final thesis
TRANSCRIPT
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CHAPTER I
THE PROBLEM
Background of the Study
Over-the-counter drugs had been utilized by many people nationwide to treat
common illnesses/ailments which is/are not serious enough to seek the help of health care
providers.
In the past, OTC consist only of relatively small number of medication but to dat,
OTC medicines are account for the majority of all medicines used in the US including
many that were once available only by prescription. Such drugs used by Americans
include everything to treat cough, colds and aches.(www.bemedwise.org)
Moreover according to FDA, 1999, Americans buy about five billion over-the-
counter drug products each year to treat their routine health problems.As cited by Roper
Starch,2011, 82 percent of American women and 71 percent of American men have used
a nonprescription medicine in the last six months to treat at least one minor health
problem.
Over four in five U.S. adults who have experienced various illnesses that can be
treated or relieved by non-prescription medications (82%) typically self-medicate for
those conditions. Colds (56%) and coughs (37%) are the most common conditions for
which adults medicate themselves. Adults are less likely to self-medicate for seasonal or
year-round allergies than they are for illnesses such as coughs, colds, heartburn, and
headaches (http://www.bemedwise.org/survey/ExecutiveSummary.pdf).
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On the other hand, according to the consumer poll, a third of Americans say they
take more than the recommended dose of a nonprescription medicine, believing that it
will increase the effectiveness of the product. Of these consumers, two thirds (69 percent)
say they take more than the recommended amount at a single time; three fifths (63
percent) report taking the next dose sooner than directed; and two fifths (44 percent) say
they take more than the recommended number of doses in a day.At the same time, a third
of Americans (36 percent) say they are likely to combine nonprescription medicines
when they have multiple symptoms, like a headache and a sore throat. This practice can
increase the risk that consumers take more than one OTC product at a time that contains
the same active ingredient (http://www.bemedwise.org/survey/summary_survey.pdf).
Cases of drugs abused/misused had been the problem towards OTC drugs all this
years.Abuse of OTC medicines is now so prevalent it is “normalized” among teens.
Nearly one in five teens (19 percent, or 4.5 million) report abusing prescription
medications to get high and one in 10 (10 percent or 2.4 million) report abusing cough
medicine to get high. Far too many teens have a false sense of security about the abuse of
OTC medicines. Two in five teens (40 percent or 9.4 million) agree that medicines, even
if they are not prescribed by a doctor, are much safer to use than illegal drugs. Nearly
one-third of teens (31 percent, or 7.3 million) believe there’s “nothing wrong” with using
medicines without a prescription “once in a while.
(
http://memorials.drugfree.org/Portal/DrugIssue/Features/Key_Findings_on_Teen_Drug_
Abuse).
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In the Philippines, cases of inappropriate use of drugs has been very common
most especially antibiotics. According to Emmanuel Edwin R. Dy, M.D, many people
just take antibiotics with improper administration with respect to drug, dose, interval,
duration this is because people are prisoned to their beliefs or misconceptions and
likewise to their inability to purchase the prescribed medicine due to financial constraints.
Adolescents used of over-the-counter drugs have been uncontrollable. Some just
take medicines without background or enough knowledge about these medications. Some
takes antibiotics without following the needed time to complete the dose, taking
analgesics and even laxatives without knowing enough about its side/adverse effects.
According to Leochico et al (2010), while self-medication is prevalent among
adolescents, they remain to have significant knowledge deficits, which may predispose
them to medication misuse and/or adverse effects.
With these findings, the researchers are the motivated to look into the variables
that affect the perception of adolescents on OTC drugs. It is hoped that the information
generated with this study will help to bridge the gap in knowledge in OTC drugs.
Statement of the Problem
This study aims to determine the relationship between Socio-demographic
characteristics and Perceptions of the Respondents on OTC drugs.
More specifically, this study gears towards the resolution of the following
problems:
1. What are the Socio-demographic characteristics of the Respondents?
A. Demographic Factors
A.1. Sex
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A.2. Monthly Family Income
A.3. Educational Attainment
A.4. Common Illnesses
A.5. Common Drugs used
B. Sociological Factors
B.1 Sources of Information
B.1.1. Peers
B.1.2. Relative
B.1.3. Media
B.1.3.a. TV
B.1.3.b. Radio
B.1.3.c. Newspaper
2. What are the perceptions of the respondents on OTC drugs in terms of:
2.1. Effects2.2. Dosage2.3. Frequency2.4. Reasons
3. What is the relationship between Socio-demographic characteristics and
Perceptions on OTC drugs?
Statement of the Objectives
In general, the study will be conducted to identify the relationship between Socio-
demographic characteristics and Perceptions of the Respondents on OTC .
Specifically it aims:
1. determine the Socio-demographic characteristics of the Respondents as to:
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A. Demographic Factors
A.1. Sex
A.2. Monthly Family Income
A.3. Educational Attainment
A.4. Common Illnesses
A.5. Common Drugs used
B. Sociological Factors
B.1 Sources of InformationB.1.1. Peers
B.1.2. Relative
B.1.3. Media
B.1.3.a. TV
B.1.3.b. Radio
B.1.3.c. Newspaper
2. determine the perceptions of the respondents on OTC drugs in terms of:
2.1. Effects
2.2. Dosage
2.3. Frequency
2.4. Reasons
3. determine the relationship between Socio-demographic characteristics and
Perceptions on OTC drugs.
Significance of the Study
Nowadays, the use of Over-the-Counter drugs is already been increasing and
somehow the rate of drug abuse or misused of drugs is rising. The health professionals
address such problems by giving health education on over-the counter drugs and
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controlling the dispensing of drugs throughout the market. Thus this study will benefit the
following group along the perception of adolescents in OTC drugs.
The results of this study will reveal information on how
Adolescents. These adolescents view their use of OTC drugs. This will help them
understand their perceptions and modify these views and behaviour for safe use of non
prescribed OTC drugs.
Nurses. The result of the study will serve as guide by nurses in planning and
rendering nursing care and health education to adolescents.
Employees of Food and Drug Administration/Bureau of Food and Drugs.This
study will increase their awareness on the alarming situation of misused of OTC drugs
hence the result will be utilized as their basis in coming up with guidance or policies or
laws to control the misuse of OTC drugs.
