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ABSTRACT
Introduction: The term drugs include prescription and non-prescription medicines, including complementary healthcare products. Rational use of drugs, as per directions will result in safer and better outcome for the patients. Rational use of drug requires the patient receive medications appropriate to their clinical needs. The concept of rational use of drug is new to the younger generations. It is important to know the usage of drugs and traditional medicine. The result of the study can be used to understand, highlight and create awareness among the society about the rational use of drugs. Objective: To assess the knowledge, attitude, awareness on rational use of drugs among non – medical students. Materials and Methods: This cross sectional study was done on 342 students in Saveetha Engineering College. The study was started after obtaining the consent from the IRB and informed consent. This study was a questionnaire-based study. It is a semi-structural questionnaire with 35 questions. Data was collected by consecutive sampling technique and analyzed using SPSS V20.0 software. Result: 35% of the participants were female and 65% of them were male participants. The analysis was done by categorizing the questions into sections of knowledge, attitude and awareness. Only about 50% of the people had knowledge about the rational use of drugs. More than 45% have wrong attitude regarding rational use of drugs. More than 65% of people, were aware about drug and its usage. Conclusion: After the analyzing the responses given in the questionnaire, we can conclude that 50% to 60% of the participants had basic knowledge, attitude and awareness regarding rational use of drugs. So we should conduct awareness programmes regarding drugs and its side effects.
INTRODUCTION
The term drugs includes prescription and non-prescription medicines, including supplementary healthcare products, Irrational use of drugs is a major problem worldwide WHO estimates that more than half of all drugs are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly.(1) The overuse, underuse or misuse of medicines results in wastage of scarce resources and widespread health hazards. Examples of irrational use of drugs include: use of too many drugs per patient ( poly-pharmacy ); inappropriate use of antimicrobials, often in inadequate dosage, for non-bacterial infections; (2)over-use of injections when oral formulations would be more appropriate; failure to prescribe in accordance with clinical guidelines; inappropriate self-medication; inappropriate self-medication, often of prescription-only medicines; non-adherence to dosing regimens.(3)
Medically inappropriate, ineffective, and economically inefficient use of pharmaceuticals is commonly observed in the health care system throughout the world, particularly in the developing countries. Most physicians would vouch for having observed this in their day-to-day practice and there is a plenty of hard evidence to reinforce this impression. Even a cursory survey of the available literature provides a wealth of data which is amazingly uniform across nations. Without any doubt, this is a global problem.(4)
Rational use of drugs or consumption of drugs as per directions will result in safer and better outcome for the patient. A conference of Experts on the Rational Use of Drugs, convened by the World Health Organisation in Nairobi in 1985 defined that: Rational use of drugs requires that patients receive medications appropriate to their clinical needs, in does that meet their own individual requirements for an adequate period of time, and the lowest cost to them and their community .(5) This is often simplified as the five rights- the right drug at the right dose by the right route at the right time for the right patient.
Some measures are necessary to take against the irrational use of the drugs which include the creation and revision of the rational drug therapy practice. Also, there is need to include people of the health care team to create awareness among patients about the rational use of drugs.
The concept of rational use of drugs is new to the younger generation, it is important to know their usage of drugs including prescription and non-prescription drugs and traditional medicines.(6)The aim of the study is to understand and highlight the need to create awareness among the society about rational usage of drugs.
MATERIALS AND METHODS
This cross sectional retrospective study was conducted in Saveetha Engineering College, Chennai. A total of 342 students were included, who were only non-medical students. The participants included only UG students of various department of Saveetha engineering college. In this study 500 students were approached out which 342 of them were willing to take part in the study. Whenever they wanted if they felt unsafe or uncomfortable. they were given the liberty to pull off from the study. The study period from 20th February to 12th May 2019. Institutional Review Board (IRB) was applied and obtained before starting.
All the students who took part in the study was briefed on the study was distributed after describing the purpose of the study. The participants were assured that participation was voluntary and confidentiality will be maintained.(7) A semi-structured questionnaire containing 35 questions relating to knowledge, attitude, awareness about rational use of drug. Consent form was obtained from the participants, after which their responses were collected and confidentiality regarding their data was maintained throughout the study. Data was entered in the excel sheet and the data was analysed using spss V20.0 software, frequency and percentage were obtained and percentage with graphs and charts.
Result
As the study was performed with a population of 342 engineering students. As the population consisted of students with age group ranging from 19 to 21. In the total of 342 participants, femaleparticipants were 35% and 65% were male participants. As the study was among engineering students 65% participants were belonging to a Mechanical engineering, 35% participants were pursuing electronics and communication engineering
Out of 342 participants, all participants were from urban areas, among which majority of participants(50%) were from Kadappa, followed by 40% participants from Nellore and 10% participants were from Tamilnadu. Amount the 342 participants majority of the participants that is 92% participants were from state board curriculum based school and remaining 8% participants finished the studied from CBSE curriculum based schools. Out of 342 Engineering students who participated in the study, 50.44% participants felt safe with self medication while 44.87%participants felt unsafe to have self medication.
