Pattern of Drug Sales at Community Pharmacies in Edo State as Evidence of Self-medication during the COVID-19 Pandemic: Implications for Policy Implementation
Background: Inappropriate self-medication, recognized as one of the indirect health effects of the COVID-19 pandemic, is especially worrisome because of reported toxicity and unproven efficacy of various drug combinations touted as cures for the disease. Little scientific documentation exists on the range of drugs being self-medicated during the pandemic in Nigeria. This study assessed the pattern of drug sales at community pharmacies during the COVID-19 pandemic to ascertain the drugs commonly used for self-medication.
Methods: A descriptive cross-sectional study was conducted across community pharmacies in Benin City, Edo state in June 2020 to assess the pattern of sales of drugs. Data was collected using a self-administered questionnaire and a record review of medication sales carried out to compare sales in the 1st and 2nd quarters of 2020. Data were analyzed using IBM-SPSS version 25.0.
Results: Sixty-two community pharmacies were assessed. Of these, record review showed an increase in sales in the 2nd Quarter, compared to the 1st quarter, of Hydroxychloroquine 62 (100.0%), Chloroquine 51 (82.3%), vitamin C 62 (100.0%) and immune boosters 61 (98.4%). Forty-one (66.1%) community pharmacies reported an increase in sales of Azithromycin and Zinc respectively and 27 (43.5%) reported an increase in the sales of Artemisinin-based combination therapy. Prescription sheets were not mandatory for the sales of these medications in any of the pharmacies.
Conclusion: There was an increase in sales of antimalaria, antibiotics, and multivitamins reported to be useful in the management of COVID-19 without prescription. Implementation of drug policies is necessary to guarantee public safety.
El Bcheraoui, C., Weishaar, H., Pozo-Martin, F. et al. Assessing COVID-19 through the lens of health systems’ preparedness: time for a change. Global Health 2020; 16: 112. https://doi.org/10.1186/s12992-020-00645-5
World Health Organisation. Weekly epidemiological update - 17 November 2020 Available at https://www.who.int/publications/m/item/weekly-epidemiological-update---17-november-2020 (Accessed on November 20, 2020)
Elston JWT, Cartwright C, Ndumbi P, Wright J. The health impact of the 2014-15 Ebola outbreak. Public Health 2017;143: 60-70
Migliori GB, Thong PM, Akkerman O, Alffenaar J, Álvarez-Navascués F, Assao-Neino MM et al. Worldwide effects of coronavirus disease pandemic on tuberculosis services, January-April 2020. Emerg Infect Dis 2020; 26(11): 2709-2712
Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson BD, Tam Y et al. Early estimates of the indirect effect of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health. 2020;8: e901-e908
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N et al. The psychological impact of quarantine and how to reduce it: a rapid review of the evidence. Lancet 2020; 395: 912-920
Zaami S, Marinelli E, Vari MR. New trends of substance abuse during COVID-19 pandemic: an international perspective. Front Psychiatry 2020; 11: 700. doi:10.1097/ADM.000000000000685
World Health Organisation. Guidelines for the regulatory assessment of medical products for use in self-medication. Geneva: World Health Organisation; 2000
Eticha T, Mesfin K. Self-medication practices in Mekelle, Ethiopia. PLoS One 2014; 9(5): e97464
Alghanim S.A. Self-medication practice among patients in a public health care system. Eastern Mediterrenean Health Journal. 2011;17(5): 409 – 416
Limaye D, Limaye V.., Krause G., Fortwengel G. A systematic review of the literature to assess self-medication practices. Ann Med Health Sci Res. 2017; 7: 1-15.
Esan D.T., Fasoro A.A., Odesanya O.E., Esan T.O., Ojo E.F., Faeji C.O. Assessment of self-medication practices and its associated factors among undergraduates of a private university in Nigeria. J Environ Public Health. 2018; 2018: 5439079 Available from: https://doi.org/10.1155/2018/5439079
Malik M, Tahir MJ, Jabbar R, Ahmed A, Hussain R. Self-medication during COVID-19 pandemic: challenges and opportunities. Drug Ther Perspect 2020; 36: 565-567
Mudenda S, Witika BA, Sadiq MJ, Banda M, Mfune RL, Daka V et al. Self-medication and its consequences during and after the coronavirus disease 2019 (COVID-19) pandemic: a global health problem. Europ J Environ Public Health 2020: 5(1): em0066
Onchonga D, Omwoyo J, Nyamamba D. Assessing the prevalence of self-medication among healthcare workers before and during the 2019 SARS-CoV-2 (COVID-19) pandemic in Kenya. Saudi Pharmaceutial Journal 2020; 28(10): 1149-1154
Islam MS, Sarkar T, Khan SH, Mostofa Kamal AH, Hasan SMM, Kabir A. COVID-19 related infodemic and its impact on public health: a global social media analysis. AJTMH 2020; 103(4): 1621-1629
Mallhi TH, Khan YH, Alotaibi NH, Alzarea AI, Alanazi AS, Qasim S, Iqbal MS, Tanveer N. Drug repurposing for COVID-19: a potential threat of self-medication and controlling measures. Postgrad Med J. 2020 Aug 26:postgradmedj-2020-138447. doi: 10.1136/postgradmedj-2020-138447. Epub ahead of print. PMID: 32848085; PMCID: PMC7448118.