Researcher. The result of the study will be instrumental in conceptualizing
research study that will include variables that are not part of this study to broaden the
understanding on OTC drugs among adolescent.
Scope and Delimitation of the Study
This study focused on the Socio-demographic characteristics affecting the
perceptions on OTC drugs among Adolescents. It focuses on finding out the perceptions
and the socio-demographic characteristics of the respondents.
The research undertaken was limited to Adolescents aged 16-18 who are not
taking any health related course and who are studying at Mariano Marcos State
University. This research will be conducted on Second Semester School Year 2011-
2012.
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The study used the descriptive-correlational research method. This It utilized
survey method using a questionnaire with guided interview to follow-up answers.
Operational Definition of Terms
For better understanding of the research of the research, the following terms are
defined as used in the study.
Adolescents. Refers to the individuals who will be the respondents of the study
aged 15-18 years of age and except those who are taking health related courses offered at
MMSU.
Over-the-Counter drugs (OTC drugs).Refers to drugs/medicines that can be
acquired in pharmacies, market or store with or without the prescription of a physician
that include antibiotics, cough remedies…,etc.
Perception.Refers to the view or opinion of the adolescents on over-the-counter
drugs.
Socio-demographic.Refers to the characteristics of the Adolescents which
includes:
Gender.Refers to the sexual category as to either a boy or a girl.
Socioeconomic Status.Refers to the financial capability of the adolescents
as categorized by NEDA.
5,999 and below – Very poor
6,000-10,999 – Poor
11,000-15,999 – Average
16,000 and below – Above average
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Family.Refers to the who are with the adolescents in the same house.
Friends/peers.Refers to the constant companion of the adolescents outside
the house.
Media.Refers to the main source of current information/s like television
magazines and newspapers.
Place of Residence. Refers to the location of the house of the adolescents
as to rural or urban.
Rural.Refers to an area outside the city/town proper where the
adolescents reside.
Urban. Refers to an area inside the city/town proper where the
adolescents reside.
Common Illnesses.Refers to ailments or conditions that the adolescents
usually treat with over-the-counter drugs.
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CHAPTER II
THEORETICAL FRAMEWORK
Review of Related Literature
This chapter presents a discussion of review of literature, theoretical framework,
conceptual framework and the research paradigm.
Over-the-counter drugs
As technology advances, drugs where classified as over-the-counter drugs or by
prescription. Prescription drugs are those that needs physicians prescription note while
over-the counter drugs are those drugs which can be bought in the store, market and
pharmacy without any physicians’ prescription (Microsoft ® Encarta ® 2008. © 1993-
2007 Microsoft Corporation. All rights reserved).
Over-the-counter (OTC) drugs are the ones that can be purchase at local
pharmacies without a doctor's prescription. These are drug substance that affects the
function of living cells and are commonly used to relieve pains, aches and itches.
According to Alexis Bergen, over-the-counter (OTC) medications currently
account for more than 100,000 drug products on the market. More than 700 of these
products were still prescription-only drugs 30 years ago.
Over-the-counter self-medicating is prevalent in the United States and other
countries. It's widely accepted to go to a local pharmacy and buy the medication to
alleviate unwanted conditions. The FDA has approved these medications for over the
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counter use with just a number of limitations. According the FDA Office of
Nonprescription Products, "Over-the-counter (OTC) drugs play an increasingly vital role
in America's health care system that have more than 80 therapeutic categories, ranging
from acne drug products to weight control drug products.
Within the last few years, several notable drugs have made the switch from
prescription to OTC status, including Claritin, Pepcid AC and Zantac, giving consumers
immediate access to effective medications. But with increased accessibility also comes an
increased risk for drug interactions and side effects, particularly for individuals who
require long-term use (Overboard on Over-the-counter drugs, Alexis Bergen).
Due to the unrestricted use of over-the-counter (OTC) drugs among the public,
problems involving the use of these drugs have arised like self-medication that often lead
to poisonings, allergy, habituation, addiction, and other adverse reactions due to misused
or decrease knowledge about the drug (Dangers of Self-medication, 2009). In other
words, self-medication had always been accompanying OTC drugs ever since this drug
was released to the public.
Classification of OTC Drugs
More than 80 classes (therapeutic categories) of OTC drugs are available in the
market that range from acne drug products to weight control drug products
(http://fdadrugcompliance.com/resources/otc/). The following are the common classes of
OTC medicines that are available currently in the United States:
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Analgesics are a class of drugs used to relieve pain. The pain relief induced by
analgesics occurs either by blocking pain signals going to the brain or by interfering with
the brain's interpretation of the signals, without producing anesthesia or loss of
consciousness. There are basically two kinds of analgesics: non-narcotics and narcotics.
Acetaminophen is the most commonly used over-the-counter, non-narcotic analgesic.
Acetaminophen is a popular pain-reliever because it is both effective for mild to
moderate pain relief and relatively inexpensive. It must be emphasized though that the
safety of acetaminophen is tied to proper use of the drug (use according to specific
prescribing instructions). If acetaminophen is not used according to the directions on the
label, serious side effects and possible fatal consequences can occur. For example, taking
more than 4000 mg/day or using it long term can increase the risk of liver damage. The
risk of liver damage with acetaminophen use is also increased by ingesting alcohol.
Many people do not realize that acetaminophen is found in more than 600 over-
the-counter drugs. It can be found in combination with other active ingredients in many
cold, sinus, and cough medications. The cumulative effect of acetaminophen must be
considered if you are talking multiple drugs which contain acetaminophen
(http://arthritis.about.com/od/analgesic/a/factsanalgesics.htm).
Analgesics are sometimes referred to as painkiller medications. There are many
different types of analgesic medications available in both prescription and over-the-
counter preparations. Examples of analgesic drugs
include aspirin, acetaminophen (Tylenol), ibuprofen(Motrin, Advil), naproxen (Aleve,
Naprosyn), the COX-2 inhibitor celecoxib, and narcotic drugs including
morphine, oxycodone, and hydrocodone (Vicodin). Analgesics may also be combined
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with other drugs in some types of medications (for example, analgesics are combined
with decongestants and/or antihistamine in many over-the-counter cold remedies)
(http://www.medterms.com).
Antipyretic is a type of medication that will prevent or reduce fever by lowering
body temperature from a raised state. They will not affect normal body temperature if the
patient does not have a fever. Fever, or pyrexia, occurs when the body reaches a
temperature above what is considered "average" (http://www.assistpainrelief.com).
