Prevalence and factors associated with self-medication for COVID-19 prevention using disproven drugs in Peru: a cross-sectional nationwide study

Main Article Content

Akram Hernández-Vásquez https://orcid.org/0000-0003-1431-2526
Fabriccio J. Visconti-Lopez https://orcid.org/0000-0002-8056-2112
Dustin M. Solorzano-Salazar https://orcid.org/0000-0003-3993-2473
Antonio Barrenechea-Pulache https://orcid.org/0000-0003-4583-5434

Keywords

COVID-19, Self Medication, Cross-Sectional Studies, Nonprescription Drugs

Abstract

Objective: The objective of this study was to identify the prevalence and factors associated with the use of drugs without evidence for the prevention of COVID-19 in Peruvians without symptoms or diagnosis, using the National Household Survey (ENAHO) 2021. Methods: A secondary analysis was made of the ENAHO 2021. We evaluated participants older than 18 years who did not undergo any test to diagnose COVID-19 and used any drug to prevent COVID-19. Adjusted prevalence ratios (aPRs) were estimated to determine the associated factors. Results: Among the 69,815 participants analyzed, the prevalence of taking a drug 4 weeks prior to the survey was 5.64%. Factors associated with drug consumption were: age 30-59 years (aPR 1.47; 95% confidence interval [CI]: 1.32-1.65); having a higher education (aPR 1.73; 95% CI:1.28-2.33); having a chronic disease (aPR 1.40; 95% CI: 1.26-1.56); not having poverty status (aPR 1.40; 95% CI: 1.26-1.56); living in an urban area (aPR 1.61; 95% CI: 1.31-1.99). Meanwhile, living in the highlands (aPR 0.77; 95% CI: 0.60-0.97) and not having a landline, cell phone, television or internet at home (aPR 0.65; 95% CI: 0.43-0.98) were protective factors from unnecessary drug consumption. Conclusion: It is concerning that even after one year of living with the pandemic and having refuted the utility of medications such as ivermectin and azithromycin, these drugs are still widely consumed by a sector of the population without symptoms or a diagnosis of COVID-19. Therefore, it is necessary to formulate and implement public health measures that address this problem, taking into account the associated factors to reduce this consumption.

