OVER THE COUNTER DRUG USE AND FACTORS INFLUENCING IT AMONG ADULTS IN EKPAN COMMUNITY DELTA STATE

TOPIC IS SUITABLE FOR:

1. Department of Public Health

2. Department of Pharmacy

3. Department of Nursing Science

4. Department of Pharmacology and Therapeutics

TOPIC: OVER THE COUNTER DRUG USE AND FACTORS INFLUENCING IT AMONG ADULTS IN EKPAN COMMUNITY DELTA STATE

TABLE OF CONTENTS

Abstract

CHAPTER ONE: INTRODUCTION
1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objectives of the Study
1.4 Research Questions
1.5 Significance of the Study
1.7 Scope of the Study
1.8 Operational Definition of Terms

CHAPTER TWO: LITERATURE REVIEW
2.1 Conceptual Review
2.2 Theoretical Review
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Introduction
3.2 Research Design
3.3 Population of the Study
3.4 Sample Size
3.5 Sampling Technique
3.6 Instrument for Data Collection
3.7 Validity of the Study
3.8 Reliability of the Study
3.9 Method for Data Collection
3.10 Method of Data Analysis

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
4.1 Introduction
4.2 Data Presentation
4.3 Demographic Profile of the Respondents
4.4 Descriptive Statistics
4.4.1 Research Question 1: Prevalence of Over-the-Counter Drug Use Among Adults
4.4.2 Research Question 2: Most Commonly Used Over-the-Counter Drugs
4.4.3 Research Question 3: Factors Influencing Over-the-Counter Drug Use
4.4.4 Research Question 4: Side Effects of Over-the-Counter Drug Use

CHAPTER FIVE: DISCUSSION OF FINDINGS
5.1 Identification of Key Findings
5.1.1 Prevalence of Over-the-Counter Drug Use Among Adults
5.1.2 Most Commonly Used Over-the-Counter Drugs
5.1.3 Factors Influencing Over-the-Counter Drug Use
5.1.4 Side Effects Associated with Over-the-Counter Drug Use
5.2 Implication of the Findings to Nursing
5.3 Limitations of the Study
5.4 Conclusion
5.5 Recommendations
5.6 Suggestion for Further Studies

References

Appendix

ABSTRACT

This study assessed “Over-the-Counter Drug Use and Factors Influencing It Among Adults in Ekpan Community, Delta State”. The specific objectives were to assess prevalence of over-the-counter drug use among adults in the Ekpan community, identify the most commonly used over-the-counter drugs among adults in the Ekpan community, assess the factors influencing the use of over-the-counter drugs among adults in the Ekpan community, and assess the side effects associated with the use over the counter drugs among adults in the Ekpan community. A descriptive research design was adopted to provide a comprehensive overview of the subject. The study employed a descriptive research design. The study population comprised all adults aged 18 years and above residing in Ekpan Community, totaling approximately 4,500 individuals. Using the Taro Yamane formula, a sample size of 347 respondents was determined.  Multi-stage sampling design, which included stratified and random sampling was also utilized. The survey comprised of structured questionnaires that had demographic variables and statements that were graded on a five point likert scale. Descriptive statistics (means and standard deviations) were used and a mean-based cutoff of 2.50 was used in making decisional purposes. The results demonstrated that there was high prevalence of OTC drug use (mean = 3.61) with paracetamol being the most commonly used drug (mean = 3.89). The reasons that led to the use of OTC drugs were affordability (mean = 3.89), long hospital queues (mean = 3.56) and advice by peers (mean = 3.34). The side effects noted included stomach upset (mean = 3.48), drug resistance (mean = 3.45), and drowsiness (mean = 3.43). Based on these findings, the study suggests more health education, control of drug sale, more healthcare services in the community, pharmacist counseling, and incorporation of drug literacy into the public health policy to ensure that people use drugs safely.

Keywords: Drug, Over-The-Counter Drugs, Self-Medication, Drug Use Factors, Side Effects, Health Education

CHAPTER ONE

INTRODUCTION (Preview)

1.1 Background of the Study

Health is not only defined as the lack of illness but also as the achievement of a complete physical, mental and social well-being. In many cultures, the quest of health has always guided human behavior and social structure. Whether through traditional medicine or the modern drug therapy, people strive to exercise health autonomy. The growing presence of personal agency in health management has ended up reflecting the contemporary cultural values as well as the changing trends of health literacy. Similarly, Akpan et al. (2024) show that the health-seeking behaviours of people in both urban and rural areas have been transformed by contemporary consumerism, online health information, and the convenience-driven lifestyle. Hence, explaining these behavioural changes is a crucial requirement when examining patterns of drug use in adults.