Antipyretic is something that reduces fever or quells it. There are 3 classes of
antipyretic medications that are sold OTC (over-the-counter) without prescription:
Salicylates -- aspirin (acetylsalicylic acid), choline salicylate (Arthropan), magnesium
salicylate (Arthriten), and sodium salicylate (Scot-Tussin Original); Acetaminophen
(Tylenol); and Nonsteroidal anti-inflammatory drugs (NSAIDs) -- ibuprofen (Advil),
naproxen (Naprosyn, Aleve), and ketoprofen (http://www.medterms.com).
Cold and Cough Medicines. This are usually used to treat sneezing, sore throat,
a stuffy nose, coughing and other symptoms for common colds. This medicines include
nasal decongestants - unclog a stuffy nose, cough suppressants - quiet a cough,
expectorants - loosen mucus so you can cough it up, and antihistamines - stop runny
noses and sneezing (http://www.nlm.nih.gov).
Antiallergic products. This treat misguided reaction to foreign substances by
the immune system, the body system of defense against foreign invaders, particularly
pathogens (the agents of infection). The most common allergic conditions that usually
address by using anti allergic product include hay fever (allergic rhinitis),asthma, allergic
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eyes (allergic conjunctivitis), allergic eczema, hives(urticaria), and allergic shock (also
called anaphylaxis and anaphylactic shock).
Sleeping pill. A prescription sedative taken for insomnia. This is usually taken to
induce sleep. An over-the-counter pill classified pharmaceutically as an aid to sleeping.
Commonly used sleeping pills, or "hypnotics", such as temazepam and zolpidem, which
is prescribed for short-term insomnia, are associated with more than a fourfold risk of
death, according to the study published in the BMJ Open journal
(http://www.guardian.co.uk),
Gastrointestinal Products. Drugs that are used to intra-abdominal ailments like
for ulcer, constipation and diarrhea. Laxatives can help relieve and prevent constipation.
But not all laxatives are safe for long-term use. Overuse of certain laxatives can lead to
dependency and decreased bowel function. Sometimes it can cause cramping, gas,
bloating, nausea or diarrhea (http://familydoctor.org).
Antidiarrheal medicines include loperamide (1 brand name: Imodium) and
bismuth subsalicylate (2 brand names: Kaopectate, Pepto-Bismol). Bismuth subsalicylate
can also be used for upset stomach and as an antiemetic (a medicine that treats nausea
and vomiting).
Loperamide works by slowing down the speed of fluids moving through your
intestines (bowels). Bismuth subsalicylate works by balancing the way fluid moves
through your intestines. It also reduces inflammation and keeps certain bacteria and
viruses that cause diarrhea from growing in the stomach and intestines
(http://familydoctor.org).
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Antiulcer drugs are a class of drugs, exclusive of the antibacterial agents, used to
treat ulcers in the stomach and the upper part of the small intestine. Recurrent gastric and
duodenal ulcers are caused by Helicobacter pylori infections, and are treated with
combination treatments that incorporate antibiotic therapy with gastric acid suppression.
Additionally, bismuth compounds have been used. The primary class of drugs used for
gastric acid suppression are the proton pump inhibitors and omeprazole
(http://www.enotes.com) .
Dermatological Products. This are used to treat skin complications or
abnormalities like pimples, acne, rashes, and roughness of the skin. One of which is Acne
treatments which work by reducing oil production, speeding up skin cell turnover,
fighting bacterial infection, reducing the inflammation or doing all four. With most
prescription acne treatments, results cannot be seen for four to eight weeks, and skin may
get worse before it gets better (http://www.mayoclinic.com).
Weight Loss Aids. Used to treat obesity should be used as an option for the
following individuals: People with a body mass index (BMI) of 30 and above with no
obesity-related conditions. A person with a BMI of 27 and above with obesity-related
conditions, such as diabetes or high blood pressure
(http://www.webmd.com/diet/guide/weight-loss-prescription-weight-loss-medicine).
Most available weight loss drugs approved by the FDA are for short-term use, meaning a
few weeks or months.
One type of weight-loss medication is "appetite suppressants." These drugs
generally come in the form of tablets or extended-release capsules (pills that release
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medication over a long period of time). Appetite suppressants can be obtained by a
doctor's prescription or purchased over the counter. One common prescription appetite
suppressant is phentermine. Another type of prescription weight loss drug is a fat
absorption inhibitor. Xenical is the only example of this type of treatment approved for
use in the U.S. Xenical works by blocking about 30% of dietary fat from being absorbed.
Xenical is now sold over-the-counter as Alli. Xenical is the only weight loss drug
approved for longer-term use in significantly obese people, although the safety and
effectiveness have not been established for use beyond two years. Newer drugs are being
studied as potential treatments for obesity, some of which are showing promise and may
be available in the near future (http://www.webmd.com).
Antibiotics. Also known as antibacterials, and they are drugs used to treat
infections caused by bacteria. Bacteria are tiny organisms that can sometimes cause
illness to humans and animals. The singular word for bacteria is bacterium
(http://www.medicalnewstoday.com).
Antibiotics are widely used in the prevention and treatment of infectious diseases
(http://www.answers.com). Antibiotics, first used in the 1940s, are certainly one of the
great advances in medicine. But overprescribing them has resulted in the development of
resistant bacteria, which are bacteria that don't respond to antibiotics that may have
worked in the past. Plus, whenever kids take antibiotics they run the risk of side-effects,
such as stomach upset and diarrhea or even a possible allergic reaction
(http://kidshealth.org). The antibiotics that are commonly used are Amoxicillin,
Clindamycin,Cefalexin, Penicillin and Streptomycin (http://en.wikipedia.org).
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The availability of new and more effective drugs, such as antibiotics, which fight
bacterial infections, and vaccines, which prevent diseases caused by bacteria and viruses,
helped increase the average American’s life span from about 60 years in 1900 to about 78
years in 2005. Drugs have vastly improved the quality of life (Microsoft ® Encarta ®
2008. © 1993-2007 Microsoft Corporation. All rights reserved).