Abstract 747 | PDF Downloads 202

References

1. WHO - World Health Organization. Weekly epidemiological update on COVID-19 - 26 October 2022 [Internet]. 2022 [cited 2023 Jan 17]. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---26- october-2022
2. Han E, Tan MMJ, Turk E, et al. Lessons learnt from easing COVID-19 restrictions: an analysis of countries and regions in Asia Pacific and Europe. The Lancet. 2020;396(10261):1525-34.
3. Dyer O. Covid-19: Peru’s official death toll triples to become world’s highest. BMJ. 2021;373:n1442.
4. Johns Hopkins University. Mortality Analyses [Internet]. Johns Hopkins Coronavirus Resource Center. 2022 [cited 2023 Jan 17]. Available from: https://coronavirus.jhu.edu/data/mortality
5. Azlan AA, Hamzah MR, Sern TJ, et al. Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia. PLOS ONE. 2020;15(5):e0233668.
6. Sanz Valero J. Enfermedad por coronavirus: pandemia e infodemia. Hosp Domic. 2022;6(1):5-9.
7. Tasnim S, Hossain MM, Mazumder H. Impact of Rumors and Misinformation on COVID-19 in Social Media. J Prev Med Pub Health. 2020;53(3):171-4.
8. Mehra MR, Ruschitzka F, Patel AN. Retraction—Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. The Lancet. 2020;395(10240):1820.
9. Etienne F. Americas report surge in drug-resistant infections due to misuse of antimicrobials during pandemic - PAHO/WHO | Pan American Health Organization [Internet]. 2021 [cited 2023 Mar 4]. Available from: https://www.paho.org/en/news/17- 11-2021-americas-report-surge-drug-resistant-infections-due-misuse-antimicrobials-during
10. Hernández-Vásquez A, Alarcon-Ruiz CA, Díaz-Seijas D, et al. Purchase of medications without prescription in Peru: a cross- sectional population-based study [Internet]. F1000Research; 2019 [cited 2023 Jan 17]. Available from: https://f1000research. com/articles/7-1392
11. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Natl Inst Health [Internet]. [cited 2023 Apr 3]; Available from: https://www.covid19treatmentguidelines.nih.gov/
12. Zavala-Flores E, Salcedo-Matienzo J, Zavala-Flores E, et al. Medicación prehospitalaria en pacientes hospitalizados por COVID-19 en un hospital público de Lima-Perú. Acta Médica Peru. 2020;37(3):393-5.
13. Barros-Sevillano JS, Sandoval CP, Alcarraz-Mundial LS, et al. Automedicación en tiempos de COVID-19. Una perspectiva desde Perú. Gac Médica México 2021;157(1):122.
.
14. Ballena CL, Cabrejos L, Dávila Y, et al. Impacto del confinamiento por COVID-19 en la calidad de vida y salud mental. Rev Cuerpo Méd Hosp Nac Almanzor Aguinaga Asenjo. 2021;14(1):87-9.
15. Navarrete-Mejía PJ, Velasco-Guerrero JC, Loro-Chero L. Automedicación en época de pandemia: Covid-19. Rev Cuerpo Méd Hosp Nac Almanzor Aguinaga Asenjo. 2020;13(4):350-5.
16. Ayosanmi OS, Alli BY, Akingbule OA, et al. Prevalence and Correlates of Self-Medication Practices for Prevention and Treatment of COVID-19: A Systematic Review. Antibiotics. 2022;11(6):808.
17. Quincho-Lopez A, Benites-Ibarra CA, Hilario-Gomez MM, et al. Self-medication practices to prevent or manage COVID-19: A systematic review. PLOS ONE. 2021;16(11):e0259317.
18. Shrestha AB, Aryal M, Magar JR, et al. The scenario of self-medication practices during the covid-19 pandemic; a systematic review. Ann Med Surg. 2022;82:104482.
19. Fernandez-Guzman D, Soriano-Moreno DR, Ccami-Bernal F, et al. Factors associated with prevention practices against COVID-19 in the Peruvian population: Disparities between rural and urban areas. PLOS ONE. 2022;17(5):e0267625.
20. Quispe-Cañari JF, Fidel-Rosales E, Manrique D, et al. Self-medication practices during the COVID-19 pandemic among the adult population in Peru: A cross-sectional survey. Saudi Pharm J. 2021;29(1):1-11.
