Analysis of the self-medication pattern among Brazilian users
of the public health system
Self-medication is a common practice not only in Brazil but also in other countries. It
consists of "the selection and use of drugs by people to treat self-diagnosed diseases or
symptoms and must be understood as an element of self-care". Included in this
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prescription generic name (or orientation) of drugs by non-qualified people, as friends,
family or the pharmacy clerks, these cases are also called "illegal medical practice". The
present data confirm the importance of the study of self-medication and support the
hypothesis of a naive and excessive belief of our society in the power of drugs, which
contributes to the growing demand for pharmaceutical products for any type of disorder,
as banal and self-limited. Thus, the drug was incorporated into the dynamics of consumer
society and therefore is subject to the same tensions, interests and stiff competition in any
market sector, moving away from its primary aim, the prevention, diagnosis and treatment
of diseases. These results reinforce the need to inform people on the proper use of
medications, as well as appropriate measures to ensure the supply of products needed,
effective, safe and affordable.
PeerJ PrePrints | http://dx.doi.org/10.7287/peerj.preprints.714v1 | CC-BY 4.0 Open Access | rec: 18 Dec 2014, publ: 18 Dec 2014
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Analysis of the self-medication pattern among Brazilian users of the
public health system
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Daniel Corradi Carregal
Luiza Oliveira Prata Silveira
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Faculdade de Medicina de Barbacena, Internship at Hospital da
Baleia,Belo Horizonte, MG - Brazil
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Faculdade de Medicina de Barbacena, Internship Hospital
Ibiapaba/Cebams; Barbacena, MG - Brazil
Correspondind Autor: Daniel Corradi Carregal
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Av. Sete de Setembro 1064/Apto.1401
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Centro, Divinópolis, MG, Brazil
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553788388611
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[email protected]
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Self-medication is a common practice not only in Brazil but also in other
countries. Consists of "the selection and use of drugs by people to treat
self-diagnosed diseases or symptoms and must be understood as an
element of self-care." 1 Included in this prescription generic name (or
orientation) of drugs by non-qualified people, as friends, family or the
pharmacy clerks, these cases are also called "illegal medical practice" 2.
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Particularly in developing countries such as Brazil, the medication is
consider a necessity complement the health system. The first option sought
to solve a health problem, and most drugs consumed by the population are
sold without medical prescription3,5. However, even in the most
industrialized countries, several medications and most common use are
available in pharmacies, supermarkets and drugstores or can be obtained
without the need of medical prescription3. Thus, the World Health
Organization has published guidelines for evaluation of medicines that can
be use in self-medication 1.
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The responsible self-medication can represent savings to the individual
and to the health system, avoiding congestion in the services offered. The
irrational self-medication, moreover, increases the risk of adverse events,
and masking diseases, which can delay the proper diagnosis. Thus, more
complex, invasive, expensive and slower recovery treatments may become
necessary. 6
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Several factors favor the irrational use of drugs, as the practice of
indiscriminate sale of medicines by Brazilian pharmacies to advertise
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prescription medicines in the media, inadequate health care and the high
cost of private health plans and private consultations 3.4,6 . Self-medication
also occurs in the higher social classes and in more developed health
systems7. In our country, where most of the population is poorly educated,
especially about medications and their proper use, self-medication
becomes even more risky. We still lack rigorous controls set by regulatory
agencies, and poor involvement of health professionals with the guidance
of users.5
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Furthermore, the non-fulfillment of the obligation to present a prescription
causes that exist in Brazil about 80 million people who do self-medication,
according to the Brazilian Association of Pharmaceutical Industries.9, 10
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The World Health Organization (WHO) performed a multicenter study of
self-medication in Latin America. Brazilian sites included: Belo
Horizonte, Fortaleza, the city of S. Paulo and outlying locations. The
objective was to characterize self-medication practices by analyzing drugs
sought by consumers in pharmacies without a physician’s prescription.
They analyzed Five thousand, three hundred and thirty-two (5,332)
different drugs, with 785 distinct active ingredients were sought. Of these,
49.5% were fixed dose combinations, 53.0% were of little intrinsic value,
44,1% required a physician’s prescription, 71.0% were not essential drugs,
and 40.0% of requests were based on prior prescriptions from the
physician. The drugs most requested were analgesics (17.3%), nasal
descongestants (7.0%), antirheumatic anti-inflamatory drugs (5.6%), and
systemic anti-infective drugs (5.6%). They concluded that Self-medication
in Brazil reflects the needs and habits of the population. It is strongly
influenced by physician’s-prescribing habits and by the inadequate
selectivity of the Brazilian pharmaceutical market. 11
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Another study called the Bambuí Project analyzed a qualitative approach
to self-medication by doing an anthropological approach based on the
model of signs, meanings, and actions. Twenty-nine inhabitants from the
town of Bambuí, Minas Gerais State, Brazil, were interviewed (17 women
and 12 men), selected among participants in a health survey that had been
on medication in the previous 90 days. The research focused on the
identification of different types of self-medication practiced by the
interviewee or by a relative, and then “ways of thinking and behaving”
associated with this practice were investigated. They concluded that the
influence of pharmacists/drugstore sales attendants as well as family and
friends, perception of the health problem as transitory and a minor issue,
familiarity with and easy access to certain pharmaceuticals, as well as
difficulties in access to (and negative assessment of) health care were
determinant factors for self-medication. 12
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The present data confirm the importance of the study of self-medication
and support the hypothesis of a naive and excessive belief of our society
in the power of drugs, which contributes to the growing demand for
pharmaceutical products for any type of disorder, as banal and self-limited.
Thus, the drug was incorporated into the dynamics of consumer society
and therefore is subject to the same tensions, interests and stiff competition
in any market sector, moving away from its primary aim the prevention,
diagnosis and treatment of enfermidades13. These results reinforce the
need to inform people about the proper use of medications, as well as
appropriate measures to ensure the supply of products needed, effective,
safe and affordable.
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