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Annals of Psychophysiology                                                                                                               Volume 4, July 2017  
©Advance Educational Institute & Research Centre                                                                    www.aeirc-edu.com 

ISSN 2412 - 3188 
 

Original Article 

Pain, Self-Medication and Administration of 

Over-The-Counter Analgesics: An Observational Study 
Salman Shaikh2, Yusra Saleem2, Shamoon Noushad 2,3& Sadaf Ahmed1,2&3 

Psychophysiology Research Lab, Department of Physiology, University of Karachi1 

Advance Educational Institute & Research Center2 

Dadabhoy Institute of Higher Education3 

Corresponding Author:  yusra@aeirc-edu.com  

 

Abstract 
Objective Self-medication is identified as a behavioral approach that indulges an individual in the 

substance use as self-administration for the treatment of any physical or psychological pain. Over 

the counter drugs are the most widely used medicines that are commonly available and 

administered without the prescription of a doctor. The aim of the study was to identify the 

prevalence and associated factors that reinforce the self-administration of the analgesics. 

Methodology An observational study had been designed that enrolled males and females 

participants of more than 18 years of age, from the city of Karachi. The recruited individuals were 

asked to fill out a structured questionnaire inquiring about the incidence of pain and prevalence of 

self-administration of analgesics. Results The study had 500 participants that involved 59% males 

and 41% females with the average age of 24.14 + 5.02 years. 100% of the participants reported 

some intensity of pain with average intensity being the most prevalent. It turned out that the 

individuals reported mild grades of physical and chemical with a high prevalence of headaches. 

Conclusion The study concludes that even though the intensity of pain remains within the bearable 

edge, the availability of the pain killers, and accessibility of instant relief and also the possibility 

of decrease in tolerance has spoiled the population to opt for over the counter analgesics time and 

again. 

 

Keywords 

Pain, self-medication, OTC – Analgesics. 

 

Introduction 

According to the WHO, self-medication is a 

part of self-care. However, it may cause more 

harm than good due to any irresponsible use 

(WHO, 2009). Self-medication with 

analgesics is common and accepted and in 

order to avoid reimbursement it is even 

recommended by health systems. Self-

medication, nevertheless, is not an easy task, 

since making choices is difficult for patients 

on the basis of the available standard 

information. Guiding information for patients 

has to be improved, but also physicians need 

to be trained how to handle self-medication 

of their patients (Therapie, 2002). Self-

medication is responsible to treat the diseases 

that do not require medical attention and may 

reduce overuse of medical services; self-

medication’s purpose is to solve minor health 

issues (Zaffani, et al., 2006). Self-medication 

can frequently cause unwanted side effects 

that would increase healthcare costs, creating 

an additional burden on the sanitary system 

(Talevi, 2010). Surveys show that OTC 

medications are considered as more effective 

as prescription medications (World self-

medication industry, 2006). The reasons for 

using self-medication are poorly understood. 

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Salman shaikh 79 

 

Annals of Psychophysiology                                                                                                               Volume 4, July 2017  
©Advance Educational Institute & Research Centre                                                                    www.aeirc-edu.com 

ISSN 2412 - 3188 
 

Most studies point to loose regulations about 

medication, and inadequate access to health 

care, as the main reasons (WHO, 2002).                                                                                                                                             

