Jm. Castel et al., MULTICENTER STUDY ON SELF-MEDICATION AND SELF-PRESCRIPTION IN 6 LATIN-AMERICAN COUNTRIES, Clinical pharmacology and therapeutics, 61(4), 1997, pp. 488-493
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.