Original Article SELF MEDICATION PRACTICE AMONG URBAN SLUM DWELLERS IN UDUPI TALUK, KARNATAKA, INDIA PRANAV V. * , PRAKASH NARAYANAN, VASUDEVA GUDDATTU Department of Public Health, Manipal University, Manipal, Karnatka Email: pranav.vy@gmail.com Received: 30 Oct 2016 Revised and Accepted: 20 Apr 2017 ABSTRACT Objective: To estimate the prevalence and associated factors of self-medication among slum dwellers, and to explore the perception of community pharmacists’ on self-medication practices in Udupi taluk of Karnataka state in India. Methods: A quantitative survey among 300 randomly selected slum dwellers and in-depth interviews with community pharmacists and pharmacy practice experts were conducted during January-April 2016. Descriptive and analytical methods were used to estimate the prevalence and to identify associated factors. Thematic analysis was carried out on qualitative data. Results: The prevalence of self-medication practice was 47%. Factors such as gender, recent experience of an illness, and stocking medicines at home were significantly associated with self-medication practice. Self-medication practices were high for common ailments and for the illnesses they perceived as ‘mild’ (66%). Community pharmacists (87%) were the main source of information on medication. The majority (76%) of participants were ignorant about the expiry date of the medicines. The qualitative data highlighted pharmacist’s’ role to promote consultation with a physician, and educating patients on completion of treatment course and possible drug reactions. Conclusion: Self-medication practices found to be common among slum-dwellers due to reasons such as lesser awareness, easy availability of over- the-counter medications, and limitations related to universal access to health. There is a need to improve the awareness of dangers of self- medication to the general public and strengthen the mechanism to monitor dispensing of medicines without prescriptions. Keywords: Over the counter (OTC) drugs, Self-medication, Slum dwellers, Udupi © 2017 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) DOI: http://dx.doi.org/10.22159/ijpps.2017v9i6.15950 INTRODUCTION Self-medication is a human behaviour, defined as the use of medication by a person to treat his or her own illness/ailment and the usage of a previously prescribed drug for a chronic or recurrent disease or symptoms, without the consultation of a registered medical practitioner and surveillance of treatment [1, 2]. Despite having its own demerits, self-medication is an important health policy component of primary health care and patient empowerment [3]. Self-medication could be beneficial for the patients, healthcare providers, and pharmaceutical industry if practices appropriately as it reduces the pressure on the healthcare system, saves time and stands as a strong alternative to treat ailments [3, 4]. An interesting point noted was that some of the drugs that could be purchased only with the prescriptions in developed countries could be purchased over the counter (OTC) in developing countries. World Health Organization (WHO) emphasized that the practice should be controlled [5, 6]. In India, the Drugs and Cosmetics Act of 1940, the Drugs and Cosmetics Rules of 1945 regulates the import, manufacture, distribution and sale of drugs and cosmetics, and that OTC has no legal implications in India. Several studies have shown that, although the OTC drugs used for self-treatment were considered as safe and efficacious, the lack of awareness on their dosage, side effects, and interactions could lead to inappropriate practices which may have serious implications in geriatrics, pediatrics and in conditions like pregnancy and lactation [7]. The most common problems associated with self-medication were the development of drug resistance, pathogenic resistance, drug-drug interactions and complications due to adverse drug reactions, polypharmacy and prolonged illness [4, 8]. It is the obligation of the Government and health authorities to promote responsible self-medication practices, ensure the quality and safety of over the counter drugs, and to inform the consumers on the usage of drugs [5]. The concept of ‘responsible self-medication’ introduced by the WHO aimed at promoting rational use of medicines through proper drug information, and adequate labeling in the package and inclusion of information leaflets [9]. Slum dwellers are considered as one of the most socioeconomically deprived population. In the developing countries like India due to easy availability of drugs and inadequate healthcare services, many of the drugs are dispensed over the counter without medical supervision. This could lead the increased use of self-medication drugs compared to prescribed drugs. As of now, there are no legal implications and regulations for the OTC drugs in India [10]. A cross-sectional study was conducted among urban slum dwellers in Udupi taluk of Karnataka state in India to estimate the prevalence and factors associated with self-medication, as well as to explore the perception of community pharmacists regarding self-medication practices of slum dwellers. MATERIALS AND METHODS A community-based cross-sectional study was conducted among randomly selected urban slum dwellers of Udupi taluk in Udupi district of Karnataka state in India, during January to April 2016. The list of slums (total 23 slums), which was procured from Udupi City Municipal Council and a two-stage cluster sampling approach was adopted. Random selection of 10 slums as the first stage and systematic random selection of 30 households from selected slums in the second stage. One eligible and consented respondent from each selected household was considered for the study. A participant information sheet which contains all relevant information about the study was explained and the written consent was obtained from participants who were willing to be part of the study. Ethical permission for the study was obtained from the Institutional Ethical Committee of Kasturba Medical College and Kasturba Hospital on 12/01/2016. The registration number was of the ethics committee is ECR/146/Inst/KA/2013 and IEC number of the study is 31/2016. In order to calculate the sample size, a pilot study was conducted in few urban slums in Udupi taluk and the estimated prevalence of self- International Journal of Pharmacy and Pharmaceutical Sciences ISSN- 0975-1491 Vol 9, Issue 6, 2017