الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 117 |  |  |
| | | from | 117 | | |
Abstract
Analgesics including NSAIDs are among the most common medications used to treat acute and severe pain associated with a variety of conditions. Prolonged-term use of analgesics drugs (non-opioid and opioid) is associated with adverse effects. However, non-opioid analgesics are among the most popular analgesics and easily available over the counter.
Rational use of medicine according to WHO is the appropriate use of medicine according to the patient’s clinical needs for the right period of time in right doses and in lowest cost.
Regarding the situation in Yemen, most pharmacies sell analgesics without a prescription leading to a high rate of self-purchase and improper use of these analgesics, particularly NSAIDS resulting in increased incidence of their adverse effects. Therefore, there is a need for a quick reaction and serious work through which to improve and rationalize the use of analgesics. The aim of present study is to study utilization of analgesics among adult’s population in Hodeidah Governorate, Yemen, as well as the following specific objectives:
1. To estimate the prevalence of the use of analgesics among adult population.
2. To describe the pattern of use of analgesics among adults.
3. To assess adult’s knowledge regarding analgesics, use.
A cross sectional study was conducted among adults (18 years and above). The study included 600 adults attending different pharmacies for purchasing medications with or without prescriptions. Data collection was done using a pre-designed interview questioner, where the researcher interviewed the purchasers. Data collection included socio-demographic characteristics for users or purchasers, medical history, the pattern of the analgesic use (duration, frequency, doses, and methods of administration, number of analgesics used, source of consultation, adverse effects reported, reasons for its use) and knowledge about analgesic use (Indications for use, contraindications of use, drug interactions, and adverse effects).
Data entry and statistical analysis were done using the software Statistical Package for Social Sciences (SPSS) version 21. Both descriptive and analytical analyses were done.
The study revealed the following main results:
Sociodemographic characteristics:
The age of the studied adults ranged between 18 and 75 years with median age of 35 years. About, one-third (31.0%) of the respondents were in the age group 25 to 35 years. Males constituted 86.0% and females 14.0%.
About two-thirds of participants (65.0%) from rural areas, while 35.0% from urban areas. About 33.2% of respondents had high school education, followed by university education 18.2%.
Nonprofessionals constituted 19.0%, professional 16.6%, and Students 16.5%.
More than two-thirds of studied adults (70.0%) were married, 27.5% of them were single.
Magnitude of use of analgesics:
The overall prevalence of analgesics use among Yemeni adults was 61.0% in Hodiedah Governorate.
Pattern of use of analgesics among self-analgesics purchasers.
About 62% of analgesics used were purchased without a prescription.
There was a statistically significant association between age, sex, occupation, and analgesics use.
There was a statistically significant association between hypertension, peptic ulcer, and diabetes and analgesic use.
About 70.0% of analgesics self-purchasers took NSAIDs, 28.6% took paracetamol and paracetamol containing compounds.
About two-thirds of users (66.9) used analgesics for less than one week. As regards the frequency of analgesic use 41.5% of users used analgesics once per day, while 31.0% used analgesics twice per day.
About 67.0% of analgesics users did not face any side effects, but 19.0% have reported nausea and vomiting, 10.9 % reported stomach burn and 2.0% reported shortness of breath.
Nearly 39.0% of those who experienced side effects stopped using analgesics, while about 61.0% of them reported continued taking analgesics.
The most common reasons for taking analgesics were headache, toothache, arthritis, and renal colic (21.4%, 18.5%, 12.9%, and 9.3% respectively).
Paracetamol and paracetamol containing compounds were used by 28.6% of self-analgesics purchasers.
About 78.0 % of self-purchasers bought paracetamol and paracetamol containing compounds analgesics without prescription.
Above two-thirds of paracetamol users (66.2%) used paracetamol and paracetamol containing compounds on demand. Almost 63.4% of paracetamol users, used 500 mg paracetamol per day, followed by 18.3% who used 1000 mg per day.