World Health Organization. Coronavirus disease (COVID-19) advice for the public: mythbusters. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters. Accessed 6 Sep 2020
Self WH, Semler MW, Leither LM, Casey JD, Angus DC, Brower RG et al. Effects of hydroxychloroquine on clinical status at 14 days in hospitalized patients with COVID-19: a randomized clinical trial. JAMA 2020; 324(21): 2165-2176.
Horby P, Mafham M, Linsell L, Bell JL, Staplin N, Emberson JR et al. Effects of Hydroxychloroquine in hospitalized patients with Covid-19. N Engl J Med 2020; 383(21): 2030-2040
Cavalcanti AB, Zampieri F, Rosa RG, Azevedo LCP, Veiga VC, Avezum A et al. Hydroxychloroquine with or without Azithromycin in mild to moderate Covid-19. N Engl J Med 2020; 383(21): 2041-2052
Rajasingham R, Bangdiwala AS, Nicol MR, Skipper CP, Pastick KA, Axelrod ML et al. Hydroxychloroquine as pre-exposure prophylaxis for COVID-19 in healthcare workers: a randomized trial. Clin Infect Dis 2020; ciaa1571. https://doi.org/10.1093/cid/ciaa1571
Boulware DR, Pullen MF, Bangdiwala AS, Pastick KA, Lofgren SM, Okafor EC et al. A randomized trial of hydroxychloroquine as postexposure prophylaxis for Covid-19. N Engl J Med 2020; 383: 517-525
Herb F Sewell, Raymond M Agius, Denise Kendrick, Marcia Stewart. Covid-19 vaccines: delivering protective immunity. BMJ 2020; 371:m4838.
Sadio AJ, Gbeasor-Komlanvi FA, Konu RY, Bakoubayi AW, Tchankoni MK, Bitty-Anderson A et al. Assessment of self-medication practices in the context of COVID-19 outbreak in Togo. Research Square preprint 2020
Wegbom AI, Edet CK, Raimi O, Fagbamigbe AF, Kiri VA. Self-medication practices and associated factors in the prevention and/or treatment of COVID-19 virus: a population-based survey in Nigeria. Research square preprint 2020. https://doi.org/10.21203/rs.3.rs-91101/v1
Nasir M, Chowdhury AS, Zahan T. Self-medication during the COVID-19 outbreak: a cross-sectional online survey in Dhaka city. Int J of Basic Clin Pharmacol 2020; 9(9): 1325-1330
Obaseki DE, Akoria O, Ogboghodo EO, Obarisiagbon OE, Mokogwu N, Omo-Ikirodah OT et al . Mainstreaming the private health sector in the response to COVID-19: facility readiness assessment for screening services in Edo state, Nigeria. PAMJ 2020 35: 93. doi: 10.11604/pamj.supp.2020.35.2.24468.
Edo State Government. About Edo State. Accessed 24 April 2020.
Oparah AC, Arigbe-Osula EM. Evaluation of community pharmacists’ involvement in primary health care. Trop J Pharm Res 2002; 1 (2): 67-74
Obaseki DE, Akoria OA, Mokogwu N, Omuemu CE, Okwara BU, Ogboghodo EO, 2020. Staff risks stratification in preparation for COVID-19 in a tertiary healthcare facility in Nigeria. PAMJ 35: 124. Doi:10.11604/pamj.supp.2020.35.2.25095
Nigeria Centre for Disease Control (NCDC). COVID 19 progression. Available at https://covid19.ncdc.gov.ng/progression/. Accessed 26th August, 2020
Lane JCE, Weaver J, Kostka K, Duarte-Salles T, Abrahao MT, Alghoul H et al. Risk of hydroxychloroquine alone and in combination with azithromycin in the treatment of rheumatoid arthritis: a multinational, retrospective study. Lancet Rheumatol 2020; 2(11): e698-e711
Mehta B, Salmon J, Ibrahim S. Potential shortages of hydroxychloroquine for patients with lupus during the coronavirus disease 2019 pandemic. JAMA Health Forum. 2020. https://doi.org/10.1001/jamahealthforum.2020.0438
Hedima EW, Adeyemi MS, Ikunaiye NY. Community Pharmacists: On the frontline of health service against COVID-19 in LMICs. Res Social and Adm Pharm. 2021; 17(1): 1964-1966. doi:10.1016/j.sapharm.2020.04.013
Ahmad A, Alkharfy KM, Alrabiah Z, Alhossan A. Saudi Arabia, pharmacists and COVID-19 pandemic. J Pharm Policy Pract 2020; 13: 41
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.