Consumer perspectives
OTC medicines are generally priced much lower than prescription products. An
analysis published in 2005 reported that the average retail price of an OTC medicine in
America was $7, whereas the average price of a name-brand prescription medicine was
$96, and the price of a generic prescription medicine was $28 USD. At the time of their
introduction to the OTC market, Alli (orlistat), Zantac (ranitidine), and Miralax
(polyethylene glycol), were all priced between 50% and 90% lower than the original
branded prescription medicines. Similarly, the cost of a 30-day supply of Claritin
(loratadine) was $96 when the drug was available by prescription and $22 following the
switch to OTC availability. Due to the economic advantage of OTC medicines,
physicians are likely to recommend the use of an OTC medicine as a substitute for an
prescription medicine to assist patients who are burdened with out-of-pocket prescription
costs. By using OTC medications, consumers not only save on drug costs, they also save
the out-of-pocket costs for doctor visits (including insured consumer’s copayments) and
transportation, as well as the cost of time spent traveling and waiting at the doctor’s
office. Using the U.S. June 2010 average hourly wage rate of $22.53, the 2 to 4 hours that
a patient saves from avoiding a doctor’s visit would result in an average savings of $45 to
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$90. According to Temin there are three factors used to assess the economic implications
of the OTC availability of topical hydrocortisone: price of the drug, cost of the doctor
visit to get the prescription, and value of the time used to go to the doctor. He estimated
that consumers saved more than $200 million the first year after topical hydrocortisone
was switched from prescription (Rx) to OTC status and more than $400 million the
second year after the switch. In a study concerning the switch of heartburn medications
from Rx to OTC status, Mansfield et al. found that consumers saved approximately $160
in out-of-pocket drug costs and $14 in physician visit costs annually
(www.pharmacytoday.org).
In the Philippines, according to Dr. Robles, people tend to use over-the counter
drugs because of the advice coming from their relatives, friends and neighbours. The
basis of utilization of drug/s is based on the effectiveness experienced after using these
drugs to treat common illnesses. On the other hand, according to Dr. Dy, the use of over-
the-counter drugs most especially antibiotics is influence by financial constraints.
According to him, due to financial instability, drugs are inappropriately. The right dose,
interval and duration of intake of the drugs are not accurately followed causing the
development of drug resistance.
Reasons of using OTC Drugs
Self-medication has always been a part of normal living. One who suffers from any
minor disease like flu, fever or headache goes to a medical store, purchases his required
medicine and takes it (Self-medication a Dangerous Practice,Zameeruddin Shakeel, Pindi
Bhattian).
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It is a common practice among our people to use a medicine when experiencing
discomfort such as headache, runny nose, cough, fatigue and stomach ache. The fact that
these symptoms seem to disturb people from time to time makes it easier for them to
decide what to buy from a nearby drug outlet. Self-medication, as a practice, is defined
by International Pharmaceutical Federation (FIP) and the World Self-Medication Industry
(1999) as, “the use of nonprescription medicines by people on their own initiatives”. It is
expected that individuals may resort to self-medication (The Dangers of Self-Medication,
Yolanda R. Robles, PhD).
According to Dangers of Self-medication (2009), a large number of people, when
they fall sick, do not consult the physician. They either consult a chemist and obtain a
medicine from his shelf, or may consult a neighbour who may be having some tablets left
over from his previous illness, and readily spares them. May be most of the times nothing
untoward happens on following such advice, but it can be dangerous.
“OTC medications save the consumer time and money because they don’t have to
go to the doctor every time they are sick. “But, it is important to understand that non-
prescription drugs should be used with the same amount of caution as prescription
drugs,” says Kathy Johnson, Pharm.D., Ph.D., associate professor of clinical pharmacy
and pharmaceutical economics and policy at the USC School of Pharmacy (Overboard on
Over-the-counter drugs, Alexis Bergen).
Today self-medication is already common to everybody in both developed and
developing countries. This may be due to different factors like individual’s satisfaction
with the healthcare provider (which is the cause of a major reason in developing
countries). Other includes interactions between prescribed drugs and the drugs taken for
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self-medication, educational level, socioeconomic factors, age and gender, distance from
the health care facilities/services. And based on some studies, the greater prevalence of
self-medication among the younger generation could be due to the better educational
level.
Obtaining OTC medication is much cheaper and easier than seeing a doctor and
going through the process of obtaining a prescription drug. As a result, there is a high
potential for inappropriate used and side effects, especially if people are unaware of the
risks.
In US, adults who self-medicate do so primarily because they are familiar with how
to treat their illness due to past experience (90%). In addition, nearly four of five say they
self-medicate because it saves them a trip to the doctor’s office (78%), their illness isn’t
serious enough to warrant a doctor’s visit (78%), non-prescription medication are just as
effective as prescription drugs (63%) and it saves time (77%) (Self-medication and
Allergies Survey-executive Summary. US Adults’ experiences with Self-Medicating).
Due to its cheap cost, OTC drugs are commonly used by the public to treat common
illnesses like the ones mentioned a while ago, and this include proprietary drugs which
are sold over-the-counter include pain relievers, cough remedies, anti-allergics, laxatives,
vitamins, tonics, antacids and many others. (Dangers of Self-medication, 2009).
Common ailments treated with OTC Drugs
According to Self-medication and Allergies Survey-executive Summary. US
Adults’ experiences with Self-Medicating, the common illness that the American
experience and commonly treated with OTC drugs are chest congestion (38%), coughing
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(36%), nasal congestion (35%), sinus headache (31%). Adults are less likely to self-
medicate for seasonal or year-round allergies than they are for illnesses such as coughs
and colds, heartburn and headache.
In India, the most common ailments for which self-medication are resort are
headaches, colds, fevers, digestive problems – diarrhea, constipation or acidity (© 2011
Window2India.com).
Self-medicating not only can be for all the wrong reasons, but it may have started
innocently as a way to alleviate an unwanted condition such as sleeplessness, pain,
anxiety, allergies, etc. Without proper professional guidance (and sometimes even with
it), abuse can ensue creating an even bigger problem for the user. Some people go to
great lengths to self-medicate starting with mild remedies and graduate to stronger and
sometimes even illegal substances (Self Medicating - Drug Rehabilitation - Help for
those who self medicate - Drug rehabs©2010 SelfMedicating.info. All Rights Reserved).
