CHAPTER 1

THE PROBLEM AND ITS BACKGROUND

INTRODUCTION
Background of the study
According to Alamadi et al. (2021), Self-medication is the practice of
administering non-prescribed medicines. Although self-medication of some
medicines is safe and widely accepted, it can lead to severe consequences,
particularly in the elderly, because drug metabolism changes with age (Amoako et
al, 2021). Self-medication practices are popular worldwide and are gaining ground in
many nations, including the Philippines, where they are becoming increasingly
prominent. According to Abdi et al. (2018), factors such as education,
socioeconomics, culture, underlying disease, and many more are contributing
components to why people undergo self-medication.
Self-medication treats common symptoms or illnesses with over-the-counter
(OTC) or prescription drugs without consulting a doctor. The government of the
Philippines understands the significance of regulating self-medication practices and
has enacted several laws and policies, such as the Food and Drug Administration
(FDA) Act of 2009, to do so. These measures were taken to guarantee various health
products' reliability, efficacy, and security, including pharmaceuticals. The growing
frequency of self-medication in the Philippines, in conjunction with the nation's aging
population, shows the need to research self-medication practices and determine
variables from the point of view of older adults in the country. This study aims to add
to the body of knowledge by investigating the self-medication behaviors of older
adults in the Philippines and the factors that influence whether or not older adults
self-medicate.

Herbal plants are also often used as a form of self-medication, and this is
becoming more and more common. This is due to the elderly's strong cultural belief
in the therapeutic capabilities of herbal plants and their potential to alleviate a
variety of health problems. Herbal plants are also freely accessible, inexpensive, and
do not require a prescription or clearance from a health practitioner. However,
because the usage of herbal plants is frequently self-diagnosed and self-treated
without sufficient guidance and monitoring, this practice poses a considerable risk to
their health. (Maramba-Lazartee, 2020).

This study aims to provide a comprehensive understanding of self-medication

behaviors and determine variables from the perspectives of older adults in the
Philippines most specifically in Urdaneta. This study will also give important
information about the regulatory policies and interventions that can be used to
improve how older adults in the Philippines self-medicate and help them take care of
themselves safely and effectively. These enlightening ideas will be shared with the
goal of enhancing the standard of living of older adults.
 The researchers chose this study because of its significance in expanding the
understanding of self-medication habits and determining factors among older
adults. This study will provide useful information that can be used to come up with
safe and effective ways to get the country's older adults to take care of their
medications properly.

Framework
The study will be guided by the Health Belief Model (HBM), which posits that an
individual's health behavior is determined by their beliefs and attitudes towards their
health and the treatments they receive (Boskey, 2022). The HBM says that the things
that affect health behavior are perceived benefits, perceived barriers, cues to action,
and self-efficacy.
Using the HBM, we can create a framework to understand why older adults
engage in self-medication practices and the determinant factors from their
perspectives:
1. Perceived susceptibility: Older adults may believe they are susceptible to
specific health problems and that self-medication can help manage their
symptoms.
 2. Perceived severity: Older adults may not think their health problems are bad
enough to warrant a trip to the doctor, so they choose to treat their symptoms
on their own.
3. Perceived benefits: Older adults may believe that self-medication offers more
convenience, is more accessible, and is less expensive than seeking medical
advice.
4. Perceived barriers: Living in a rural area, having limited mobility, or needing
more money can make it hard for older people to get health care services.
5. Cues to action: Older adults may be prompted to self-medicate based on
previous experiences with medications, advice from friends or family, or
advertising for OTC drugs.
This framework highlights the importance of understanding older adults'
perspectives on self-medication practices and the determinant factors influencing
their behavior. By taking these characteristics into account, the researchers can
gather significant information in regard to self-medication practices by older adults.

Significance of the study

The generalization of this study would be a great contribution to the vast
knowledge in relation to the awareness of self-medication practices and
determinants factors from the perspectives of older adults. Furthermore, the results
of this study could be highly significant and beneficial for the following:
1. Older Adults
The findings of this study will help older adults to have a deeper
understanding of Self-medication practices and determinant factors.
2. Geriatric Nurses
Geriatric Nurses play an important role in taking care of older
adults. This study will provide additional knowledge for Nurses in
taking care of older adults who have been self-medicating. The results
of this study will show the determinant factors of self-medication from
the perspective of older adults.
3. Community
For they also play a vital role in taking care of older adults. This
research would give them the idea that such self-medication could be
harmful to older adults.
4. Proponents of the Study
This refers to the students conducting the study. They will find
self-fulfillment and gain knowledge and skills in this study. This study
will help and inspire more researchers to be more innovative and
creative in their future endeavors.
5. Future Researchers
This study will serve as a reference for researchers on the subject
of research in the field of Nursing. This will serve as a guide to further
developing the research with the connection to the variables used.
Scope and Delimitation
Scope
This study is to focus on the self-medication practice and its determinant
factors from the perspective of older adults ages 60 and above.
Delimitation
The study is delimited only to 25 older adults ages 60 and above in Urdaneta
City. The main purpose of our study is to Identify the determinant factors of
self-medication from the perspective of older adults. However, the study excludes
the effects of self-medication practice on their behavior.

