Differences of Self-Medication-Related Behavior among Medical
Students before and during the COVID-19 Pandemic
RASMI ZAKIAH OKTARLINA, LAURENSIUS AMEDEO SITINDAON, EFRIYAN IMANTIKA,
LIANA SIDHARTI
Faculty of Medicine, University of Lampung
Jalan Prof. Dr. Sumantri Brojonegoro No. 1, Bandar Lampung, 35145
INDONESIA
Abstract: - The COVID-19 pandemic has turned into a global public health emergency, followed by several
changes in the situation. Change is occurring in healthcare where doctors are reducing hours of practice and
people are anxious about coming into contact with infected patients or contaminated objects in healthcare.
Medical students are one of the most frequently used self-medication practitioners. This study examines
whether there are differences in behavior related to self-medication before and during the COVID-19 pandemic.
This research is a comparative descriptive study with a cross sectional research design. This study took a
population of students from the Faculty of Medicine, University of Lampung. Samples were taken using a non-
probability sampling technique, in the form of consecutive sampling. This study compared self-medication
behaviors before and during the COVID-19 pandemic. There were six self-medication-related behaviors that
were compared in this study using frequency comparison tables and charts. There is a difference in the average
self-medication behavior, from 3.00 before the COVID-19 pandemic, to 3.48 during the COVID-19 pandemic.
There are several behaviors related to self-medication that were carried out for the first time during the COVID-
19 pandemic, which were not previously carried out. There are various reasons for refraining from visiting the
doctor when exposed to health problems before and during the pandemic, namely the emergence of reasons for
fear of visiting clinics or homes because they could come in contact with infected patients or contaminated
objects during the COVID-19 pandemic. There are differences in behavior related to self-medication before and
during the COVID-19 pandemic by students of the Faculty of Medicine, University of Lampung.
Key-Words: - COVID 19, SARS CoV 2, Self-medication
Received: April 28, 2021. Revised: January 9, 2022. Accepted: January 25, 2022. Published: March 14, 2022.
1 Introduction
Health is an important thing for individuals to be
able to carry out their daily activities properly. Self-
medication is a part of self-care that aims to
maintain health, prevent sickness, and recover from
disease. The use of drugs is the main differentiator
between self-medication and self-care [1].
Self-medication is defined as the use of
medicines without consulting a doctor to treat one's
health problems on one's own initiative or on the
advice of others [2]. Medicines used in self-
medicated behavior include traditional medicines
and OTC (over-the-counter) drugs [3]. Family, close
friends, neighbors, pharmacists, previous
prescription drugs, and advertisements in
newspapers and other media are sources of self-
medication information [4]. Self-medication is very
common among medical students [1].
The world is currently experiencing COVID-19
pandemic. COVID-19 is caused by infection with
the novel coronavirus (SARS CoV 2), which was
first identified in Wuhan, Hubei, China, on
December 12, 2019. Patients who were originally
identified as having been exposed to the novel CoV
(formerly known as 2019-nCoV) were linked to
seafood consumption in Wuhan [5, 6, 7]. SARS CoV
2 belongs to the Coronaviridae family. Shortness of
breath, coughing, and chest pain are signs of SARS
CoV 2 infection, which progresses to respiratory
problems known as Acute Respiratory Distress
Syndrome (ARDS) [8].
The COVID-19 pandemic has become a global
public health emergency. This disease is life-
threatening because of its rapid spread. This
situation was complicated by the health care system
and limited resources [2]. The COVID-19 pandemic
was also followed by various information, both
accurate and inaccurate, that was widely shared on
social media about drugs that were believed to
prevent and treat COVID-19, despite a lack of strong
medical evidence and safety [9]. Doctors who
decreased their hours of practice during the COVID-
19 pandemic, as well as people who were frightened
to visit clinics or hospitals because they may come
into contact with patients, were among several
situations that occurred during the COVID-19
pandemic [10]. Self-medicated behavior is more
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2022.18.34
Rasmi Zakiah Oktarlina,
Laurensius Amedeo Sitindaon,
Efriyan Imantika, Liana Sidharti
E-ISSN: 2224-3496
340
Volume 18, 2022
likely to occur as a result of these circumstances.
Buying pharmaceuticals by reusing/resending prior
prescriptions, taking medicines on the suggestion of
family or others, and consuming leftover medicines
are all examples of self-medication behaviors [11].
In this unprecedented context (the COVID-19
pandemic), and the aforementioned potential
implications for the occurrence of self-medicated
behaviors, researchers feel it was important to
examine the impact of the COVID-19 pandemic on
the tendency to do behavior related to self-
medication. This study seeks to find out whether
there was differences in behavior related to self-
medication before and during the COVID-19
pandemic among students of the Faculty of
Medicine, University of Lampung. The study was
conducted on a population of medical faculty
students as one of the populations that tends to do
self-medication.
