RESUMO
Background: Self-treatment is recognized as one of the global public health issues. Geographical distance, constrained financial resources, and lack of awareness are the main barriers for people in remote areas to access health care. Self-treatment may also have risky consequences such as side effects and antibiotic resistance. It is assumed that the rate of self-treatment is high in the unreachable hilly tribal areas because of the geographical factor. Aim and Objective: The primary objective of the present study is to find out the prevalence and reason of self-medication, and the sources of drug information. The secondary objective is to assess the awareness of routine medical check-up among the tribal population of the hilly areas of the Koraput district of Odisha. Materials and Methods: A retrospective study was conducted after receiving clearance from the Institutional Ethical Committee, SLN MCH, Koraput. The study was conducted from February 2022 in some hilly villages near Koraput, which is a typical mountainous commune with the terrain divided by many mountains. Simple random sampling was done using computer software for selecting participants (sample size: 200). The participants were contacted and our interviewer visited door-to-door for face-to-face interviews. The research team developed a structured questionnaire to use in the face-to-face interviews. The questionnaire included questions about demographic characteristics, access to medical facilities, frequency of routine medical check-ups in the past 12 months, health information sources, and distance to the nearest health facility. A series of questions regarding self-treatment practices were also asked: Whether they had purchased any medication without prescription in the past 3 months, what the symptoms were, and what kind of medicines they bought, and the reasons they bought the medicines on their own. Results: The study found that prevalence of self-medication was 92 (46%, C.I. 95%). The majority of residents had self-medication when they suffered from common cold and cough (16% of participants), fever (8%), diarrhea (6%), body pain or myalgia (8%), and allergy (2%). The most prevalent groups of drugs used were antipyretics such as paracetamol (36%), antibiotics (30%), antihistamines (14%), and analgesics such as diclofenac and nimesulide (26%). The most common reason for choosing a local practitioner or private pharmacist and health worker was the subjects’ proximity to them. Of the self-medicated population in our study, 62% procured medicines from local practitioners, chemists, or health workers residing in their villages or nearby villages. Conclusion: Rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time and at the lowest cost to them and their community. Self-medication unfortunately does not follow the standard, scientific, and rational criteria. Due to self-medication quality of medicine, scientific, and rational procurement, rational prescription is always questionable.
RESUMO
Background: A materiovigilance program is a system that is used for the identification, collection, and reporting of possible adverse reactions resulting from the use of medical devices. This monitoring program ensures the safety of patients and aids the post-marketing surveillance process. The Materiovigilance Programme of India (MvPI) was launched on July 6, 2015. Aims and Objectives: The primary objective of the study was to generate evidence based data on the safety of the medical devices used in our institute and to analyze the risk benefit ratio of reported adverse events of medical devices and to communicate the safety information to the stake holders. The secondary objective was to educate and advocate the concept of MvPI and creating a culture of adverse events reporting among health workers. Materials and Methods: A retrospective study was conducted after receiving clearance from the Institutional Ethical Committee, Saheed Laxman Nayak Medical College and Hospital (SLN MCH), Koraput. Data about Medical Device-Associated Adverse Events (MDAEs) were collected from MDMC, SLN MCH, Koraput, for the period from October 2019 to February 2022. MDAE reports were collected by a materiovigilance associate during the period from October 2019 to February 2022. Events were reviewed to verify whether or not they were documented in patient’s electronic records and a database of devices was created, which included the events associated with each device. Device-related MDAEs were classified by patient characteristics and the medical devices used. Results: In the 15-month study period, a total of 56 cases of MDAE were reported to MDMC, SLN MCH, Koraput. Of these, 17.9% MDAEs (10 cases) were adverse events related to surgical gloves, 8.9% (five cases) were associated with pulse oximeters, 7.14% of cases (4 cases) were due to glucometer malfunctioning, and 7.1% were related to HIV diagnostic kits such as false positives and false negatives. Adverse events such as skin rashes, irritation on skin, itching, redness of eyes, and gum bleeding in patients with dental braces were reported. A majority of device defects involved inaccuracy in the data reported by the devices (seen in 10.7% of cases), while six cases were due to device malfunctioning. Conclusion: This study shows only the tip of iceberg of the reporting trends of MDME. There is inequality in reporting by different grades of health care workers and from different departments. It highlights the necessity of conducting awareness programs, training and workshops regularly. Device-related safety and reporting of device-related adverse events should be subject of attention and further research.