Objectives of the Study

Statement of the purpose
This study aims to investigate older adults' self-medication habits and
determinants. With an aging population, there has been a considerable increase in
self-medication among older adults, and understanding the causes of these practices
is critical.
The research seeks to answer the following questions:
1. What are the most prevalent self-medication techniques among the elderly?
2. What variables influence older adults’ self-medication practices?
3. Without the supervision of a healthcare expert, how do older adults select which
drugs to take and when to take them?

Definition of terms
Self-medication: The practice of using over-the-counter (OTC) and prescription
medications without seeking medical advice.
Older adults: Individuals aged 60 years and older.
Chronic conditions: Long-lasting health problems, such as arthritis, cardiovascular
disease, and diabetes.
Health Belief Model (HBM): A theoretical model that posits that an individual's
health behavior is determined by their beliefs and attitudes towards their health and
the treatments they receive.
Perceived benefits: An individual's belief that a healthy behavior will have positive
outcomes.
Perceived barriers: An individual's belief that a healthy behavior will have negative
consequences.
Cues to action: Stimuli that prompt an individual to engage in a particular health
behavior.
Self-efficacy: An individual's belief in their ability to engage in a particular health.

CHAPTER 2
REVIEW OF RELATED LITERATURE
This chapter presents a summary of related local and foreign literature that has
shown similar and impressive results relevant to the research being reviewed. The
analysis was undertaken to gain further insights and support the present study.
RELATED LITERATURE
LOCAL LITERATURE
Self-medication is widespread in developing nations, where it has negative effects on
both the economy and society. On the one hand, it is seen as a significant part of
self-care that heavily relies on the knowledge and experience of the consumer with
regard to medicine use.(Parulekar, Meena, et.al.,2016) On the other hand, the
improper application can result in misuse and drug resistance, among other
problems. The reasons why people self-medicate have been investigated through
surveys carried out in developing nations in order to comprehend the determinants
of self-medication and to explain the influence of knowledge and information on
self-medication behaviors. (Meena, et.al.,2016) An extensive, systematic literature
evaluation based on survey results on self-medication in developing nations was
conducted in order to comprehend the same. 25 surveys were chosen from a total of
52 survey articles for this review. According to the study results, the main factors
influencing self-medication behaviors were cost, time, and prior experience with the
medication and symptoms, whereas healthcare professionals emerged as the main
sources of information and knowledge. Self-medication is a phenomenon that is very
common and has both possible advantages and related hazards. We definitely need
to look at and devise appropriate interventions to promote responsible
self-medication and in turn, rational drug use in the developing world, to guarantee
that the dangers and benefits of medicine usage are known by consumers.

FOREIGN LITERATURE

According to (SS Moryazavi, 2017), Self-medication is possible at any age. However,

the elderly are given special consideration when it comes to therapy and
pharmaceuticals because, according to numerous studies, they are the primary users
of medicines in the majority of developed nations.
The availability of essential pharmaceuticals is scheduled to occur at predetermined
times, in sufficient quantities, in the appropriate dosage forms, with guaranteed
quality and information, and at costs that the individual and the community can pay.
However, self-medication affects people's decisions about seeking medical attention.
It causes resource waste, delays in issue diagnosis, and ineffective therapies. It can
potentially result in harmful medication responses and significant health risks. (AD
Kassie, 2018)
Considering how many google searches have increased since the epidemic began, it
has been reported that the trend of self-medication has spread globally(Onchonga,
2020)
It has been identified as one of the significant societal challenges affecting economic
and health systems, with varying prevalence depending on contextual factors like
gender, income, knowledge, and educational attainment.(M Janatolmakan,2022)
Self-medication has become increasingly common all over the world. According to
available data, over 80% of all drugs are available over the counter in
underdeveloped nations. Self-medication replaces medical care for those who
cannot afford it due to its reduced cost. ( Alireza Abdi,2022)
In terms of movement, self-care, and regular activities, tatus in the exposure group
was statistically considerably better than that in the control group. On the other
hand, there was no statistically significant difference between the measures of pain,
discomfort and anxiety, depression. With practical knowledge about and availability
to over-the-counter medications and home remedies, the quality of self-medication
practices for minor symptoms can be enhanced.( Ryuichi Ohta et al.,2022)
The development of technology and the internet has made it possible to obtain a
wealth of medication information.(Hassan A Alsaad et al.,2022)