21. Mostajo-Radji MA. Pseudoscience in the Times of Crisis: How and Why Chlorine Dioxide Consumption Became Popular in Latin America During the COVID-19 Pandemic. Front Polit Sci [Internet]. 2021 [cited 2023 Mar 4];3. Available from: https://www. frontiersin.org/articles/10.3389/fpos.2021.621370
22. Instituto Nacional de Estadística e Informática. Ficha Técnica “Encuesta Nacional de Hogares 2021” [Internet]. INEI; 2022 [cited 2023 Jan 17]. Available from: http://iinei.inei.gob.pe/iinei/srienaho/Descarga/DocumentosMetodologicos/2021-55/2_ FichaTecnica.pdf
23. Arias F, Izquierdo-Condoy JS, Naranjo-Lara P, et al. A Cross-Sectional Analysis of Self-Medication Patterns during the COVID-19 Pandemic in Ecuador. Medicina (Mex). 2022;58(11):1678.
24. Chaudhry B, Azhar S, Jamshed S, et al. Factors Associated with Self-Medication during the COVID-19 Pandemic: A Cross- Sectional Study in Pakistan. Trop Med Infect Dis. 2022;7(11):330.
25. Ministerio de Salud. Documento Técnico “Manual de Implementación del Modelo de Cuidado Integral de Salud por Curso de Vida para la Persona, Familia y Comunidad (MCI)” [Internet]. MINSA; 2021 [cited 2023 Jan 17]. Available from: http://bvs. minsa.gob.pe/local/fi-admin/rm-220-2021-minsa.pdf.
26. Benites-Meza. Self-Medication in peru during the COVID-19 pandemic: How harmless it could be? [Internet]. 2022 [cited 2023 Jan 17]. Available from: https://www.ijpvmjournal.net/article.asp?issn=2008-7802;year=2022;volume=13;issue=1;spage=62; epage=62;aulast=Benites-Meza
27. Hughes CM, McElnay JC, Fleming GF. Benefits and Risks of Self Medication. Drug Saf. 2001;24(14):1027-37.
28. Molento MB. Ivermectin against COVID-19: The unprecedented consequences in Latin America. One Health. 2021;13:100250.
29. Montastruc JL, Bondon-Guitton E, Abadie D, et al. Pharmacovigilance, risks and adverse effects of self-medication. Therapies. 2016;71(2):257-62.
30. Khoshbakht R, Kabiri M, Neshani A, et al. Assessment of antibiotic resistance changes during the Covid-19 pandemic in northeast of Iran during 2020-2022: an epidemiological study. Antimicrob Resist Infect Control. 2022;11(1):121.
31. Toro-Alzate L, Hofstraat K, de Vries DH. The Pandemic beyond the Pandemic: A Scoping Review on the Social Relationships between COVID-19 and Antimicrobial Resistance. Int J Environ Res Public Health. 2021;18(16):8766.
32. Jansen T, Rademakers J, Waverijn G, et al. The role of health literacy in explaining the association between educational attainment and the use of out-of-hours primary care services in chronically ill people: a survey study. BMC Health Serv Res. 2018;18(1):394.
33. OECD. Paid sick leave to protect income, health and jobs through the COVID-19 crisis [Internet]. 2020 [cited 2023 Mar 4]. Available from: https://read.oecd-ilibrary.org/view/?ref=134_134797-9iq8w1fnju&title=Paid-sick-leave-to-protect-income- health-and-jobs-through-the-COVID-19-crisis
34. Presidencia del Consejo de Ministros - Plataforma del Estado Peruano. Suspensión Perfecta de Labores [Internet]. 2023 [cited 2023 Mar 4]. Available from: https://www.gob.pe/9031-suspension-perfecta-de-labores
35. Parra Huaman R, Silvestre Francisco A. La aplicación de la suspensión perfecta de labores en época de estado de emergencia sanitaria [Internet]. Universidad Cesar Vallejo; [cited 2023 Apr 3]. Available from: https://repositorio.ucv.edu.pe/bitstream/ handle/20.500.12692/56140/Parra_HRJ-Silvestre_FAL-SD.pdf?sequence=1&isAllowed=y
36. INEI. Evolución de la pobreza monetaria 2010-2021 [Internet]. Instituto Nacional de Estadística e Informática; 2022 [cited 2023 Mar 4] p. 5-24. Report No.: 1(69). Available from: https://www.gob.pe/institucion/inei/informes-publicaciones/3878272- evolucion-de-la-pobreza-monetaria-2010-2021
37. Instituto Nacional de Estadística e Informática. Perú: Evolución de los indicadores de empleo e ingresos por departamento, 2007-2017 [Internet]. INEI; 2018 [cited 2023 Jan 17]. Available from: https://www.inei.gob.pe/media/MenuRecursivo/ publicaciones_digitales/Est/Lib1537/cap10.pdf
