Exploring medicines use patterns and practices among the public in the Gaza strip, Palestine: A qualitative study

Year 2023, Volume: 27 Issue: 1, 469 - 480, 28.06.2025

Ashraf Abu Mhadi Siew Chin Ong , Yehia Abed

Abstract

Objectives: To examine patterns and practices of medication adherence and associated factors in the Palestinian population. Methods: qualitative methodology through focus group discussions using a semi-structured interview guide. We identified 26 adult participants through purposive sampling who reported taking medication during or three months prior to the study. Discussions were videotaped, transcribed verbatim, and translated. A manual thematic content analysis of the data was conducted to identify themes and subthemes. Results: The study revealed that participants obtained their medications primarily from public pharmacies. Some participants were unable to obtain their medications, or only partially, due to financial difficulties. The majority of participants used herbal medicines, and self-medication to treat illness was a common practice among participants, depending on their past experience with medicines. Participants adhered satisfactorily to the doctor's prescription, while adherence was low in terms of skipping scheduled doses and stopping the medication when they felt better. The expiration date of medications was not a major problem for half of the participants. Participants were poorly informed about the side effects of their medications. Information about medicines could be obtained from doctors and pharmacists, but most participants had concerns about whether this information was adequate, especially when it came from government doctors and pharmacists. CONCLUSION: Participants used medicines inappropriately. Some participants misunderstood the safety of medicines. Rational use of medicines could be improved by providing participants with the necessary drug information.

