CHAPTER ONE
INTRODUCTION
1.1 Background to the study
Over-the-counter (OTC) drugs have been widely used in self-medication, for many years, in the treatment of common health problems. Traditionally, self-medication is the taking of drugs, herbs or home remedies on one’s own initiative, or on the advice of another person, without consulting a doctor (Hernandez-Juyol and Job-Quesada, 2002). However, in practice, it is defined as the treatment of common health problems with medicines designed and labeled for use without professional supervision and approved as safe and effective for such use (Abduelkarem, 2017). It involves the use of medicinal products by the consumer to treat self-recognized disorders or symptoms, or the intermittent or continued use of a medication prescribed by a physician for chronic or recurring diseases or symptoms.
Even though OTC drugs may have a considerable benefit as a part of self-care, it also poses many potential risks in self-medication It commonly associates with risks such as misdiagnosis, use of excessive drug dosage, prolonged duration of use, drug interactions, and poly-pharmacy. Moreover, it is one of the major reasons for antibiotic resistance. It may also cause skin problem, hypersensitivity, and allergy, especially in the case of those patients that do not follow the instructions given by the label or package (Addis, Melese and Nassa, et al 2020).
Among pregnant women, OTC drugs have been widely used in the treatment of common pregnancy-related health issues. Pregnancy is a dynamic process in which anatomic and physiological changes occur from fertilization to parturition. Any given OTC agent has different effects depending on the stage of the embryo and fetal development. Despite the occurrence of an adverse outcome that depends not only on the physical and chemical nature of the drug but also on the dose, duration, frequency, route of exposure, and gestational timing involved, many pregnant women use OTC drugs without adequate safety precautions. The prevalence of self-medication among pregnant women was reported to be high throughout the world. It is estimated to be 22-44% (Mohseni, Azami-Aghdash and Sheyklo, et al. 2018). Furthermore, a relatively higher magnitude, up to 85%, is being reported from a resource-limited setting, particularly in Africa (Beza, 2018).
Previous studies reported that the most frequent reasons for self-medication are having a minor illness, health care costs, lack of adequate time to visit a physician, prior experience in using a drug, and long waiting time to visit a qualified practitioner (Sisay, Mengistu and Edessa, 2018). In the developing world like Nigeria where health care resource is very limited across the 36 states, people live with extreme poverty, and the illiteracy rate is very high; the practice of self-medication could have greater negative impacts, especially when practiced by very fragile population like pregnant women.
The low awareness of the potential side effects of OTC use among antenatal clients and the relative difference in the knowledge, attitude, and socio-cultural condition of antenatal clients may cause the prevalence of self-medication in different settings to fluctuate. Unlike relatively resource-rich communities, self-medication may be highly widespread among illiterates, unemployed, women with low socioeconomic status, and women in their first trimester of pregnancy. Therefore, this study aims at assessing those factors that influence the prevalence of OTC drug use among antenatal clients of the Babcock University Teaching Hospital, Ogun State.
1.2 Statement of the problem
The problem statement of this study is that antenatal clients are among the most vulnerable groups of the population for drug-induced adverse as drugs such as OTC medication show effects on their fetus and themselves. The harmful effect of OTC use is expected to be high if they are not used based on prescription, supervision, or follow-up of authorized health care providers (Food and Drug Administration, 2005), because the pharmacokinetic profile of the drug may be altered due to maternal physiologic changes during pregnancy. As a result, unexpected adverse drug reactions may occur. Moreover, medications may pass through the placenta and cause harm to the fetus (Adanikin and Awoleke, 2017).
Despite the occurrence of an adverse outcome that depends not only on the physical and chemical nature of the drug but also on the dose, duration, frequency, route of exposure, and gestational timing involved, many pregnant women use OTC medication without adequate safety precautions. Some of the reasons found in previous investigations include the need to reduce the cost of consultation and the cost of transportation to and from the hospitals or health care facilities.
1.3 Objectives of the study
This study aims to examine the determinant contributing to the prevalence of OTC medication among antenatal clients, using the Babcock University Teaching Hospital (BUTH) as a case in point. To achieve this aim, however, the following objectives will be examined:
- Determine the factors that inform the use of OTC medication among antenatal clients in BUTH.
- Ascertain the disease conditions for which antenatal clients in BUTH use OTC medication.
- Determine the OTC drugs that are most often used by antenatal clients in BUTH.
1.4 Research questions
- What factors determine the use of OTC medication among antenatal clients in BUTH?
- Which disease conditions do antenatal clients in BUTH use OTC medications for?
- Which OTC drugs are most commonly used by antenatal clients of BUTH?
1.5. Research Hypothesis
Ho: There are no factors that determine the use of OTC medication among antenatal clients in BUTH.
Ho: There are no disease conditions antenatal clients in BUTH uses OTC medications for.
Ho: The OTC drugs are not mostly commonly used by antenatal clients of BUTH.
1.6 Scope of the study
The study focuses on the determinant contributing to prevalence of Over-the-counter medication among antenatal client in Babcock University Teaching Hospital, Ogun State. The scope of this study includes practicing nurses at the BUTH. The population of nurses for the study includes from the Nursing Services department of the hospital.
1.7 Significance of the study
One of the goals of the National Health Policy (2019) of the Federal Ministry of Health is to reduce maternal, newborn, child, and adolescent morbidity and mortality. To achieve this important goal, all stakeholders work together to eliminate the various factors, including self-medication and other practices that work against and hinder the wellbeing of antenatal clients in Nigeria. Understanding and managing attitudes toward OTC medications and by so doing promoting medication safety among pregnant women will go a long way in achieving this goal.
1.8 Operational Definition of Terms
Medication: This are prescription of drugs used to diagonised, prevent and treat diseases.
Antenatal Client: This is a person using the service of health workers, nurses or doctors, which are for medical checkups, pregnancy checkups, Parental nutrition including prenatal vitamins, which prevents potential health problems throughout the course of the pregnancy and promotes the mother and child's health alike.
BUTH: Babcock University Teaching Hospital
