Benefits and risks of self medication.

School of Pharmacy, The Queen s University of Belfast, Belfast, Northern Ireland.
Drug Safety (Impact Factor: 3.41). 02/2001; 24(14):1027-37. DOI: 10.2165/00002018-200124140-00002
Source: PubMed

ABSTRACT Self medication is becoming an increasingly important area within healthcare. It moves patients towards greater independence in making decisions about management of minor illnesses, thereby promoting empowerment. Self medication also has advantages for healthcare systems as it facilitates better use of clinical skills, increases access to medication and may contribute to reducing prescribed drug costs associated with publicly funded health programmes. However, self medication is associated with risks such as misdiagnosis, use of excessive drug dosage, prolonged duration of use, drug interactions and polypharmacy. The latter may be particularly problematic in the elderly. Monitoring systems, a partnership between patients, physicians and pharmacists and the provision of education and information to all concerned on safe self medication, are proposed strategies for maximising benefit and minimising risk.

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    ABSTRACT: The practice of self-medication is exemplary in raising the question of medicinal uses and risks. In contrast to the biomedical or pharmacological view of self-medication, the anthropological approach looks to understand the logics that underpin it. Therefore, I wished to question how users choose the medicines they take and how they construct the modalities of their use. However, not only are the users conscious of the risks associated with pharmaceutical use, they even devise strategies that specifically aim to reduce these risks. Based on research carried out in France on how people use medicines in the context of self-medication, I examined the strategies they adopt in order to reduce the risks connected with such use. This study relies on qualitative research. It combines interviews with users and anthropological observation, both conducted at the participants' homes, to reveal their uses, their decisions, their hesitations and the precautions they take regarding their medicines. The logics underpinning the management of risks associated with medicinal consumption are varied. Thus we find quantitative and qualitative logics, in virtue of which users choose to limit their medicines depending on the number of different medicines or on their intrinsic qualities. Their choices hinge on a logic of cumulation and a logic of identity, where, in the former, users seek to increase or reduce their medicinal consumption to augment the efficacy of a medicine or, in the latter case, they aim to reduce the risks in relation to their personal characteristics. In the same way, the perception of risk that underpins consumption practices is organised according to the notions of risk in itself and risk for oneself, where risk is either considered to be inherent to the medicine or to be linked to the incompatibility between a given substance and a person's body. Managing risk is thus done in parallel to managing efficacy, where a balance is sought between maximising the latter and minimising the former. This either leads patients to limit the consumption of medicines because of their adverse effects, or, on the contrary, to consume them precisely for these effects. Risk reduction strategies often consist of verifying, experimenting with, and personalising treatments. Although users sometimes resort to practices that do not comply with biomedical recommendations, they do so in order to attain the values and exigencies of biomedicine as regards the validation or personalisation of treatments. However irrational and peculiar these practices may appear, the mechanisms on which they are based do not necessarily break away from medical recommendations. Therefore, anthropologically speaking, we cannot oppose good and bad practices in terms of medicinal uses, since what health professionals would consider to be bad practices are thought by patients to be in keeping with good use.
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