The common ailments that the public commonly treated with OTC drugs are
fever, headache, cough and colds, digestive problems, muscle ache and pains. And
paracetamol, analgesics (NSAID’s) and antimicrobials are the most commonly used class
of drugs. Herbs were also used for self-medication (Journal of Public Health
Medicine.Vol). 18,No. 4,pp. 437-442).
Misused of OTC Drugs
Common over-the-counter drugs that among college students includes laxatives,
pain reliever, cold remedies and antacids. According to the Journal of American College
Health (Vol. 56, No. 5), about 75% of students reported self-administering OTC pain
medication when they experienced pain symptoms including headache, ear and throat
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pain, stomach pain, menstrual pain, and musculoskeletal pain. And the most common
medication used is acetaminophen. In addition, the used of sleeping aids like OTC night
time cold medications were noted since 80% of 278 students had difficulty falling asleep
for 1-4 per month.
In recent years there has been an increasing trend in self-medication with non-
prescription drugs [sometimes referred to as over-the-counter (OTC) medicines] available
in pharmacies and in retail outlets. According Waszaifya et al (2004), more than half of
their respondents take OTC drugs on regular basis, though females has higher frequency
in taking than OTC drugs males. They said that what mostly influences them is the
pharmacist’ recommendation and that majority of them claimed that they read the
package insert of the drug that they usually buy in the pharmacy or market though some
reported of not reading the package insert before using the drugs because they claimed
that they already read this from previous occasion.
On the other hand, some even reported encountering cases of inappropriate OTC
drug use that they had classified as abuse. Some participants reported cases of mixing
OTC products with alcohol. Wills (1997) described the use of soluble aspirin tablets
along with fizzy cola drinks or beer in order to produce a ‘high’, despite the lack of
pharmacological evidence. The use of laxatives to lose weight especially by young
women with eating disorders has been often cited (Waszaifya et al 2004).
On the other hand, in the Philippines setting, there are lots of cases wherein
misused of OTC drugs is very evident most especially antibiotics. According to Dr.
Emmanuel Dy (Inappropriate antibiotic use in the Philippines), Filipinos are fond of
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taking medications without proper administration with respect to drug, dose, interval,
duration. Like what mostly observe in the community, some would just take antibiotic
just for one day not knowing that this may lead to the development of resistance to
specific bacteria causing now the decrease effectiveness of the drug to some strains of
bacteria.
Furthermore, there are self-medication can be harmful to people with the wrong
choice of drugs. According to a local survey, many people ask advice on medicines from
their relatives, friends and neighbours. The latter judge effectiveness of drugs from their
own experience then uses it as a basis for giving advice. The problem with that practice
is, while there is commonality in symptoms of diseases, the extent and nature of a disease
may not be the same. Thus, rather than helping solve the problem, the chosen drug may
contribute to the problem or aggravate the condition. Let us take asthma, for example. It
is characterized by wheezing, cough and difficulty of breathing. For cough, a friend may
recommend an antitussive (anti-cough). When such drug is given, the sick person may
find it more difficult to breathe due to accumulated pleghm. A bronchodilator and an
expectorant could have been used instead. Second is the problem of contra-indications.
What is good for Juan may not be good for Juana because the latter is allergic or
hypersensitive to the medicine of Juan even when they have the same condition. Also, the
cause of the medical condition may be different. In hypertension, for example, a doctor
may give a patient a beta-blocker but to another he will prescribe a diuretic. Because the
nature of hypertension in these two patients is not the same and will require different
drug treatment. Third, the problem of adverse drug interactions. Even OTC medications
are not harmless if used improperly. They are notorious for producing undesirable effects
23
like reduced effectiveness, reduced absorption of another drug and also of increasing the
possibility of toxicity from another drug. This problem is common among people who
use many drugs for various ailments. It is not safe to add a drug to a therapeutic regimen
without the knowledge of the prescriber. This problem is also encountered with herbal
supplements which can be bought from groceries and health shops. They were implicated
in many adverse drug interactions with prescription and non-prescription medications.
Again, their concomitant use with maintenance drugs must be communicated with
prescribers (Robles 2006).
All of these problems carry a cost, not just in terms of pesos but also in terms of
health and well-being of a person. While self-medication is more economical, wrong self-
medication may be even more costly and dangerous. It is a virtue to seek advice from
well-informed health professionals who have access to scientific information before they
give advice to laymen on the use of OTC medications (Robles 2006).
Factors that Affects the Utilization of OTC Drugs
The following are the factors that affect the utilization of OTC Drugs among
Adolescents:
Age. According to Erik Erickson, development mostly depends upon what is
done to us. From here on out, development depends primarily upon what we do. And
while adolescence is a stage at which we are neither a child nor an adult, life is definitely
getting more complex as we attempt to find our own identity, struggle with social
interactions, and grapple with moral issues. Our task is to discover who we are as
24
individuals separate from our family of origin and as members of a wider society.
Unfortunately for those around us, in this process many of us go into a period of
withdrawing from responsibilities, which Erikson called a "moratorium." And if we are
unsuccessful in navigating this stage, we will experience role confusion and upheaval. A
significant task for us is to establish a philosophy of life and in this process we tend to
think in terms of ideals, which are conflict free, rather than reality, which is not. The
problem is that we don't have much experience and find it easy to substitute ideals for
experience. However, we can also develop strong devotion to friends and causes. It is no
surprise that our most significant relationships are with peer groups
(http://www.learningplaceonline.com).
Monthly Family Income. This involves certain factors which influence
utilization of OTC Drugs. Underlying the process of utilization of over-the-counter drugs,
it may constitute a crucial situation to Adolescents. Most adolescents submit to self-
utilization/medication as needed. This means that when the family income is increased,
the frequency of consultation to health facilities or duration of medical visit, before an
individual is prompted to utilize OTC drugs, increases. It was also noted that Over-the-
counter drug utilization is determined in a significant manner by the financial status of
the family (Oano, 2004).
Educational Attainment. The higher the educational background of on
individual, the higher the knowledge with regards to a certain thing. Like in the
utilization of OTC drugs, the more the individual expose to higher education, the
higher/advance he/she is in understanding the uses, effects and complications brought
25
about by drug used. Several studies also shows that many are ill informed on the use and
side effects of drugs like pain medications. And that more education is still needed
(http://www.ncbi.nlm.nih.gov).
