PROMOTING PROPER USE OF MEDICINES IN SCHOOL CHILDREN- AN INTERVENTIONAL STUDY

Mangesh Bankar*, Vijay Thawani**, Kunda Gharpure.*- Government Medical College, Nagpur, India.**-VCSGGMSRI, Uttarakhand, India.

Proper use of medicines is an important life skill

Teaching proper use of medicines is the most neglected domain of school health curriculum, especially in developing economies.

Children and adolescents get few opportunities to learn how to use medicines appropriately.

Study targeted school children- earlier the intervention, longer lasting health-related behavior can be successfully inculcated in them.

Introduction

1) To study of base-level knowledge about use of medicines in school children

2) To implement an intervention in the form of information, education and communication (IEC) to increase medicine knowledge among school children

3) To see the effect of IEC on the awareness about proper use of medicines in school children.

Objectives

Material and Methods

Design: This was an interventional, questionnaire based

survey in which level of awareness about proper use of medicines in school children was compared before and after giving an intervention in the form of lectures to the school children.

Setting: This study was conducted at local level i.e.

children in IXth and Xth standard were selected from 4 different schools of Nagpur city.

Materials and Methods

Interventions: Pretesting done by administering a questionnaire containing 25 questions

Teaching material related to rational use of medicines was explained and distributed to teachers

Also posters related to Do’s and Don'ts of Medicine use were displayed on Notice Boards.

After a week same questionnaire administered again to judge the improvement

Material and Methods (contd.)

Results:

Table 1: Participants' responses to the questions

All figures in percentages, pretest n=400, post test n=423, *P<0.05, ***P<0.0001 when compared to post test value (Actual questions were full length sentences which have condensed in table)

Questions Pretest POST TEST Yes No Don't

Know YES NO

1. Sharing of medicine with a friend having similar complaints

38.5 61.25 0.25 14.42 85.58***

2. Analgesics are extremely safe 31.75 60 8.25 17.97 82.03*** 3.Need to Inform doctor about medicines you are already taking

64.25 35.5 0.25 91.96 8.04***

4. Injections are more effective than tablets 80.5 15.25 4.25 18.44 81.56*** 5. Need to ask doctor about when to take medicine- before or after meal

67 26 7 73.05 26.95

6. Vitamins are generally safe even after overuse 37.25 43.25 19.5 16.08 83.92*** 7. Use previously leftover antibiotics if same complaints

63 36.75 0.25 16.55 83.45***

8. Breaking or crushing the tablet/capsule before using

39 45.75 15.25 12.77 87.23***

9. Take double dose next day if you forget to take your medicine

16 78.25 5.75 3.78 96.22***

10. Taking high dose of medicine speed up recovery 18.25 73.5 8.25 8.98 91.02*** 11. Herbal medicines do not have any side effects 62.5 37 0.5 17.02 82.98*** 12. Costly medicines are better than cheaper ones. 22 66.5 11.5 15.6 84.4* 13. New symptom during treatment can be adverse reaction

55.75 26.5 17.75 64.07 35.93*

14. Stop taking medicines if symptoms improved 33.5 64 2.5 8.98 91.02*** 15. moist broken tablets should not be used 57.25 31.75 11 88.89 11.11*** 16. Antibiotic use for minor illnesses 42 45.75 12.25 15.37 84.63*** 17. Shake well liquid medication bottle before use 11.25 88.75 0 7.33 92.67 18. Effectiveness decrease after expiry 3 97 2.13 97.87

Doctor

Pharm

acist+

Doctor

Friend

Teache

r

Pharm

acist

0

20

40

6064

28.75

3.75 2.75 0.75

48.5 46

1.5 8 1.75

Fig 2-Pre and Post test Percent responses showing persons who can give correct medicine related in-

formation

PretestPost test

Perc

ent

Resp

onse

s

1 2 3 40

10

20

30

40

50

60

70

8067.5

28.75

3 0.75

31.91 34.04

22.22

11.82

Fig. 4-Pre and Post test responses regarding irrational use of antimicrobials

PretestPost test

Total number of responses

Perc

ent

resp

onse

s

***- P<0.0001

***

***

1 2 3 40

1020304050607080 73.5

22.25

2.5 1.75

26.9535.93 37.12

0

Fig1- Pre and post test percent responses regarding adverse effects of injections

PretestPost test

Total number of correct responses

Perc

ent

resp

onse

s

***

***-P<0.0001

1 2 3 40

10

20

30

40

50

60

70 64.75

23.25

8.53.5

17.26

30.73 30.02

21.99

Fig. 3- Pre and post test Percent responses regarding information to

be asked to doctor

PretestPosttest

Total number of responses

Perc

ent

resp

onse

s

**6

******

***- P<0.0001

**6

******

***- P<0.0001

1 2 3 00

1020304050607080

65.5

15.25

1.75

17.5

66.9

21.99

6.38 4.72

Fig.5- Pre and Post test responses regarding excessive use of antimicrobials

Pretest Posttest

Total number of correct responses

Perc

ent

resp

onse

s

1 2 3 40

10203040506070

52.75

33.5

11.25

2.53.55

16.5522.46

57.44

Fig. 6- Pre and Post test percent responses regard-ing Precautions to be taken before buying

medicines

PretestPost test

Total number of responses

Perc

ent

resp

onse

s

***

***- P<0.0001

Children’s knowledge about medicines was insufficient.

They mostly learn about medicines by observing family members or by exposure to media advertising.

Adults lacking proper knowledge of medicines

Media advertising can influence inappropriate use of analgesics, vitamins.

Physicians often do not take the time to educate their patients

School curricula do not include rational use of medicines

Discussion

Understanding risks and limitations of medicine use- gaining more responsibility

Moreover, schoolchildren can become conduits of information about medicines to their families.

This study showed that properly timed and meticulously implemented intervention can bring about a positive change in the attitude and knowledge of school children.

Discussion

Need for educating children about medicines

Education to school children to communicate with health care providers

Provide education to children in the form of Hands on experience

Physicians, pharmacists, nursing staff should be urged to conduct such courses.

Policy Implications

It is important to know attitude, beliefs and questions

Autonomy among children with regard to any aspect of medicine use.

Inclusion of village school children

Future research agenda

Thank You