Local Studies
Drug misuse poses a serious threat to the healthcare system and the socioeconomic
welfare of many communities. Drug use is more prevalent as people age because of
changes to their cognitive and physical functions. One of the best ways to assess an
elderly person's health is to look at their self-medication. This investigation into
elderly self-medication in Shahr-e-Kord was conducted. In Situation ( i.e., 350 adults
over 65 participated in this cross-sectional survey in 2015. Sampling was carried out
twice. Using maps, the city of Shahr-e-Kord was initially separated into four sections.
From each region, 88 persons were chosen. The research tool was a survey known as
the Health Belief Model (HBM). Using SPSS version 20, the chi-squared test, the
independent-samples t-test, and the Pearson correlation coefficient were used to
evaluate the data.
Foreign Studies
This study intends to review the literature on self-medication programs that helped
create a self-administration of medication (SAM) program specifically for older
adults with mental health issues. Traditional approaches to medication
administration in mental health inpatient settings are paternalistic and echo the
medical model of care. It is necessary to research novel approaches to treating
depression in older adults that take a customized, creative approach to redress the
power gap for patients. Using Hek et alsearch .'s methodology, electronic databases
were searched to find essential themes in the deployment of self-administration
programs. The literature study revealed seven themes: the organization of SAM,
evaluations, and hazards related to SAM, patient education, SAM and medication
adherence, the patient's perspective, benefits and obstacles to SAM, and
professional concerns. The initiative to provide a customized pathway for the
implementation of SAM at OPMH was then built on top of these findings. SAM
program implementation is noticeably lacking throughout the UK, particularly in
mental health services. Older Adults' Mental Health is prepared for the adoption of
the change in the administration of medications. The NHS plan's tailored,
person-centered care principles can all be fulfilled through the self-administration of
medication.(Murray, 2010)
This study gives knowledge about the most common type of self-care, which is
defined as the preservation of one's own health through illness prevention and
self-treatment, is self-medication (Ryan, Wilson, Taylor, & Greenfield, 2009)
It is advised that a training program be created and put into place to alter the
knowledge and views of the elderly about self-medication due to the negative effects
of self-medication and its high frequency among them.
Physical activity, food, self-awareness, outlook/attitude, lifelong learning, faith,
social support, financial security, community engagement, and independence are
among the 10 factors determinant for healthy aging.(Lu et al.,2022)

CHAPTER 3
METHODOLOGY
Data Gathering Instrument
Understanding older adults' self-medication practices and determinant factors is
crucial as the population ages. Qualitative research is excellent for studying these
behaviors and reasons because participants may tell their stories. This
data-gathering method gives a deeper understanding of older adults’ thoughts and
experiences. This qualitative data-collecting tool will gather older adults'
self-medication practices and factors. Semi-structured interviews will maximize data
collection for the researchers.
Qualitative Data Gathering Instrument:
1. Demographic Information
- Age
- Gender
- Education Attainment
- Occupation
- Income
2. Self-Medication Practices
- Please Describe your self-medication practices. What medications do
you take and why?
- Do you consult any healthcare professionals or anyone before taking
your medication?
- How often do you self-medicate?
3. Determinant Factors
 - What factors influence your decision to take any medication or do
self-medication?
- Are there any barriers that prevent you from seeking any medical
advice before doing any self-medication?
4. Reflections
- Can you describe any adverse effects of your self-medication?
- What steps have you taken to ensure that your self-medication is
effective and safe?
- Do you have any other thoughts or reflections about self-medication
practices that you would like to share?

The following qualitative data collection tool is intended to collect detailed

information on self-medication practices and determinant factors from the
perspectives of older adults. This data collection provides a more nuanced insight
into older adults' experiences and perspectives, which is critical in understanding
the issues they confront and how they approach healthcare and self-care.

Data Gathering Procedure

The data-gathering procedure to be used in this study will be semi-structured
interviews and focus groups. Semi-structured interviews will be used to collect
individual perspectives from older adults who engage in self-medication practices.
The interviews will be conducted in a confidential setting and will be
audio-recorded or written for transcription purposes. Focus groups will be used to
gather collective perspectives from older adults who engage in self-medication
practices.

Data Analysis
The data collected will be analyzed using thematic analysis. Thematic analysis is a
qualitative data analysis method that involves identifying, coding, and categorizing
themes in the data. Thematic analysis will allow us to identify common themes and
patterns in the data and to gain an in-depth understanding of self-medication
practices and determinant factors from the perspective of older adults. To have a
systematic categorization of data the researchers will use the Colaizzi method.
According to Wirihana et al. (2018), the Collaizi method is often adopted because it
enables researchers to uncover emergent themes and their interconnected linkages.

Ethical Considerations
The study will be conducted in accordance with ethical principles and guidelines.
All participants will provide informed consent and their privacy and confidentiality
will be protected. The audio-recorded data will be kept confidential and will only be
accessible to the research team. The findings of the study will be used for academic
purposes only and will not be used for commercial purposes.
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