Inappropriateness of medication use and associated health risks: A cross-sectional study from Pakistan

Purpose: To evaluate the patterns of medication use and medication appropriateness among people in different regions of Pakistan. Methods: A cross-sectional study involving 410 individuals in four provinces of Pakistan (Punjab, Sindh, Baluchistan and Khyber Pakhtunkhwa) as well as the capital city, Islamabad, via a convenient sampling method. The questionnaire used comprised three major sections: (a) medication use patterns of the population, (b) medication storage and wastage practices, and (c) development of secondary disease after medication use. The questionnaires were completed under the supervision of pharmacists trained for the purpose. Results: The majority of the study population preferred bottle caps for taking oral liquid medicines (83.9 %), and the proportion using bottle caps was highest in Punjab (55.2 %) followed by Sindh (21.8 %). A significant proportion of the population consider the use of very hot water as a reconstitution medium for suspensions (36.3 %). In many cases, suspensions were constituted by mere estimation of the vehicle used (56.1 % from Punjab, 18.9 % from Sindh, 16.1 % from KPK, 7.7 % from Baluchistan, and 1.1 % from Islamabad). Significant differences were observed in the handling of leftover drugs among respondent populations, as well as the overall diverse modes of disposal recorded (43.9 %). Doctors (46.6 %) and relatives were the main sources of instructions on medicine usage (37.6 %). A disinclination to purchase a full course of medicine was observed. Knowledge of medicine storage and measuring tools for oral liquids showed striking peculiarities among the various study populations. Conclusion: Inappropriate medication use among the general population of Pakistan requires educational interventions and awareness programs to promote rational drug use in the society.