mahajan Imaging Tanima Dwivedi, S., Sahoo, B., Bhopale, S., Vig, S., Gupta, R., Madan, K., Hadda, V., Gupta, N., Garg, R., … Guleria, R. (2021). Ivermectin in mild and moderate COVID-19 (RIVET-COV): a randomized, placebo-controlled trial. Research Square. https://doi.org/10.21203/rs.3.rs-191648/v1
Muller, R. (2021). Systemic toxicity of chloroquine and hydroxychloroquine: prevalence, mechanisms, risk factors, prognostic and screening possibilities. Rheumatology International, 41(7), 1189–1202. https://doi.org/10.1007/s00296-021-04868-6
Notz, Q., Herrmann, J., Schlesinger, T., Helmer, P., Sudowe, S., Sun, Q., Hackler, J., Roeder, D., Lotz, C., Meybohm, P., Kranke, P., Schomburg, L., & Stoppe, C. (2021). Clinical Significance of Micronutrient Supplementation in Critically Ill COVID-19 Patients with Severe ARDS. Nutrients, 13(6), 2113. https://doi.org/10.3390/nu13062113
Okoye, O. C., Adejumo, O. A., Opadeyi, A. O., Madubuko, C. R., Ntaji, M., Okonkwo, K. C., Edeki, I. R., Agboje, U. O., Alli, O. E., & Ohaju-Obodo, J. O. (2022). Self medication practices and its determinants in health care professionals during the coronavirus disease-2019 pandemic: cross-sectional study. International Journal of Clinical Pharmacy, 44(2), 507–516. https://doi.org/10.1007/s11096-021-01374-4
Oldenburg, C. E., Pinsky, B. A., Brogdon, J., Chen, C., Ruder, K., Zhong, L., Nyatigo, F., Cook, C. A., Hinterwirth, A., Lebas, E., Redd, T., Porco, T. C., Lietman, T. M., Arnold, B. F., & Doan, T. (2021). Effect of Oral Azithromycin vs Placebo on COVID-19 Symptoms in Outpatients With SARS-CoV-2 Infection. JAMA, 326(6), 490. https://doi.org/10.1001/jama.2021.11517
Onchonga, D., Omwoyo, J., & Nyamamba, D. (2020). Assessing the prevalence of self-medication among healthcare workers before and during the 2019 SARS-CoV-2 (COVID-19) pandemic in Kenya. Saudi Pharmaceutical Journal, 28(10), 1149–1154. https://doi.org/10.1016/j.jsps.2020.08.003
Preskorn, S. H., & Quadri, S. (2020). Why Are Patients With COVID-19 at Risk for Drug-Drug Interactions? Journal of psychiatric practice, 26(6), 485–492. https://doi.org/10.1097/PRA.0000000000000502
Rashid, M., Chhabra, M., Kashyap, A., Undela, K., & Gudi, S. K. (2020). Prevalence and Predictors of Self-Medication Practices in India: A Systematic Literature Review and Meta-Analysis. Current Clinical Pharmacology, 15(2), 90–101. https://doi.org/10.2174/1574884714666191122103953
Ruamviboonsuk, P., Lai, T. Y. Y., Chang, A., Lai, C.-C., Mieler, W. F., & Lam, D. S. C. (2020). Chloroquine and Hydroxychloroquine Retinal Toxicity Consideration in the Treatment of COVID-19. Asia-Pacific Journal of Ophthalmology, 9(2), 85–87. https://doi.org/10.1097/APO.0000000000000289
Sadio, A. J., Gbeasor-Komlanvi, F. A., Konu, R. Y., Bakoubayi, A. W., Tchankoni, M. K., Bitty-Anderson, A. M., Gomez, I. M., Denadou, C. P., Anani, J., Kouanfack, H. R., Kpeto, I. K., Salou, M., & Ekouevi, D. K. (2021). Assessment of self-medication practices in the context of the COVID-19 outbreak in Togo. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-020-10145-1
Saleh, M., Gabriels, J., Chang, D., Soo Kim, B., Mansoor, A., Mahmood, E., Makker, P., Ismail, H., Goldner, B., Willner, J., Beldner, S., Mitra, R., John, R., Chinitz, J., Skipitaris, N., Mountantonakis, S., & Epstein, L. M. (2020). Effect of Chloroquine, Hydroxychloroquine, and Azithromycin on the Corrected QT Interval in Patients With SARS-CoV-2 Infection. Circulation: Arrhythmia and Electrophysiology, 13(6). https://doi.org/10.1161/CIRCEP.120.008662
Sanders, J. M., Monogue, M. L., Jodlowski, T. Z., & Cutrell, J. B. (2020). Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19). JAMA. https://doi.org/10.1001/jama.2020.6019
Sciannameo, S., Zalazar, V., Aristegui, I., Parera, D., & Sued, O. (20222). Encuesta sobre el impacto de la pandemia COVID-19 en el consumo de medicamentos, drogas recreativas y bebidas alcohólicas en Argentina Survey on the impact of the COVID-19 pandemic on the consumption of medicines, recreational drugs and alcoholic beverages in Argentina. Rev. OFIL·ILAPHA, 32(4), 347–353. https://doi.org/10.4321/S1699-714X2022000400007