An observational cross-sectional study was 

conducted among people of all phases 

Questionnaire consisted of close-ended 

questions related to personal data, symptoms 

that led to analgesic use, type of most used 

analgesics, most important source of 

information, and frequency of analgesics use 

by people (Amit & Nadeem, 2016). This 

study showed higher prevalence of analgesic 

use in males as compared to female 

(Kasulkar, 2015). People all over the world 

suffer common health problems (e.g. colds, 

headaches, digestive problems and muscle 

aches) in roughly the same frequency and 

respond in the same way to these problems 

(El Nimr et al., 2015). Surveys show that 

OTC medications are seen by many people as 

being as effective as prescription medications 

(World self-medication industry.2006), the 

reasons for using self-medication are poorly 

understood (El Nimr et al., 2015). The aim of 

the present study was to estimate the 

prevalence of self-medication with drugs and 

complementary/alternative medicines among 

people of Karachi, Pakistan; to describe the 

patterns of medication use; and to identify 

reasons for self-medication (El Nimr et al., 

2015). It was hoped that the results would 

guide decision-makers to take action to 

address self-medication and limit its potential 

effects. The most commonly used analgesic 

for self-medication was acetaminophen 

(paracetamol), followed by fixed-dose 

combinations of paracetamol and other no 

steroidal anti-inflammatory drugs such as 

ibuprofen and diclofenac. Paracetamol is the 

most commonly available analgesic 

preparation with favorable side effect profile 

(Amit & Nadeem., 2016). The underlying 

motivation for this study is the prevailing 

health issues associated with inappropriate 

use of drugs, which is increasingly becoming 

a challenge in our environment. This study 

was designed to determine the proportion of 

general outpatients who self-medicate, types 

of drugs used and the reasons for resorting to 

self-medication. It is hoped that our findings 

will guide us in evolving strategies to reduce 

self-medication to its barest minimum. In 

Pakistan, people have easy access to 

medication and can purchase prescribed 

medications, such as anti-acne medications 

and antibiotics, over the counter without the 

need for a prescription from a physician. One 

of the basic causes of self-medication is 

psychological factor. 

 

Methodology 
The survey was conducted among 500 

participants including both males and 

females, of more than 18 years of age, from 

the city of Karachi. The recruited individuals 

were asked to fill out a structured 

questionnaire that consisted of 16 MCQ’s 

and the data was analyzed using Spss and 

Microsoft excel. Questions regarding the 

demographic data (age, sex, educational 

level, income, occupation and marital status), 

incidence, origin, intensity of pain, 

knowledge about the analgesic bought and 

prevalence of self-administration of 

analgesics were asked to the subjects.     

                                                                                                                                                          

Results 

The study had 500 participants that involved 

59% males and 41% females with the average 

age of 24.14 + 5.02 years. Results of the study 

suggested 100% of the participants reported 

some intensity of pain with average intensity 

being the most prevalent. It turned out that 

the individuals reported mild grades of 

physical pain with a high prevalence of head, 

neck and muscles pain and the less common 

are arthritis dysmenorrheal pain.                                                                                                                                                   

 

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Salman shaikh 80 

  

Annals of Psychophysiology Volume 4, July 2017©Advance Educational Institute & Research Centre 
www.aeirc-edu.com 

ISSN 2412 - 3188 
 

 

Table 1 Demographics 

 Age 24.3 + 5.07 

Gender (n) 

Male 295 

Female 205 

Education (%) 

Under-Matric Matric Intermediate Under-graduate Graduate Post-graduate 

0.2 1.6 14.4 49.3 29.3 5.2 

Smoking (%) 

None Occasional Regular 

67.3 11.0 21.6 

Self-Medication History (%) 

Yes 10.4 No 89.6 

Family History (%) 

Yes 17.6 No 82.4 

 

 

Figure 1 Shows that approximately 15% of the targeted population reported the duration 

of pain for less than a day while the same ratio of population reported long lasting pain for 

more than three months and the highest % of people i.e. 27.7% reported the pain lasting 

for less than a month. 

 

 
 

 

 

 

 

 

14.6

25.5
27.7

16.6
15.6

less than a day less than a week less than a

month

more than a

month/two

more than three

months

Duration of Pain (%)

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Salman shaikh 81 

  

Annals of Psychophysiology Volume 4, July 2017©Advance Educational Institute & Research Centre 
www.aeirc-edu.com 

ISSN 2412 - 3188 
 

 

 

Figure 2 Shows the major reasons of pain as reported by the people, in which a large group 

of people i.e. (36% of the targeted population) reported pain as a result of previous illness 

while 18% reported pain because of accidents, 15 % reported pain to be as the result of any 

surgery and 21% of the subjects were unable to report the cause of pain. 

 
 

 

 

Figure 3 Majority of the population was observed purchasing the analgesics lastly in 

between one week to one month while approximately 40% people last bought analgesics 

less than one week ago. 

 

 
 

injury or 
accident  at 
home/work

18%

result of illness
36%

result of 
surgery

15%

unknown cases
21%

others
10%

Reasons of Pain (%)

less than one
week

one week to
one month

one to six
months

more than six
month/year

40.3

50.7

7.6
1.4

Analgesic Last Purchased (%)

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Salman shaikh 82 

  

Annals of Psychophysiology Volume 4, July 2017©Advance Educational Institute & Research Centre 
www.aeirc-edu.com 

ISSN 2412 - 3188 
 

 

Figure 4 Showing types of analgesics people usually prefer in their routine with the 

maximum use of flurbiprofen (24%) and acetaminophen (23%) and normal use of 

ibuprofen and other combination drugs. 

