Assessment of Prevalence, Knowledge and Practice of Over-the-Counter Medications Use among General Population

The rate of use of over the counter (OTC) drugs is radically expanding step by step. Over the counter medications are drugs sold easily to consumer without a physician’s instruction. A cross sectional descriptive design was adopted for this study to assess the prevalence, knowledge and practice of over-thecounter medications use among general population. A sum of 440 people was selected utilizing probability cluster sampling by evaluating individuals who met the inclusion criteria. The participants were collected data on knowledge and practice of over-the-counter medications use with a self-structured questionnaire through structured interview method. An aggregate of 500 people were met with respect to their utilization of OTC medications, among which 440 were selected. The commonness of self-medicine with OTC medications in our examination was seen as 88%. Among which 97% of them had adequate knowledge on OTC meds and just 3% had inadequate knowledge. With respect to level of Practice, it was discovered that 67.7%of themhad lowpractice, 31.1% had moderate practice and 1.13% had high practice. There was a feeble negative connection existed among knowledge and practice (r=-0.244) whichwas signi icant at p<.001. Therewas likewise ameasurably statistically signi icant af iliation noted between the degree of knowledge with medicinal professionals in their family at p<0.01 and source of awareness at p<0. 001. Correspondingly, an af iliation was found between the degree of practice with educational quali ication at p < 0.01, OTC medicine utilization in years at p < 0.01and source of awareness at p <05.


INTRODUCTION
The International Pharmaceutical Federation characterizes self-medication as the utilization of non-doctor prescribed meds by individuals own plan. (International Pharmaceutical Federation, 2018) These medications are frequently situated on racks in drug stores with simple access by patients, yet may likewise be situated in non-drug store outlets, for example, markets, accommodation shops. OTC drugs are viable in treating normal diseases, and it encourages the patients to choose sheltered, viable item. (Patel et al., 2017) All around, self-medicine has been accounted for as being on the ascent. Individuals around the globe will in general treat the malady, practically half either trust that the issue will run its course or utilize a home cure. About 25% visit a specialist or utilize physician recommended prescription recently acquired for a similar condition. The staying 25% go to the OTC drugs. (Sandeep et al., 2013) India right now positions eleventh as far as the market of over the counter (OTC) medications and it is additionally expected to reach to ninth situation in next ive years (Nagaraj et al., 2015). Central Drugs Standard Control Organization (CDSCO) is the overseeing body that directs import, production, distribution, and offer of medications and beauty care products by Drugs and Cosmetics Act (DCA) and its subordinate enactment, Drugs and Cosmetics Rules (DCR), 1940. OTC medications which are sold by drug stores without a prescription of therapeutic specialist additionally falls under this act (Drugs and Cosmetics Rules, 1945).
On average, U.S., family units spend about $338 every year on OTC items (Pharma News HQ, 2018). India's present OTC medication showcase is pegged at around $4 billion which is developing quickly with numerous pharmaceutical organizations (Dey, 2017). In 2016, India's over the counter (OTC) advertise grew 8 percent to $2.7 billion, with a ive-year compounded annual growth rate (CAGR) of 9 percent (DB6 Global OTC database, 2018). Today three out of each ive individuals report having taken in any event one OTC medication in the past 6months (Revathi, 2012). According to the Consumer Healthcare Products Association (CHPA), 81% of US adults use OTC medicines as a irst line treatment for minor illnesses (Certi ied Healthcare Protection Administrator, 2020).
In numerous nations, OTC medications are chosen by an administrative of ice to guarantee that they are protected and viable when utilized without doctor's consideration. Assuming control over-thecounter medications despite everything has hazard. Some communicate with different drugs, enhancements, nourishment and beverages and a few causes issue for individuals with certain therapeutic conditions. (Medline Plus, 2016) The combination with poor community pro iciency about medication well being and utilization, potentiates misuse and abuse of drugs in India. This, in turn, can add to sick well being, general well being dilemmas, for example, antibiotic resistance and further impoverishment of the community. (Porter and Grills, 2016) Different examinations have demonstrated that the utilization of OTC is twice as regular as that of recommended prescription. (Jensen et al., 2014) There is no guideline for the utilization of OTC medications in India. Albeit OTC medications are accepted to be sheltered and compelling, undoubtedly they are most certainly not. They cover the underlying disease and may cause a few unfavourable impacts. Very few studies were conducted with usage of OTC drugs in our state. Hence, we conduct the study to evaluate the prevalence and assess the knowledge and practice of OTC medications use among general population.