When questioned about the awareness about over the counter (OTC) medicines, 36.07% participants were aware while remaining 43.11% participants were not aware. When asked about the OTC and its safety with prescription medicines, 41.94% participants agreed and 36% participants disagreed. 50.73% participants were aware about generic medicine and the remaining 34.90% participants were not aware. When asked about a question that the same generic content of medicines is available under different names 51.32% participants 30.79% participants disagreed whileAbout 59.65% participants have the knowledge of taking the precautions which using medicine inpregnant and breastfeeding women while the remaining 23.98% participants are unaware.
The participants were then questioned on their attitude towards drugs as like costlier medicines are better than cheaper ones for which 50.6% students agreed 31.6% students disagreed and the remaining where 17.8% were not aware about the relationship between cost and the quality of drugs. The participants of about 50.7% of total participants had an attitude that medicines manufactured by foreign multinational companies are better whereas remaining 34.9% of the participants were strongly against that attitude. But when asked about the fact that is it important for patient to know about common side effects of medicines, 50.6% of the participants strongly agreed and 34.8% of the participants disagreed. A question assessing the attitude of the participants were asked which stated that whether mass communication a bad medium to educate about medicines for which 50.6%participants agreed and 32.7% participants strongly disagreed.
The participants were asked a question assessing their approach towards drug. Majority of them agreed to the fact that they will take the medicines only after reading the label. Brand name and the expiry date was the main categories of choice. Other categories are listed below in (figure.4)
About 45.32% participants agreed to the fact that medicines can be bought without prescription whereas the around 38.30% participants strongly disagreed. 50.58% participants had an attitude that medicines can be stopped if the symptoms disappear and the remaining 36.55% participants were against this attitude.
Around 46.20% participants purchase medicines online, while 39.77% prefer retail outlets. Around 41.81% participants agreed that they will purchase all medicines written in the prescription and 39.18% participants dont. 47.21% agree and stick to doctors advice and instructions where as 36.07% participants were not following doctors advice & instructions.
Discussion
This study assess the knowledge, attitude, and awareness of rational use of drugs among Engineering students. This study would take into consideration minimal exposure to knowledge and attitude, of the engineering students about various issues concerned about rational usage of drugs. Hence assessing their knowledge about the rational use of drugs would be helpful in promoting the rational use of drugs and improving the awareness. It is well known that safe and effective drug therapy is possible when patients are well informed about medications and about their use and side effects if taken without prescription . In this study majority of the participants had the knowledge and were aware about most of the issues concern about the rational usage of drugs as addressed in the questionnaire which seems to be a promising finding but in a long run all of them need to have a correct knowledge about all the issues addressed(8). Surprisingly only 36.07% of the participants were aware about over the counter (OTC) medicine.(figure:1)Ironically only 41.81% of the participants responded the OTC can be safely taken with the prescription medicines. Another study reports that many patients reported that they were not aware about the name, composition and side effects of the drugs prescribed for them.(9) As is clear from this study, majority of the participants had the attitude of reading the label on the medicines before using it but 76% of them look for its brand name and a whooping 100%of the participants look for its expiry date. (Figure:4)But, here 57% of them look for the generic name of the drug. About 47.21% participants stick to the doctors advice and instruction regarding the prescribed drugs. And About 46.20% participants agree that they mix medicines obtained from various doctors for the same problem. While 43.40% of the participants strongly disagree with the concept of mixing allopathic treatment with alternative medicine method like Ayurvedic traditional home remedy homeopathy. While a majority of participants(10), 50.58% stop their medications without consulting a doctor.(figure:3)This study brings out clearly the fact that majority of students possess moderate attitude and awareness, and their knowledge about rational use of drugs is encouraging and at the same time has to be improved drastically.(11)
CONCLUSION
Majority of students were aware about various issues concerned with Rational use of drugs but the knowledge related to Over the counter Drugs was found to be limited. As students are future pillars of the nation, they need to be aware of all the aspects of Rational use of drugs. Inadequate/improper knowledge in the above areas is a matter of concern and needs to be taken. Awareness programmes regarding rational use of drug and its Adverse drug reactions should be undertaken so that the deficit in knowledge, attitude and practice of rational use of drugs can be identified and appropriate corrective measures taken which will help in improving the quality of health care.
Limitations
- The participants were from the college level, who may have a basic knowledge about commonly used drugs in the market.
- The participants were from the engineering discipline only; other coaching or education streams werent included in the study.
Conflict of interest: None declared
Ethical approval: The study was approved by the Institutional Review Board
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