Peers. A recent study suggests that adolescents with a large network of
friendships on such social cause them to be more apt to drink alcohol. Parents don’t deny
the influence their children’s’ peers have on them, but they do wonder just how far their
influence stretches. A recent article also suggests that there are other factors that increase
the risk of alcohol onset among teens such as age, race, team sports and their position in
the social network arena. The study further found that being in close proximity to the
most popular peers was a definite factor in the onset of drinking. The study showed that
the density of the networks magnified the spread of influence among the adolescents and
also amplified the dynamics. The findings also suggest that limiting the size of these
social peer groupings may have a positive influence on delaying the onset of alcohol
usage. If adolescents are easily influence by their peers in drinking alcohol, how much
more in just taking OTC drugs (http://www.addictiontreatmentmagazine.com).
Relatives. Family and peer relationships are important for adolescent drug use
because both are primary groups where attitudes and behaviors are learned. According to
social learning theory, an individual learns to take drugs in small, informal groups (Akers
& Sellers, 2004; Bahr, Maughan, Marcos, & Li, 1998; Petraitis, Flay, & Miller, 1995). It
is in these intimate settings that people are taught, through imitation and reinforcement,
to hold attitudes that are favorable or unfavorable to drug use (Reed & Rountree, 1997).
Within families where alcohol is used, adolescents may observe alcohol use, acquire
26
favorable attitudes toward alcohol use, and begin using alcohol themselves (Wills,
Mariani, & Filer, 1996). Similarly, if their friends drink alcohol, adolescents are likely to
receive positive social reinforcement from their friends for drinking (Petraitis, Flay, &
Miller, 1995). Many social learning theorists focus on peers because of the significance
adolescents place on friends as adolescents mature and gain autonomy from their parents.
However, families also appear to be important for learning attitudes and behaviors about
alcohol and other drug (Bahr et al 2005).
Media. The large proportion of OTC advertising does have serious effects in that
there is a possibility these ads can help further a trend for today’s youth to find a pill for
any type of pain that they might have possibly inducing an overmedicated population
which can have serious long-term health effects (http://www.utexas.edu/nursing/).
Theoretical Framework
Imogene King defined perception as an individual’s representation or image of
reality, each one view of what is going on in the world. What we see and perceive is
influenced by what we know, what we look for and what is familiar to us. Perception is a
process in which data is obtained through the senses and from memory are organized,
interpreted and transformed.
King’s Conceptual System or the Open System Model includes goal, structure,
function, resources and decision making. The Conceptual System has health as a goal in
nursing. Structure is represented by the three open systems. Functions are demonstrated
in reciprocal relations of individuals in interactions and transactions. Resources include
27
both people (health professionals and their clients) and money, goods, and services for
items needed to carry out specific activities. Decision making occurs when choices are
made resource allocation to support attaining system goals.
King’s presents assumptions that human being are open systems in constant
interactions with the environment.
The Conceptual System is composed of three interacting systems: the personal
systems, the interpersonal systems and the social systems.
Personal systems. Represents an individual/person who values their perceptions,
self, growth and development, body image, time and space.
Interpersonal systems. Represents interaction of the individual to others. It
includes communicating, transaction, role and stress.
Social systems. Represents group interaction with one another. It is always an
important role in goal attainment which includes organization, authority, power status
and decision making.
The used of over-the counter drugs will be dependent on the interaction of the
person/individual. He uses OTC drugs if he recognizes it as beneficial to his health or
may be due to his transaction, interaction and communication within his environment
which includes his family, friends, health care provider and the society.
The Open System Model is being used because human being is categorized as an
open system because its perception, belief and understanding changes upon experience
28
and the environment. It is used as the framework of the study because it states that a lot
of factors always affect the person’s perceptions and behaviour. With this, the Open
System Model will be employ to determine if the environment, together with the
experiences and the different factors that will be identified affects the perception of the
adolescents on utilization of over-the-counter drugs.
Conceptual Framework
Figure 1 shows the research paradigm of the study which indicates that socio-
demographic profile of the respondents which are considered as factors that could affect
the perception of adolescents on over-the-counter drugs.
The research paradigm of this study consists of 2 boxes. The first box encloses the
socio-demographic profile of the respondents as to sex, monthly family income,
educational attainment, and sources of information which includes peers, relatives and
media. This profile represents the independent variable. The second box encloses the
perception of the respondents on OTC drugs as to effects, dosage, frequency and
reason/s. This box represents the dependent variable.
The arrow between the first and second box indicates the possible relationship
between the 2 variables: the socio-demographic profile and the perception of the
respondents on OTC drugs. The origin of the arrow represents the independent variable
while the point of the arrow represents the dependent variable.
29
Research Hypothesis
This section will try to determine the possible outcome of this study with regards
to the relationship between the independent (socio-demographic profile) and dependent
variables (perceptions on OTC drugs).
In relation to this research study, the following hypothesis will be proposed:
1. There is a relationship between the socio-demographic profile and the
perceptions on OTC drugs among the respondents.
30
CHAPTER III
METHODOLOGY
This chapter presents the methods that will be utilized by the researcher. This
includes the research design, locale of the study, samples and sampling procedures,
instrument/tool, data gathering procedure, and statistical treatment of data.
Research Design
The study will employ a descriptive-correlational design.
Descriptive will be used to determine the profile of the respondents as to sex,
monthly family income, educational attainment, and sources of information. It also tries
to determine the common illnesses experience by the respondents and the common drugs
they used to treat these illnesses. It is likewise correlational because it will work into the
relationship of the independent and dependent variables. The independent variable is
considered to be the socio-demographic profile/characteristics of adolescents while the
dependent is the adolescent’s perception on over-the-counter (OTC) drugs.
Locale of the Study
This study will be conducted at Mariano Marcos State University, Batac Campus,
except the College of Health Sciences. Mariano Marcos State University is the largest
tertiary school in the province. It is a state-funded institution of higher learning that
serves the Ilocos region and its surrounding regions. It is covers a vast of land of
31
approximately 300 hectares (though the land is separated). It is has different campuses,
mainly located at Batac, Laoag, Paoay, Currimao and Dingras. It has approximately has
18,000 officially enrolled students and about 10,000 students are studying at Batac
campus. The university has 9 colleges and under these colleges several courses are being
offered. At Batac campus, there are 5 colleges that offer different courses. At College of
Health Sciences in offers BS in Pharmacy, BS in Nursing, BS in Physical Therapy;
College of Business and Accountancy the following courses are being offered - BS in
Accountancy, BS in Economics, BS in Business Administration (Management
Accounting, Marketing Management, Human Resources Development Management), BS
in Tourism Management, BS in Cooperative Management, BS in Entrepreneurship, BS in
Hospitality Management. The College of Agriculture, Food and Sustainable
Development - BS in Agriculture, BS in Forestry, BS in Development Communication,
BS in Home Technology, BS in Agricultural Technology, Bachelor of Agricultural
Technology, Diploma of Agricultural Technology, Forest Ranger, Technical
Homemaking, Associate in Home Technology, Associate in Technical Homemaking.
