MULTICENTER STUDY ON SELF-MEDICATION AND SELF-PRESCRIPTION IN 6 LATIN-AMERICAN COUNTRIES

Objective: To evaluate the patterns of self-medication in Latin-Americ an countries. Methods: This cross-sectional drug utilization study too k place at 242 pharmacies in 11 study areas in six countries. Unselect ed samples of customers were interviewed with a structured questionnai re after they had purchased a medicinal product without any medical pr escription and without seeking or accepting the advice of the pharmaci st or pharmacy counter assistant. Results: We interviewed 8597 consume rs. They had purchased 10,569 pharmaceutical products. Ten percent of the products were intended for family use, 14.1% were for children, 68 .2% were for adults, and 7.9% were for elderly people. Thirty-nine per cent of the products were fixed-dose combinations, and 19% contained t hree or more active ingredients. Analgesics (16.8%) were the leading g roup of drugs, followed by antibiotics (7.4%), antiinflammatory and an tirheumatic products (5.9%), and vitamins (5.1%). Consumers interviewe d purchased relatively high numbers of cardiovascular drugs (494, 5%) and drugs that act on the central nervous system (256, 2.4%). Only 34% of dispensed drugs had an approved over-the-counter status; less rest rictive criteria suggest that 24% should have been dispensed on a medi cal prescription. Conclusions: The high proportion of fixed-dose combi nations reflects poorly regulated pharmaceutical markets. The relative ly high proportion of drugs dispensed without a medical prescription t hat nevertheless need medical follow-up is probably attributable to di fficult access to medical care. The potential effectiveness of these t reatments is therefore jeopardized by lack of medical follow-up. There is a need for implementation of a comprehensive pharmaceutical and he alth care policy in the participating countries.