2 Methods
This research is a comparative descriptive research
with a quantitative approach using a cross sectional
research design. This research was conducted using
primary data taken from the answers to the
questionnaire. There are six behaviors related to self-
medication compared in this study, namely 1)
behavior consuming supplements to improve
physical and cognitive abilities; 2) behavior buying
drugs just in case if needed; 3) refrain from
consulting a doctor even though had disturbing
health symptoms; 4) self-medicated behavior to deal
with health complaints according to
symptoms/complaints; 5) the behavior of consuming
the remaining drugs from a doctor's prescription to
treat health complaints; and 6) behavior advises
family or close friends to deal with complaints of
health by self-medication without a doctor's
recommendation first [1, 12, 13, 16, 21]. All data are
presented in the form of tables and graphs of
frequency comparisons to describe the findings
obtained.
2.1 Participants
The population in this study is all students of the
Faculty of Medicine, University of Lampung with a
total population of 683 students. The sampling
technique used was non-probability sampling, in the
form of consecutive sampling. The Slovin formula
was used to determine the number of samples in this
study, which resulted in a sample size of 252.
2.2 Data Collection and Data Analysis
Data collection using a questionnaire was conducted
between January 1 and 10, 2021. Respondents were
questioned about their experiences during the
COVID-19 pandemic. The COVID-19 pandemic
phase of the research began on April 13, 2020, when
SARS CoV 2 infection was declared a national
emergency in Indonesia. The questionnaire used was
a structured questionnaire that was developed on
purpose, consisting of 6 statements and 2 questions
containing behaviors related to self-medication. The
questionnaire was created by the author and the
validity of the contents of the questionnaire was
confirmed through consultation with experts and
trials. Respondents get one point for each statement
that a behavior had been performed, with a total
maximum score of 6. All participation was
voluntary.
3 Results
3.1 Differences in the Number of Behaviors
Related to Self-Medicine Conducted before
and during the COVID-19 Pandemic
The number of self-medicated behaviors carried out by
respondents before and during the COVID-19 pandemic
was different. The average number of behaviors related to
self-medication carried out before the COVID-19
pandemic was 3.48, while the average before the COVID-
19 pandemic was 3. Detailed information about the
differences in the number of respondent behaviors is
presented in figure 1.
Fig. 1: Differences in the Number of Behaviors Related to
Self-Medicine Conducted Before and During the COVID-
19 Pandemic
Statistical analysis is needed to see if there are
significant differences between the number of self-
medication-related behaviors performed before and during
the COVID-19 pandemic. For this reason, the Chi Square
test was carried out because the data distribution was not
normal. The results of the Chi Square test can be seen in
Table 1. The statistical analysis results show that the
number of self-medication behaviors before and after the
COVID-19 pandemic shows a significant difference
where the Asymp value. Signature < (0.05).
Tabel 1. The results of the Chi Square test differ in
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2022.18.34
Rasmi Zakiah Oktarlina,
Laurensius Amedeo Sitindaon,
Efriyan Imantika, Liana Sidharti
E-ISSN: 2224-3496
341
Volume 18, 2022
the number of self-medication behaviors carried out
before and during the COVID-19 pandemic
Before Pandemic
During Pandemic
Chi-Square
12.400a
15.333a
df
3
3
Asymp. Sig.
.006
.002
3.2 Differences in Self-Medication-Related
Behavior before and during the COVID-19
Pandemic
Self-medication-related behavior, in the form of
consuming supplements, among students of the
Faculty of Medicine, University of Lampung, was
different before and during the COVID-19
pandemic. The behavior of self-medication
supplements both before and during the pandemic
was carried out by 38.1% (96) of the total sample
(252 respondents). It is interesting to find that there
was a change in behavior in 67 (26.6%) of
respondents who initially did not take supplements
before the pandemic period changed to taking
supplements during the pandemic period. Self-
medicated supplements were not carried out both
before and during the COVID-19 pandemic by 86
(34.1%) other respondents.
Self-medication related behavior, in the form of
buying medicines just in case if needed, was mostly
done by respondents (students of the Faculty of
Medicine, University of Lampung). This behavior
was carried out by 69% (174) of respondents both
before and during the COVID-19 pandemic. This
behavior was first carried out by 10.7% (27)
respondents during the COVID-19 pandemic and
4.8% (12) other respondents stopped doing this
behavior during the COVID-19 pandemic. As many
as 15.5% (39) of respondents did not buy medicine
just in case it was needed both before and during the
pandemic period.