Keywords

Medicine Irrational use , Quality use of medicines , Patterns of medicines use

References

• [1] 1. Alfian SD, Sukandar H, Lestari K, Abdulah R. Medication Adherence Contributes to an Improved Quality of Life in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study. Diabetes Ther. 2016;7(4):755-64. [https://doi.org/ 10.1007/s13300-016-0203-x]
• [2] 2.Olsson IN, Runnamo R, Engfeldt P. Medication quality and quality of life in the elderly, a cohort study. Health Qual Life Outcomes. 2011;9(1):95. [https://doi.org/ 10.1186/1477-7525-9-95]
• [3] 3.United Nations (2017, 28.March). “Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health ”. from file:///C:/Users/MOH/Downloads/G1707604.pdf.. (accessed on 21 Jun 2021)
• [4] 4.Pan American Health Organization (2016, september). “Access And Rational Use Of Strategic And High-Cost Medicines And Other Health Technologies”. CE158.R16. from https://iris.paho.org/handle/10665.2/33730. (accessed on 21 Jun 2021)
• [5] 5.Rasool BKA, Fahmy SA, Abu-Gharbieh EF, Ali HS. Professional practices and perception towards rational use of medicines according to WHO methodology in United Arab Emirates. J Pharmacy practice. 2010;8(1):70.
• [6] 6.Thawani V. Rational use of medicines: Achievements and challenges. Indian J Pharmacol. 2010;42(2):63-4. [https://doi.org/ 10.4103/0253-7613.64486]
• [7] 7.Kheir N, Hajj ME, Wilbur K, Kaissi R, Yousif A. An exploratory study on medications in Qatar homes. Drug Healthc Patient Saf. 2011;3:99-106. [https://doi.org/ 10.2147/DHPS.S25372]
• [8] 8.Dawood OT, Hassali MA, Saleem F. Factors affecting knowledge and practice of medicine use among the general public in the State of Penang, Malaysia. Journal of Pharmaceutical Health Services Research. 2017;8(1):51-7.
• [9] 9.Ministry of Health Malaysia. A NATIONAL SURVEY ON THE USE OF MEDICINES (NSUM) BY MALAYSIAN CONSUMERS. 2016. https://www.pharmacy.gov.my/v2/sites/default/files/document-upload/national-survey-use-medicine-iii-nsum-iii.pdf.
• [10] 10.Dawood OT, Hassali MA, Saleem F, Ibrahim IR, Abdulameer AH, Jasim HH. Assessment of health seeking behaviour and self-medication among general public in the state of Penang, Malaysia. J Pharmacy Practice. 2017;15(3).
• [11] 11.Dawood OT, Hassali MA, Saleem F. A qualitative study exploring medicines use pattern and practice among general public in Malaysia. BMC public health. 2016;14(2):0-.
• [12] 12.Cameron A, Roubos I, Ewen M, Mantel-Teeuwisse AK, Leufkens HG, Laing RO. Differences in the availability of medicines for chronic and acute conditions in the public and private sectors of developing countries. Bull World Health Organ. 2011;89(6):412-21. [https://doi.org/ 10.2471/BLT.10.084327]
• [13] 13.Dawood OT, Ibrahim MIM, Abdullah AC. Familiarisation of Children with Medicines and their Sources of Information. Journal of clinical diagnostic research. 2014;8(1):329.
• [14] 14.Schafheutle EI, Hassell K, Noyce PR, Weiss MC. Access to medicines: cost as an influence on the views and behaviour of patients. Health Soc Care Community. 2002;10(3):187-95. [https://doi.org/ 10.1046/j.1365-2524.2002.00356.x]
• [15] 15. Palestinian Ministry of Health (2021). Annual Pharmaceutical Report,. General Directorate of Pharmacy, MOH: 17..
• [16] 16.Yassine M, Al-Hajje A, Awada S, Rachidi S, Zein S, Bawab W, et al. Evaluation of medication adherence in Lebanese hypertensive patients. J Epidemiol Glob Health. 2016;6(3):157-67. [https://doi.org/ 10.1016/j.jegh.2015.07.002]
• [17] 17.Ong SC, Ooi GS, Shafie AA, Hassali MA. Knowledge, attitude and disposing practice of unused and expired medicines among the general public in Malaysia. Journal of Pharmaceutical Health Services Research. 2019;11(2):141-8. [https://doi.org/ 10.1111/jphs.12333]
• [18] 18.Mamo S, Ayele Y, Dechasa M. Self-medication practices among community of harar city and its surroundings, Eastern Ethiopia. J Pharmacy practice. 2018;2018:1.
• [19] 19.Sherazi BA, Mahmood KT, Amin F, Zaka M, Riaz M, Javed AR. Prevalence and measure of self medication: a review. Journal of pharmaceutical Sciences. 2012;4(3):1774. [https://doi.org/ 10.1111/ijcp.13665]
• [20] 20.Nusair MB, Al-Azzam S, Alhamad H, Momani MY. The prevalence and patterns of self-medication with antibiotics in Jordan: A community-based study. Int J Clin Pract. 2021;75(1):e13665. [https://doi.org/ 10.1111/ijcp.13665]
• [21] 21.Pandey S, Deshpande M, Mody J, Surabathula V, Balhara S, Kamath A. Self-Medication and Over the Counter Drugs: A Survey Study of the Indian Population. Biomed Sci J[Rev Internet]. 2020;1(02).
• [22] 22.Jafarzadeh A, Mahboub-Ahari A, Najafi M, Yousefi M, Dalal K. Medicine storage, wastage, and associated determinants among urban households: a systematic review and meta-analysis of household surveys. BMC Public Health. 2021;21(1):1127. [https://doi.org/ 10.1186/s12889-021-11100-4]
• [23] 23.Paut Kusturica M, Tomas A, Tomic Z, Bukumiric D, Corac A, Horvat O, et al. Analysis of expired medications in Serbian households. Zdr Varst. 2016;55(3):195-201. [https://doi.org/ 10.1515/sjph-2016-0025]
• [24] 24.See M, Butcher BE, Banh A. Patient literacy and awareness of medicine safety. Int J Pharm Pract. 2020;28(6):552-60.
• [25] 25.Raja MAG, Al-Shammari SS, Al-Otaibi N, Amjad MW. Public attitude and perception about analgesic and their side effects. International Journal of Pharmaceutical Research 2020:35-52.
• [26] 26.Brounéus F, Macleod G, Maclennan K, Parkin L, Paul C. Drug safety awareness in New Zealand: public knowledge and preferred sources for information. Journal of Primary Health Care. 2012;4(4):288-93. [https://doi.org/ 10.1071/hc12288]
• [27] 27.Hameen-Anttila K, Pietila K, Pylkkanen L, Pohjanoksa-Mantyla M. Internet as a source of medicines information (MI) among frequent internet users. Res Social Adm Pharm. 2018;14(8):758-64. [https://doi.org/ 10.1016/j.sapharm.2017.09.007]28. Dawood OT, Hassali MA, Saleem F, Ibrahim IR. Assessment of self-reporting reading of medicine's labels and the resources of information about medicines in general public in Malaysia. Pharmacol Res Perspect. 2018;6(2):e00387.
• [28] 28.Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-57.
• [29] 29.World Health Organization. Promoting Rational Use of Medicines: Core Components - WHO Policy Perspectives on Medicines, . 2002 September. https://apps.who.int/iris/bitstream/handle/10665/67438/WHO_EDM_2002.3.pdf?sequence=1&isAllowed=y (accessed on 21 Jun 2021)
• [30] 30.World Health Organization. How to investigate the use of medicines by consumers. 2004 https://www.who.int/drugresistance/Manual1_HowtoInvestigate.pdf (accessed on 18 March 2017)
• [31] 31.Kitzinger, illness. The methodology of focus groups: the importance of interaction between research participants. J Sociology of health. 1994;16(1):103-21.
• [32] 32.Tan CS, Hassali MA, Neoh CF, Saleem F. A qualitative exploration of hypertensive patients’ perception towards quality use of medication and hypertension management at the community level. Pharmacy Practice. 2017;15(4).
• [33] 33.Alkhalidi D, Jamshed SQ, Elkalmi RM, Baig MR, Aslam A, Hassali MA. General Public Views, Attitudes, and Experiences toward Drug Safety in Dubai, United Arab Emirates: A Qualitative Approach. Pharmacy (Basel). 2019;7(1):19. [https://doi.org/ 10.3390/pharmacy7010019]
• [34] 35.Fusch PI, Ness LR. Are we there yet? Data saturation in qualitative research. The qualitative report. 2015;20(9):1408.
• [35] 36.Polkinghorne DE. Language and meaning: Data collection in qualitative research. Journal of counseling psychology. 2005;52(2):137.