38. Carrasco-Escobar G, Manrique E, Tello-Lizarraga K, Miranda JJ, et al. Travel Time to Health Facilities as a Marker of Geographical Accessibility Across Heterogeneous Land Coverage in Peru. Front Public Health [Internet]. 2020 [cited 2023 Jan 17];8. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2020.00498
39. Ministerio de Salud. Diagnóstico de brechas de infraestructura y equipamiento del sector salud [Internet]. MINSA; 2021 [cited 2023 Jan 17]. Available from: https://www.minsa.gob.pe/Recursos/OTRANS/08Proyectos/2021/DIAGNOSTICO-DE-BRECHAS. pdf
40. Westgard CM, Rogers A, Bello G, et al. Health service utilization, perspectives, and health-seeking behavior for maternal and child health services in the Amazon of Peru, a mixed-methods study. Int J Equity Health. 2019;18(1):155.
41. Sánchez-Sánchez J, Alarcón-Loayza J, Villa-Castillo L, et al. Availability of essential diagnostics at primary care public clinics in Peru. Microbes Infect. 2021;23(1):104761.
42. Economic Commission for Latin America and the Caribbean. The sociodemographic impacts of the COVID-19 pandemic in Latin America and the Caribbean [Internet]. CEPAL; 2022 [cited 2023 Jan 17]. Available from: https://www.cepal.org/en/ publications/47923-sociodemographic-impacts-covid-19-pandemic-latin-america-and-caribbean
43. Ortiz-Prado E, Fernandez-Naranjo R, Torres-Berru Y, et al. Exceptional Prices of Medical and Other Supplies during the COVID-19 Pandemic in Ecuador. Am J Trop Med Hyg. 2021;105(1):81-7.
44. Rubin R, Abbasi J, Voelker R. Latin America and Its Global Partners Toil to Procure Medical Supplies as COVID-19 Pushes the Region to Its Limit. JAMA. 2020;324(3):217-9.
45. Instituto Nacional de Estadística e Informática. Perú: Crecimiento y distribución de la población total, 2017 [Internet]. INEI; 2018 [cited 2023 Jan 17]. Available from: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/ Lib1673/libro.pdf
46. Instituto Nacional de Estadística e Informática. Perú: Perfil Sociodemográfico, 2017 [Internet]. INEI; 2018 [cited 2023 Jan 17]. Available from: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1539/cap01.pdf
47. Rojas-Adrianzén C, Pereyra-Elías R, Mayta-Tristán P. Prevalencia y factores asociados a la compra de antimicrobianos sin receta médica, Perú 2016. Rev Peru Med Exp Salud Pública. 2018 Sep 11;400-8.
48. Instituto Nacional de Estadística e Informática. Estadísticas de las Tecnologías de Información y Comunicación en los Hogares [Internet]. INEI; 2022 [cited 2023 Jan 17]. Available from: https://cdn.www.gob.pe/uploads/document/file/3706137/Las%20 Tecnolog%C3%ADas%20de%20Informaci%C3%B3n%20y%20Comunicaci%C3%B3n%20en%20los%20Hogares%3A%20Abr- May-Jun%202022.pdf?v=1664405809
49. León Montoya GB, Acosta Román M, Saavedra Chinchayán ME, Almonacid Quispe S. Medicina tradicional como tratamiento de la COVID-19 en estudiantes y familiares en una universidad de la sierra del Perú. Aten Primaria. 2023 Jan 1;55(1):102526.
50. The Lancet Infectious Diseases. The COVID-19 infodemic. Lancet Infect Dis. 2020 Aug 1;20(8):875.
51. Alhaddad MS. The use of social media among Saudi residents for medicines related information. Saudi Pharm J. 2018 Dec 1;26(8):1106-11.
52. Gaviria-Mendoza A, Mejía-Mazo DA, Duarte-Blandón C, et al. Self-medication and the ‘infodemic’ during mandatory preventive isolation due to the COVID-19 pandemic. Ther Adv Drug Saf. 2022;13:20420986221072376.
53. Gharpure R. Knowledge and Practices Regarding Safe Household Cleaning and Disinfection for COVID-19 Prevention — United States, May 2020. MMWR Morb Mortal Wkly Rep [Internet]. 2020 [cited 2023 Jan 17];69. Available from: https://www.cdc. gov/mmwr/volumes/69/wr/mm6923e2.htm