College of Arts and Sciences offers the following - BS in Mathematics, BS in Computer
Science, BS in Biology, BS in Environmental Science, AB in Sociology, AB in English
Studies, BS in Chemistry. College of Engineering- BS in Agricultural Engineering, BS in
Ceramic Engineering, BS in Chemical Engineering, BS in Civil Engineering, BS in
Computer Engineering, BS in Electrical Engineering, BS in Electronics Engineering, BS
in Mechanical Engineering; College of Law that offers only Bachelor of Law. Outside
Batac Campus includes College of Industrial Technology that offers the following
courses- BS in Industrial Education, BS in Industrial Technology (ladderized), BS of
32
Automotive Technology; College of Teacher Education - Bachelor in Secondary
Education, Bachelor in Elementary Education, Short-Term Programs; and College
Aquatic Science and Applied Technology- BS in Marine Biology and BS in Fisheries.
Samples and Sampling Procedures
The target population of the study includes adolescents aged 15-18 and are
currently studying at Mariano Marcos State University, Batac Campus.
Data will be gathered through a tool where list of names of students will be taken.
Multi-Stage Sampling will be used wherein the researchers use two sampling
method. First, the Cluster Sampling, wherein the researchers will divide the population of
MMSU, Batac Campus per course to group the samples and then used the Systematic
Sampling Method to select the elements to be included in the sample. In this case, the
researchers list all the different courses at MMSU, Batac Campus and get the samples by
using an interval in between the list of subjects (courses). The interval is determined by
getting the quotient of the total population over the 20% of the total population (k=N/n,
wherein k is the interval, N is the total population and n is the sample that will represent
the total population, it is the 20% of the N).
The Instrument or Tool
The research instrument that will be used in gathering data is a Survey-
Questionnaire. This research questionnaire will be submitted to the research adviser for
improvement and approval and upon this, questionnaires will be revised. It has 3 parts:
Part 1 of the questionnaire deals about the socio-demographic profile of the respondents.
33
Part 2 determines the common illnesses experience and the common drugs used by the
respondents. Part 3 will determine the respondents’ perception on OTC drugs as to its
effect, dosage, frequency and the reason of taking these drugs.
Data Gathering Procedures
Before the distribution of the survey-questionnaires, a letter will be presented to
the dean to obtain a permission to conduct the study. After which, a letter will be
forwarded to the dean of different colleges, where the samples are located, to have their
approval to conduct the study to their college. After obtaining an approval from the
different deans of the colleges where the study will be conducted, the researchers will
distribute the survey-questionnaire to the respondents with guided instructions. After
which, the data will be collected, arranged and interpreted according to the appropriate
statistical treatment.
Statistical Treatment
The data that will be gathered on the profile of the respondents will be tabulated
and will be analyzed using a distribution and percentage.
Frequency counts and percentage will be used to present the profile of the
respondents.
The mean will be used to describe the perceptions of the respondents on OTC
drugs.
Pearsons r – to determine the degree and test the relationship between the
respondent’s profile and to the perceptions on OTC drugs.
34
Point Biserial correlation will also be used to determine and test the relationship
of the respondents’ socio-demographic data/profile and their perceptions on OTC drugs.
35
QUESTIONNAIRE
SOCIODEMOGRAPHIC FACTORS AFFECTING THE PERCEPTION
OF OTC DRUGS OF ADOLESCENTS
General Direction: Please provide the necessary answers to the questions.
I. Personal Profile
Name (Optional) : __________________________________________________
Address : _________________________________________________________
Age : _____ 15 _____ 17
_____ 16 _____ 18
Sex : _____ Male _____ Female
Year Level : _____ 1st _____ 3rd
_____ 2nd _____ 4th
Course : ____________________________
Family Income (Monthly) : __________ below 1000
__________ 1001-3000
__________ 3001-5000
__________ 5001-10000
__________ Others (please specify)
Sources of Information Regarding OTC Drugs: _____ peers
_____ relatives
_____ media
_____ Others (please specify)
II. You are allowed to answer the following questions freely in a relatively
unrestricted manner.
36
1. Put a check on the space provided before each of the following common illnesses
which you had experienced.
_____ fever _____ cough _____ others (please specify)
_____ headache _____ constipation
_____ flu _____ wounds
_____ dizziness _____ toothache
_____ diarrhea _____ stomach ache
2. Put a check on the space provided before each of the following over-the-counter
drugs which you usually use in treating common illnesses as indicated below:
Fever Cough
_____ Paracetamol (Biogesic) _____ Guiafenesin
(Robitussin)
_____ Ibuprofen (Alaxan) _____ Carbocisteine
(Solmux)
_____ Aspirin (Tylenol) _____ Lagundi (Ascof)
_____ Others (please specify) _____ Others (please specify)
Flu Headache
_____ Paracetamol (Biogesic) _____ Aspirin (Tylenol)
_____ Ibuprofen (Alaxan) _____ Mefenamic acid
(Dolfenal)
_____ Aspirin (Tylenol) _____ Ibufropen (Advil)
_____ Others (please specify) _____ Others (please specify)
Stomach ache Dizziness
_____ Aspirin (Tylenol) _____ Diphenhydramine (
_____ Ibufropen (Advil) _____ Meclozine (Bonamine)
_____ Mefenamic acid (Dolfenal)
37
_____ Others (please specify) _____ Others (please specify)
Diarrhea Constipation
_____ Diphenoxylate/Atropine (Lomotil) _____ Diphenylmethane
(Bisacodyl)
_____ Loperamide (Diatabs) _____ Others (please specify)
_____ Others (please specify)
Wounds Toothache
_____ Amoxicillin _____ Aspirin (Tylenol)
_____ Clindamycin _____ Mefenamic acid
(Dolfenal)
_____ Others (please specify) _____ Ibufropen (Advil)
_____ Others (please specify)
3.a. Direction: Please answer the following questions by putting on check mark to the
response that is true to you.