In this environment of health autonomy, the use of over-the-counter (OTC) drugs has turned out to be one of the distinguishing features of modern healthcare behaviour. OTC drugs are those pharmaceutical substances that can be bought without a medical prescription and are therefore legally available to the general population, usually used in the treatment of mild to moderate health conditions. Offor et al. (2022) hypothesize that they are so readily available and cheap that they become the first option of adults who want to receive an immediate effect of eliminating the most widespread diseases, and this situation is especially common in the developing countries where official care is hardly accessible. Agwogie et al. (2023) also mention that the informal character of the usage of OTC drugs blurs the line between controlled and uncontrolled health practice and promotes the culture of self-diagnosis and autonomous treatment among adults.

The perceptions of cultural beliefs and individual experiences have a strong influence on choices made about OTC drugs. Most of the African communities like Nigeria have health practices that are entrenched in the community knowledge and people depend on personal and community experiences instead of consulting medical experts. Ogu and Ezumah (2024) state that these cultural mindsets create faith in non-prescription products as effective and common substitutes of clinical visits. Okoro and Lahai (2021) demonstrate that the decision to take a drug, its dosage, and frequency are often based on the generational knowledge and community narratives. Such cultural tendency to self-medicate aligns with the general social values of resilience and resourcefulness, and it is especially strong in environments where healthcare provision is not reliable.

Media, advertising, and digital platform effects are also another very important determinant of OTC drug usage. Adults are now exposed to health information and pharmaceutical advertising and reviews like never before due to the digitalization of health information. Adigwe (2023) argues that such inflow of information tends to create the impression of competence in the users who might consider OTC medication to be a dependable and self-administerable part of health. This online empowerment comes along with a considerable normalization of uncontrolled drug use, where the medical consultation is ranked as second or redundant. According to Agwogie et al. (2024), as much as information autonomy is empowering, it also provides a culture of casual drug use driven by the perception of need rather than clinical need.

Patterns of OTC drug use among adults are also mediated by socioeconomic factors, such as the level of education, income and occupation. Persons who have higher education can have better health literacy and confidence in reading the label on the drug or dosage instructions. Poor people, on the other hand, can afford OTC alternatives to hospitalization. According to Jacobs et al. (2024), OTC drugs are especially appealing to adults of the working classes, who do not have time or money to use formal healthcare systems. Agwogie et al. (2023) note that stress or fatigue in the workplace may trigger people to self-medicate as a defense strategy, which further confirms the correlation between socioeconomic status and drug-use behavior.

The dynamics are localized, in the case of Nigeria, in the Niger Delta region, specifically, in the Ekpan community of the Delta State. Ekpan is a semi urban community with industrial activity and residential settlements and the various levels of education, occupation exposure, and health care access come together. Offor et al. (2022) state that in such communities, there is usually a reflection of the national trends, such as the prevalence of self-medication. Akpan et al. (2024) confirm that the existence of pharmacies and patent medicine shops in Ekpan has contributed to the easy access to OTC drugs by the local community, thus, strengthening informal health practices. Since the factors affecting OTC drug use in this community vary widely, including cultural beliefs and socioeconomic limitations, the knowledge of the nature of these factors provides significant insight into the overall meaning of adult self-medication in modern Nigeria.

1.2 Statement of the Problem

The use of over the counter (OTC) drugs is a part and parcel of adult self-care and informal health-management in both developed and developing environments. In most cultures, people now use non-prescription pharmacotherapies to treat mild pathologies and alleviate symptoms without referring to medical professionals (Okoro & Lahai, 2021; Ogu & Ezumah, 2024). This trend has been facilitated by a combination of forces, some of which include an increasing culture of health autonomy, the widening availability of pharmaceutical commodities, and a growing gap between the population need and the supply of traditional healthcare services. Such dependence on OTC products has been exacerbated in Nigeria and more so in semi-urban and peri-urban areas, which is why researchers have been conducting studies to understand the driving force, trends, and contextual factors behind such a practice among adults. Although OTC use comes with some convenience, it is critical to question the degree to which individual, societal and structural influences influence such behaviour.

The present situation in Ekpan, Delta State, demonstrates that the use of OTC drugs has become common among adult locals and is often performed without proper medical supervision and low health literacy. Instead of professional advice being used in making the choices, most people rely on anecdotal accounts, peer counselling, and media representations to choose medications. Agwogie et al. (2023) also state that, despite the moderate awareness regarding drug safety among the adults in a few urban centres, the communities, including Ekpan, tend to be more casual and risk-prone, and this approach is determined by the availability of products and socio-economic factors. This disparity between the normative and the actual practices is an indication of dire necessity to explore the predisposing factors that influence the association between adult population and OTC drugs in this region.