54. Nelson T, Kagan N, Critchlow C, et al. The Danger of Misinformation in the COVID-19 Crisis. Mo Med. 2020;117(6):510-2.
55. Gallotti R, Valle F, Castaldo N, et al. Assessing the risks of ‘infodemics’ in response to COVID-19 epidemics. Nat Hum Behav. 2020;4(12):1285-93.
56. Acosta-Quiroz J, Iglesias-Osores S. COVID-19: Desinformación en redes sociales. Rev Cuerpo Méd Hosp Nac Almanzor Aguinaga Asenjo. 2020;13(2):217-8.
57. Arroyo-Hernández H, Quijano-Escate R, Clavo M de los Á, et al. Análisis de las respuestas a rumores sobre COVID-19 en Perú. Rev Cuba Inf En Cienc Salud [Internet]. 2020 Sep [cited 2023 Jan 17];31(3). Available from: http://scielo.sld.cu/scielo. php?script=sci_abstract&pid=S2307-21132020000300005&lng=es&nrm=iso&tlng=es
58. Nieves-Cuervo G, Manrique-Hernández E, Robledo-Colonia A, et al. Infodemia: noticias falsas y tendencias de mortalidad por COVID-19 en seis países de América Latina. Rev Panam Salud Pública. 2021;45:1-7.
59. Skogen JC, Bøe T, Finserås TR, et al. Lower Subjective Socioeconomic Status Is Associated With Increased Risk of Reporting Negative Experiences on Social Media. Findings From the “LifeOnSoMe”-Study. Front Public Health [Internet]. 2022 [cited 2023 Jan 17];10. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2022.873463
60. Okoye OC, Adejumo OA, Opadeyi AO, et al. Self medication practices and its determinants in health care professionals during the coronavirus disease-2019 pandemic: cross-sectional study. Int J Clin Pharm. 2022;44(2):507-16.
61. Vasquez-Elera LE, Failoc-Rojas VE, Martinez-Rivera RN, et al. Self-medication in hospitalized patients with COVID-19: A cross- sectional study in northern Peru. Germs. 2022;12(1):46-53.
62. Gosselin P, Castonguay C, Goyette M, et al. Anxiety among older adults during the COVID-19 pandemic. J Anxiety Disord. 2022;92:102633.
63. Martins Van Jaarsveld G. The Effects of COVID-19 Among the Elderly Population: A Case for Closing the Digital Divide. Front Psychiatry [Internet]. 2020 [cited 2023 Jan 17];11. Available from: https://www.frontiersin.org/articles/10.3389/ fpsyt.2020.577427
64. Semenzato L, Botton J, Drouin J, et al. Chronic diseases, health conditions and risk of COVID-19-related hospitalization and in- hospital mortality during the first wave of the epidemic in France: a cohort study of 66 million people. Lancet Reg Health - Eur. 2021;8:100158.
65. Wegbom AI, Edet CK, Raimi O, et al. Self-Medication Practices and Associated Factors in the Prevention and/or Treatment of COVID-19 Virus: A Population-Based Survey in Nigeria. Front Public Health [Internet]. 2021 [cited 2023 Jan 17];9. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2021.606801
66. Wilder LV. Polypharmacy and Health-Related Quality of Life/Psychological Distress Among Patients With Chronic Disease. Prev Chronic Dis [Internet]. 2022 [cited 2023 Jan 17];19. Available from: https://www.cdc.gov/pcd/issues/2022/22_0062.htm
67. Visconti-Lopez FJ, Hernández-Vásquez A, Solorzano-Salazar DM, et al. Chronic disease relapses: A cross-sectional study of the associated factors and socioeconomic inequalities during the COVID-19 pandemic in Peru. PLOS ONE. 2022;17(9):e0274697.
68. Heshmatifar N, Davarinia Motlagh Quchan A, Mohammadzadeh Tabrizi Z, et al. Prevalence and Factors Related to Self- Medication for COVID-19 Prevention in the Elderly. Iran J Ageing. 2021;16(1):112-27.
69. Jerez-Roig J, Medeiros LFB, Silva VAB, et al. Prevalence of Self-Medication and Associated Factors in an Elderly Population: A Systematic Review. Drugs Aging. 2014;31(12):883-96.
70. Rahman S, Singh K, Dhingra S, et al. The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population – Public Health Implications. Ther Clin Risk Manag. 2020;16:1007-22.

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>