Shehnaz, S. I., Agarwal, A. K., & Khan, N. (2014). A Systematic Review of Self-Medication Practices Among Adolescents. Journal of Adolescent Health, 55(4), 467–483. https://doi.org/10.1016/j.jadohealth.2014.07.001
Sisay, M., Mengistu, G., & Edessa, D. (2018). Epidemiology of self-medication in Ethiopia: a systematic review and meta-analysis of observational studies. BMC Pharmacology and Toxicology, 19(1), 56. https://doi.org/10.1186/s40360-018-0248-8
Souza, M. T. de, Silva, M. D. da, & Carvalho, R. de. (2010). Integrative review: what is it? How to do it? Einstein (São Paulo), 8(1), 102–106. https://doi.org/10.1590/s1679-45082010rw1134
Story, M. J. (2021). Essential sufficiency of zinc, ω-3 polyunsaturated fatty acids, vitamin D and magnesium for prevention and treatment of COVID-19, diabetes, cardiovascular diseases, lung diseases and cancer. Biochimie, 187, 94–109. https://doi.org/10.1016/j.biochi.2021.05.013
Tasnim, S., Hossain, M. M., & Mazumder, H. (2020). Impact of Rumors and Misinformation on COVID-19 in Social Media. Journal of Preventive Medicine and Public Health, 53(3), 171–174. https://doi.org/10.3961/jpmph.20.094
Teng, C., Reveles, K. R., Obodozie-Ofoegbu, O. O., & Frei, C. R. (2019). Clostridium difficile Infection Risk with Important Antibiotic Classes: An Analysis of the FDA Adverse Event Reporting System. International Journal of Medical Sciences, 16(5), 630–635. https://doi.org/10.7150/ijms.30739
The RECOVERY Collaborative Group. (2020). Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19. New England Journal of Medicine, 383(21), 2030–2040. https://doi.org/10.1056/NEJMoa2022926
Wegbom, A. I., Edet, C. K., Raimi, O., Fagbamigbe, A. F., & Kiri, V. A. (2021). Self-Medication Practices and Associated Factors in the Prevention and/or Treatment of COVID-19 Virus: A Population-Based Survey in Nigeria. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.606801
WHO Solidarity Trial Consortium. (2021). Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results. New England Journal of Medicine, 384(6), 497–511. https://doi.org/10.1056/NEJMoa2023184
World Health Organization (WHO). (2000). Guidelines for the regulatory assessment of medicinal products for use in self-medication. Retrieved from: https://apps.who.int/iris/handle/10665/66154
World Health Organization (WHO). (2020, abril 19). The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. Retrieved from: https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19
World Health Organization (WHO). (2023a). Clinical management of COVID-19: living guideline. Retrieved from: https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2023.1
World Health Organization (WHO). (2023b). Drugs to prevent COVID-19: living guideline. Retrieved from: https://www.who.int/publications/i/item/WHO-2019-nCoV-prophylaxes-2023.1
World Health Organization (WHO). (2023c). Therapeutics and COVID-19: living guideline. Retrieved from: https://www.who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2023.1
Yasmin, F., Asghar, M. S., Naeem, U., Najeeb, H., Nauman, H., Ahsan, M. N., & Khattak, A. K. (2022). Self-Medication Practices in Medical Students During the COVID-19 Pandemic: A Cross-Sectional Analysis. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.803937
Yusuf, I., & Sarkinfada, F. (2021). Gaps in the implementation of covid-19 mitigation measures could lead to development of new strains of antimicrobial resistant pathogens: Nigerian perspective. Em Pan African Medical Journal (Vol. 40). African Field Epidemiology Network. https://doi.org/10.11604/pamj.2021.40.12.23274
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Francisco Samuel Estrela Dantas; Vanessa Erika Abrantes Coutinho; Rodolfo de Abreu Carolino; Thaise de Abreu Brasileiro Sarmento; Caio Visalli Lucena da Cunha; Camila Pereira da Silva; Matheus Leite Ferreira
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.