One of the main gaps in the literature is the lack of contextualization in the interaction of cultural norms, economic limitations, and availability of healthcare to influence the use of OTC drugs on a community level. Even though there is literature on the national trends on self-medication, there is little on Ekpan in particular, despite its unique socio-economic and industrial characteristic. As Offor et al. (2022) note, studies have not been able to uncover the reasons behind the continued and unmonitored use of OTC drugs by adults, thus, creating an explanatory gap regarding the ways in which subjective experiences and structural healthcare constraints come together to strengthen the habitual consumption of the drugs in this context. This gap is crucial in the formulation of localised health-education approaches and policy interventions. The study hence will assess over the counter drug use and factors influencing it among adults in Ekpan Community Delta State.

1.3 Objectives of the Study

The main objective of this study is to examine over the counter drug use and factors influencing it among adults in Ekpan Community Delta State. Other objectives of this study are:

1.To assess prevalence of over-the-counter drug use among adults in the Ekpan community.

2.To identify the most commonly used over-the-counter drugs among adults in the Ekpan community.

3.To assess the factors influencing the use of over-the-counter drugs among adults in the Ekpan community.

4.Assess the side effects associated with the use over the counter drugs among adults in the Ekpan community.

OTHER PARTS OF CHAPTER ONE INCLUDE:

1.4 Research Questions

1.5 Significance of the Study

1.6 Scope Of The Study

1.7 Operational Definition of Terms

CHAPTER TWO

LITERATURE REVIEW(Preview)

This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the contributions of scholars who had previously conducted studies on similar research topics. The chapter intends to deepen the understanding of the study and address the perceived gaps in existing literature. This chapter, therefore, focuses on the concept of drugs, concept of over-the-counter (OTC) drug, self-medication and its relationship with OTC drug use, and regulatory framework and public health implications of OTC drug use, etc. The chapter covers the following subheadings:

2.1 Conceptual Framework

2.2 Theoretical Framework

2.3 Empirical studies

2.4 Summary of the Reviewed Literature

CHAPTER THREE

RESEARCH METHODOLOGY  (Preview)

Research Design: The study adopted a descriptive research design.

Population of the Study: The population of the study comprises approximately adults aged 18 years and above residing in Ekpan Community, Delta State, who have accessed over-the-counter medications at least once.

Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 367 participants.

Sampling Technique: The study employed a multi-stage sampling technique involving stratified and simple random sampling methods to select the individual respondents.

Research Instrument: The study utilized a self-developed structured questionnaire as the instrument for data collection.

Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their responses. The analysis was conducted using SPSS, and the results were presented in tables, charts, and graphs.

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS

MAJOR FINDINGS (Preview)

The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made:

i. The study found that the prevalence of over-the-counter (OTC) drug use among adults in Ekpan Community, Delta State, is high, as evidenced by mean scores ranging from 3.17 to 3.73, all above the acceptance benchmark of 2.50. The highest mean score of 3.73 was recorded for frequent OTC drug use during minor illnesses, followed by purchasing OTC drugs without consulting a health professional (3.64) and keeping OTC drugs at home for regular use (3.58), indicating widespread self-medication among adults in the community.

ii. The study found that paracetamol is the most commonly used over-the-counter drug among adults in Ekpan Community, with a mean score of 3.89. This was followed by cough syrups or lozenges (3.59), multivitamins or supplements (3.58), antimalarial drugs (3.55), antacids (3.52), and antibiotics such as amoxicillin (3.38). All mean scores exceeded the acceptance benchmark of 2.50, indicating that these medications are widely used by adults in the community, often without professional medical advice.

iii. The study found that several socioeconomic and healthcare-related factors influence the use of over-the-counter drugs among adults in Ekpan Community, as evidenced by mean scores ranging from 3.18 to 3.89, all above the acceptance benchmark of 2.50. Affordability compared with hospital treatment recorded the highest mean score of 3.89, followed by long hospital waiting times (3.56) and the time-saving benefits of OTC drugs (3.49). Advice from friends and family (3.34), lack of nearby health facilities (3.27), and advertisements (3.18) also influenced OTC drug use.

iv. The study found that the use of over-the-counter drugs among adults in Ekpan Community is associated with reported side effects and unsafe medication practices, as evidenced by mean scores ranging from 3.15 to 3.48, all above the acceptance benchmark of 2.50. Stomach upset or nausea recorded the highest mean score of 3.48, followed by drug resistance (3.45), drowsiness (3.43), mixing different OTC drugs without medical advice (3.25), allergic reactions (3.24), and taking more than the recommended dosage (3.15). These findings indicate the need for increased public health education on the safe use of OTC medications.

CHAPTER FIVE: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

This chapter covers the following outline:

5.1 Identification of key findings

5.2 Implication of the Findings to Nursing

5.3 Limitations of the Study

5.4 Conclusion

5.5 Recommendations

5.6 Suggestion for Further Studies

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