A. OTC drugs used for Fever
1. Effect of the drug:
___ this drug decreases my temperature
___this drug relieves pain when I have fever
___ this drug will restores my energy quickly
___ others (please specify)___________________________________
2. Dosage: _____250 mg ________750 mg
______500mg _______others(Please Specify)
3. Frequency per day: _______once ________twice
________thrice _________ Others( please specify)
B. OTC Drugs used for headache
38
1. Effect of the drug:
___ this drug relieve my headache
___ this drug relieves the pain that I felt and help me resume my
activities immediately
___ this drug relieve dizziness when I have headache
___ others (please specify)___________________________________
2. Dosage: _____250 mg ________750 mg
______500mg _______others(Please Specify)
3. Frequency per day: _______once ________twice
________thrice _________ Others( please specify)
C. OTC Drugs used for Flu
1. Effect of the drug:
___ this drug relieves body pain
___ this drug relieves all of my symptoms
___ this drug lowers down my elevated temperature
___ others (please specify)___________________________________
2. Dosage: _____250 mg ________750 mg
______500mg _______others(Please Specify)
3. Frequency per day: _______once ________twice
________thrice _________ Others( please specify)
D. OTC Drugs used for Dizziness
1. Effect of the drug:
___ this drug relieves my dizziness
___ this drug prevents nausea and vomiting
___ this drug relieves the pain that I felt when I feel dizzy
39
___ others (please specify)___________________________________
2. Dosage: _____250 mg ________750 mg
______500mg _______others(Please Specify)
3. Frequency per day: _______once ________twice
________thrice _________ Others( please specify)
E. OTC Drugs used for Diarrhea
1. Effect of the drug:
___ this drug hardened my stool
___ this drug decreases peristaltic movement
___ this drug decrease the frequency of defecating
___ others (please specify)___________________________________
2. Dosage: _____250 mg ________750 mg
______500mg _______others(Please Specify)
3. Frequency per day: _______once ________twice
________thrice _________ Others( please specify)
F. OTC Drugs used for Cough
1. Effect of the drug:
___ this drug loosen my phlegm, thus it will easily come out
___ this drug decreases the frequency of coughing
___ this drug relieve the itchiness that I felt on my throat when I have
cough
___ others (please specify)___________________________________
2. Dosage: _____250 mg ________750 mg
______500mg _______others(Please Specify)
3. Frequency per day: _______once ________twice
40
________thrice _________ Others( please specify)
G. OTC Drugs used for Constipation
1. Effect of the drug:
___ this drug softens my stool
___ this drug help me defecate easily
___ this drug helps me attain normal defecation
___ others (please
specify)___________________________________
2. Dosage: _____250 mg ________750 mg
______500mg _______others(Please Specify)
3. Frequency per day: _______once ________twice
________thrice _________ Others( please specify)
H. OTC Drugs used for Wound
1. Effect of the drug:
___ this drug prevent infection
___ this drug promote faster wound healing
___ this drug treat the wound
___ others (please
specify)___________________________________
2. Dosage: _____250 mg ________750 mg
______500mg _______others(Please Specify)
3. Frequency per day: _______once ________twice
________thrice _________ Others( please specify)
I. OTC Drugs used for Toothache
1. Effect of the drug:
___ this drug relieves toothache
41
___ this drug kill the bacteria that causing toothache
___ this drug treats toothache
___ others (please
specify)___________________________________
2. Dosage: _____250 mg ________750 mg
______500mg _______others (Please Specify)
3. Frequency per day: _______once ________twice
________thrice _________ Others( please specify)
J. OTC Drugs used for Stomach ache
1. Effect of the drug:
___ this drug relieves stomach ache
___ this drug treats stomach ache
___ this drug prevent complications
___ others (please specify)___________________________________
2. Dosage: _____250 mg ________750 mg
______500mg _______others(Please Specify)
3. Frequency per day: _______once ________twice
________thrice _________ Others( please specify)
3.b Please put a check to the response that is true for you:
Reasons
Fev
er
Hea
dach
e
Flu
Diz
zine
ss
Dia
rrhe
a
Cou
gh
Con
stip
atio
n
Wou
nd
Too
thac
he
Sto
mac
h ac
he
I take this drug because
my friends told me that
it is effective for them in
curing this illness
42
I take this drug because
my friends told me so
I take this drug because
my friend/s use it
I take this drug because
my mother and my
family members told me
that this drug is effective
in curing this illness
I take this drug because
my mother and my
family told me so
I take this drug because
my because my mother
and my family use it
I take this drug because I
saw in television that it
was effective in curing
this illness
I take this drug because I
heard from the radio that
it was effective in curing
this illness
I take this drug because I
read it from the
newspaper
I take this drug to save
time and effort in going
to the physician
I take this drug because I
believe that it is cheaper
43
than the one that is
prescribed by the
physician
I take this drug because
whenever I experience
this illness, this drug
always effective in
curing my condition
I take this drug because
it brings me happiness.
I take this drug because I
don’t want to miss my
class
I take this drug because
it is not serious that it
need medical
consultation
I take this drug because I
have no confidence on
my doctors
Others(Please
Specify):____________
______________
3.c. Please answer the following by putting a check mark to the response that is true for
you. You can check more than one of the responses:
44
Reasons
Fev
er
Hea
dach
e
Flu
Diz
zine
ss
Dia
rrhe
a
Cou
gh
Con
stip
atio
n
Wou
nd
Too
thac
he
Sto
mac
h ac
he
if I take more
tablets, it will
increase the
effectiveness of the
drug.
If I take the tablet
one after the other,
it will take effect
immediately
I can take any
medication even
without the
prescription of the
physician
I can take two
drugs at the same
time so that my
illness will easily
be cured
I can stop taking
my medications
when the
symptoms had
already
disappeared
There are no side
effects if I take
more tablet than
45
what is needed
I should seek
consultation before
taking any
medications
I should follow the
recommended dose
and frequency to
avoid harmful
effects
I should complete
the specified
duration for taking
the medication to
prevent
complication
Others (please
specify)_________
46