MATERIALS AND METHODS
For the present study, a quantitative approach with descriptive research design was used. The study was conducted in 10 selected villages attached to Rural Health Training Centre (RHTC) of Sri Ramachandra Institute of Higher Education and Research (DU) at Vayalanallur of Thiruvallur District. The number of outpatients attending RHTC per day was around 50-200 patient. The selected villages of RHTC of SRIHER consists of 9 panchayats and 39 villages. A study was conducted after obtaining ethical clearance from the Institutional Ethical Committee of Sri Ramachandra Institute of Higher Education and Research (DU). A formal permission was obtained from the Head of the Department, Community Medicine. The data were collected from 440 individuals consuming over the counter medications who met the inclusion criteria by using a Probability cluster sampling technique. Self-structured questionnaire was developed by the investigator consisting of 3 sections, Background variables and structured questionnaire on prevalence, knowledge and practice of OTC medication. The written consent was obtained from each participant after explaining the study in detail and the background data was collected. The data were collected through structured interview method and data was analyzed with descriptive and inferential statistics.

RESULTS AND DISCUSSION
The results of the present examination uncovered that the mean age of the participants was 45.3 with the base and greatest age of 18 and 86 individually. 36.1% had a place with the age gathering of 31-45 years. As for gender, 74.8% of the participants were females. Concerning educational quali ication, 27.6% of the participants have secondary school level of instruction. According to conjugal status 80.5% were hitched. As for sort of family 40.5% had a place with joint family and 59.5% had  (Babakor and Ghamdi, 2018) Similarly the study results supports the cross-sectional investigation at Mansoura University, Egypt among irst and last year students of both medical and nonmedical colleges to investigate the predominance of self-medication practice, likely reasons, manifestations looking for self-medicine, and wellsprings of advice. The expert infers that the commonness of self-medication was 62.9% and commonest reason of self-medicine was "no need to visit the specialist for a minor sickness" and "information from past experience". Drug store representative, neighbours and family were the most regular wellsprings of exhortation. (Cecyli and Pragathi, 2020)

Figure 1: Distribution of Level of Knowledge on
Over-the-Counter medications use among General Population (N=440) (Helal and Abou-ElWafa, 2017) additionally reported with consistent discoveries that about 80% of participants in provincial and 90% of participants in urban areas detailed that headache was the most well-known signs for which OTC drug is started. Whereas, the other indications/symptoms are fever (80%) in the rustic territory and cold and cough (74%) in the urban area was the most generally recognized symptom for taking OTC medication.
The present investigation results depict that, 97% of them had adequate knowledge on OTC medications and 3% had inadequate knowledge (Figure 1). The present investigation reveals that 67.7% had low practice, 31.1% had moderate practice and 1.13% had high practice ( Table 2). The mean knowledge & practice score were 12.5 with a standard deviation of 2.02 and 40.7 with a standard deviation of 5.12 respectively.
The present examination supports the examination led to survey the knowledge, attitude and practice of self-medicine among 276 health science students at Debre Markos University. The expert concluded that 64.6% of the respondents had great degree of knowledge with respect to self-medicine and 58.4% rehearsed self-medication (Abebe et al., 2017).
So also, results were stable with an examination led among 103 pregnant ladies in Okwe General Hospital Asaba in Delta State. The outcomes of the investigation portrayed that 80.6% of the respondents had good knowledge on the utilization of nonprescription medications during pregnancy with a mean knowledge score of 8.7±3.0, 64(62.1%) of respondents practiced drugs without consultant's prescription. (Okandeji-Barry et al., 2016) The present examination exhibits that there is a weak negative connection was noted among knowledge and practice (r=-0.244) which was signi icant at p<.001. The present examination results show that association of demographic variables with knowledge was medical professionals in their family and source of awareness was seen as factually huge with knowledge (p<0.01 and p<0.001).
Additionally, a factually critical af iliation found between the degree of practice with educational quali ication at p < .01, OTC medicine utilization in years at p < .01andsource of awareness at p < .05. The outcomes were likely with study directed among 110 grown-ups in the age gathering of 20 or more living in Chapapani-12, Pokhara. The outcomes demonstrated that there is critical relation-ship of practice with education status of respondents. (Sharma et al., 2017)

CONCLUSIONS
The Present investigation surmises, that the utilization of OTC medications is generally being practiced among majority of participants with pervasiveness pace of about 88%. Larger part of the participants had satisfactory information on OTC medications and as yet being practiced among them supported by simple openness of medications. It is imperative to assemble mindfulness about risky utilization of OTC medications among all inclusive community to forestall wrecking complexities.