Self-medication in children population: a systematic review and meta-analysis

Self-medication is defined by the World Health Organization (WHO) as the use of medicines to treat self-recognized symptoms or ailments without consulting a physician. Self-medication practice was found among children either self-practice or with caregiver assistance. This study aimed to assess the prevalence and patterns of self-medication practice in children. This study utilized systematic review and meta-analysis by searching papers published during 2013 to 2022 in PubMed, ScienceDirect, Scopus, and Embase. The two sets of keywords “children” and “self-medication” or “non-prescription” were used. It was found that 4,333 articles were retrieved. After inclusion-exclusion screening, 83 articles were included in the study. Joanna Briggs Institute (JBI) was used as a critical appraisal checklist for quality assessment. To assess the prevalence of self-medication in children, meta-analysis was conducted among 77 out of 83 studies. The prevalence of general self-medication in children was 61% (95% CI: 49%-72%, I2= 99.81%, n=24 studies) The prevalence of self-medication in children varied across different symptoms or medication of interest. Self-medication among children with fever was 61% (95% CI: 36%-83%, I2= 99.59%, n=6 studies) followed by dental problems 53% (95% CI: 39%-67%, I2= 94.26%, n=5 studies), respiratory tract infection 40% (95% CI: 26%-55%, I2= 99.19%, n=12 studies). In addition, self-medication practice of antibiotics was found 28% (95% CI: 20%-38%, I2= 99.48%, n=16 studies). Sub-group analyses disclosed that prevalence of self-medication practice is higher in high-income nations when compared to middle-income counterparts, higher among adolescents than younger children, and higher during the COVID-19 pandemic than before the pandemic. In addition, it was found that shorter recall period tended to provide lower prevalence rate of self-medication in children. Antipyretics/ analgesics were the most self-medicated drugs, followed by antibiotics, respiratory, and gastrointestinal drugs. Flu-like symptoms, fever, and gastrointestinal issues were prevalent indications for self-medication. Pharmacies were reported as the primary source of self-medicated drugs, while family, friends, and neighbours provided crucial information. Factors like financial constraints, time limitations, and previous experiences were identified as key influencing factors for self-medication practice. It worth noted that among those reported using antibiotics by themselves, half of them completed antibiotic courses, posing an increased risk of drug resistance. These findings disclosed that the prevalence of self-medication practice is relatively high. While self-medicating for specific conditions is acceptable, it is crucial to verify that children or their guardians choose the correct medication and administer it appropriately. The government and related health professionals should provide support to ensure self-medication practice among children.