 

 
Conclusion 
The study concludes that even though the 

intensity of pain remains within the bearable 

edge, the availability of the pain killers, 

accessibility of instant relief and also the 

possibility of decrease in tolerance has 

spoiled the population to opt for over the 

counter use of analgesics either prescribed or 

suggested by friends and relatives without 

seeking advice from the doctor. Subjects 

usually increase the dosage according to their 

own requirements because the prolong use of 

the drug makes the body resistant to the drug 

effect, so an increase in dose may help.  Pain 

is one of the primary reasons that influence 

people towards self-medication and OTC 

(Gualano et al., 2015 & Langelove, 2016). 

 

Acknowledgements    

We are thankful for the co-operation of Ms. 

Kisa Fatima and Ms. Alvira Ali in initial 

execution of the study objectives. 

 

Conflict of Interest 
There is no conflict of interest between the 

authors. 

 

References 

 El Nimr, N. A., Wahdan, I. M. H., 

Wahdan, A. M. H., & Kotb, R. E. (2015). 

Self-medication with drugs and 

complementary and alternative medicines 

in Alexandria, Egypt: prevalence, 

patterns and determinants. EMHJ-

Eastern Mediterranean Health 

Journal, 21(4), 256-265.  

 Ely, L. S., Engroff, P., Guiselli, S. R., 

Cardoso, G. C., Morrone, F. B., & Carli, 

G. A. D. (2015). Use of anti-

inflammatory and analgesic drugs in an 

elderly population registered with a 

Family Health Program. Revista 

Brasileira de Geriatria e 

Gerontologia, 18(3), 475-485. 

salicyle 
acid
0%

caffeine
4%

acetaminophen
23% morphine

1%

flurbiprofen
24%aspirin

5%

ibuprofen
18%

don't know
6%

Combination 
Drugs
19%

Types Of Analgesics Used (%)

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Salman shaikh 83 

  

Annals of Psychophysiology Volume 4, July 2017©Advance Educational Institute & Research Centre 
www.aeirc-edu.com 

ISSN 2412 - 3188 
 

 Gualano, M. R., Bert, F., Passi, S., Stillo, 

M., Galis, V., Manzoli, L., & Siliquini, R. 

(2014). Use of self-medication among 

adolescents: a systematic review and 

meta-analysis. The European Journal of 

Public Health, 25(3), 444-450. 

 Humayun, S., Imran, W., Naheed, I., 

Javid, N., Hussain, M., & Azhar, M. 

(2016). Analysis of Self Medication 

Practices. Professional Medical Journal, 

23(5), 608-613. 

 Kasulkar, A. A., & Gupta, M. (2015). 

Self-medication practices among medical 

students of a private institute. Indian 

journal of pharmaceutical sciences, 

77(2), 178. 

 Kumar, A., & Vandana, A. N. A. (2016). 

Analgesics self-medication among 

undergraduate students of a Rural 

Medical College. Journal of 

pharmacology & pharmacotherapeutics, 

7(4), 182. 

 Lagerløv, P., Rosvold, E. O., Holager, T., 

& Helseth, S. (2016). How adolescents 

experience and cope with pain in daily 

life: a qualitative study on ways to cope 

and the use of over-the-counter 

analgesics. BMJ open, 6(3), 

e010184.Responsible self-care and self-

medication. (2006). A worldwide review 

of consumer surveys. Ferney-Voltaire, 

Franc: World Self-Medication Industry. 

 Talevi, A. (2010). The new patient and 

responsible self-medication practices: a 

critical review. Current drug safety, 5(4), 

342-353.Use of analgesics in self-

medication,Therapie. (2002); 57(2):115-

8. 

 WHO Drug Information. (2002). The 

benefits and risks of self-medication.14 

(1): 81. 

 World Health Organization. (2009). Self-

care in the context of primary health care.                                                                   

 Zaffani, S., Cuzzolin, L., & Benoni, G. 

(2006). Herbal products: behaviors and 

beliefs among Italian 

 women. Pharmacoepidemiology and 

drug safety, 15(5), 354-359. 

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