About 86.0% of the users did not face any side effects, but 7.0% of them have reported stomach burn, and 4.2% reported nausea and vomiting. The most common reason for the intake of paracetamol and paracetamol containing compounds was headache (57.7%)
Diclofenac sodium and potassium, and ibuprofen were the most commonly NSAIDs used (32.3% & 17.3% respectively).
About 56.0% of NSAIDs users purchased the analgesics without a prescription. About 62.0 % of NSAIDs users reported no side effects.
The most common reasons for taking NSAIDs were toothache, arthritis, back pain, and as an anticoagulant (22.6%, 21.4%, 20.8% & 9.8% respectively).
More than one third (36.4%) of users took NSAIDs once per day, while 32.9% used it twice per day. More than half (59.0%) of the NSAIDs users experienced moderate pain.
Knowledge of studied adults regarding analgesics.
Approximately two-thirds (65.8%) of the studied adults mentioned that analgesics could be used without a prescription, while only 20.0% stated that they should be used with a prescription.
About 28.0% of studied adults stated that analgesics should be used after meals.
About 71.0% of the studied adults didn’t know whether analgesics can interact with other medications or not and 16.7% stated that analgesics do not interact with other medications.
More than half (56.5%) of studied adults stated that analgesics didn’t cause side effects,
Thirty-eight percent only of studied adults stated that analgesics have contraindications.
Nearly 41.0% of the studied adults obtained information regarding analgesics from the pharmacist and, only 37.3% consulted their physician.
The adults that had high education had good information about analgesics use compared to illiterate adults.
There was a highly significant association between age and knowledge of studied adults regarding appropriate time of taking analgesics, use of analgesics is harmful to pregnant mother, use of analgesics in specific doses, analgesics have contraindication (P = 0.002, P= 0.0001, P= 0.0006, P= 0.006, respectively).
Those who mentioned taking the drugs with food or after meal are higher among those aged 18-24years (63.7%) compared to those aged 45 – 55% years and those aged 55years and above (84.6% and 29.8% respectively).
The frequency who knows is more among younger age group (44.5%) compared to older age group (22.4%).
Those how gave right answer is more among those aged 18-24 years (77.3%) compared to those aged 55 and above (53.7%).
The frequency of those who gave right answer decreases with age (43.6% among 18-24 age group versus 20.9% among 55 and above age group).
There was a highly significant association between gender and the knowledge that analgesics have side effect, interact with other medications and their use fore long time leads to addiction (P=.035, P=.015, P=.005 respectively).
The majority of males mentioned that analgesics do not have side effects (57.0%) compared to 46.4% among females.
More males know that analgesics interact with other medications (13.0% among males versus 9.5% among females)
There was a highly statistically significant association between residence and using prescription to purchase analgesics, and analgesics interact with other medications, used in specified doses, and have contraindications (P=0.0001, P=0.007, P= 0.0001, P=0.006 respectively)
There was a highly significant association between level of education and all aspects of knowledge of studied adults regarding analgesics use.
6.2. Conclusion
- The overall prevalence of analgesics use among Yemeni adults participants in the current study was 61.0% (67.8% of them purchased analgesics for themselves and 32.2% for others), mainly for the treatment of occasional health conditions.
- The middle age group (from 25 to 44) used analgesics in high rate compared to other ages.
- The majority of analgesics users were using them without prescription.
- The most Non-opioid analgesics used was NSAIDs, paracetamol and paracetamol containing compounds.
- Paracetamol and diclofenac were among the most commonly used drugs and they represent alone about 62.0% of all analgesics used.
- This study showed a highly significant association between adult’s knowledge about analgesics and level of education.
- About half of the study participants mentioned that analgesics do not have side effects.
- More than two-thirds (70.8%) of. participants and did not know about analgesics interaction with other medications.
- There was a statistically significant association between knowledge of the studied population regarding analgesics use and age, gender, residence and level education. where it was more evident among younger age groups, male gender, urban residence, and among those with higher level of education.