The behavior of refraining from consulting a
doctor despite having disturbing health symptoms
was carried out by 33.7% (85) of respondents. This
behavior increased during the COVID-19 pandemic
by 16.3% (41) first time respondents during the
pandemic period. This behavior was stopped during
the pandemic by 8.3% (21) of respondents. As many
as 41.7% (105) responses did not perform this
behavior.
Self-medicating behavior to deal with health
complaints was a common behavior by respondents,
both before and during the COVID-19 pandemic.
This behavior was carried out by 81.3% (205)
respondents both before and during the COVID-19
pandemic. However, it was found that several
respondents first resolved their complaints by self-
medication during the COVID-19 pandemic as many
as 3.2% (8) of respondents.
Most of the respondents did not practice self-
medicated behavior by consuming prescription
drugs. This behavior was not carried out, both before
and during the COVID-19 pandemic, by 65.1%
(164) of respondents. As many as 6.7% (17) of
respondents were found to have carried out this
behavior for the first time during the COVID-19
pandemic.
The behavior of advising family or close friends
to deal with complaints of health with self-
medication without a doctor's recommendation itself
was found that 28.6% (72) of respondents did it both
before and during the COVID-19 pandemic. As
many as 62.7% (158) of respondents did not
recommend self-medication, either family or close
friends. Detailed information on the frequency
distribution of respondents is presented in Table 2.
Table 2. Distribution and Frequency of Respondents Based on Behavior Related to Self-Medicine
Yes, before and
during the COVID-
19 pandemic
Yes, only during
the COVID-19
pandemic
Yes, only before
the COVID-19
pandemic
No, never at all
Total
n
%
n
%
n
%
n
%
n
%
96
38,1
67
26,6
3
1,2
86
34,1
252
100
174
69
27
10,7
12
4,8
39
15,5
252
100
85
33,7
41
16,3
21
8,3
105
41,7
252
100
205
81,3
8
3,2
12
4,8
27
10,7
252
100
61
24,2
17
6,7
10
4,0
164
65,1
252
100
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2022.18.34
Rasmi Zakiah Oktarlina,
Laurensius Amedeo Sitindaon,
Efriyan Imantika, Liana Sidharti
E-ISSN: 2224-3496
342
Volume 18, 2022
72
28,6
16
6,3
6
2,4
158
62,7
252
100
3.2 Differences in Reasons for Not Visiting a
Doctor before and during the COVID-19
Pandemic
Respondents who chose “Yes, it's done” in the
statement regarding the respondent's choice when
experiencing health problems before and during the
COVID-19 pandemic, were asked to provide
answers/reasons for choosing to refrain from
visiting doctors. The same reason was found before
and during the COVID-19 pandemic. The reason
was that the disease/complaint was not serious.
However, a different reason was found in the
second most frequent order before and during the
COVID-19 pandemic. The second most common
reason for respondents who answered "yes" to the
questionnaire before the pandemic was previous
experience with complaints so they knew how to
treat it while the second most frequent reason on the
questionnaire during the pandemic period was fear
of visiting clinics or hospitals because of possible
contact with infected patients or contaminated
objects. Detailed information on the frequency
distribution of respondents is presented in Table 3.
Table 3. Difference Reasons for Not Visiting a Doctor Before and During the SARS CoV 2 (COVID 19)
Pandemic
Reasons for Not Visiting a Doctor Before and
During the COVID-19 Pandemic
Before COVID-19
Pandemic
During COVID-19
Pandemic
n
%
n
%
Diseases/complaints that were experienced were not
serious
92
48,4
79
32
Previous experience with complaints so that you know
how to treat them
51
26,8
46
18.6
Save money on going to the doctor
43
22,6
31
12,6
The location of the health service facility/doctor is far
away
3
1,6
2
0,8
There is no transportation
1
0,5
1
0,4
Fear of visiting clinics or hospitals because they may
come into contact with infected patients or
contaminated objects*
-
-
76
30,8
Not having the right time due to doctors reducing their
practice hours during the COVID-19 pandemic*
-
-
12
4,9
Total
190**
100
247**
100
* Other reasons that appeared on questionnaires during the COVID 19 pandemic
** Each respondent can choose more than one reason
3.3 Difference in Complaints that Were
Often Treated with Self-Medication before
and during the COVID-19 Pandemic
To obtain data in this category, respondents were asked
to provide answers to complaints that were often treated
with self-medication. The results of the data processing
can be seen in Table 4. In general, there is not much
difference between the complaints that are often felt by
respondents, both before the pandemic or during the
pandemic. Even if we carefully analyze the data in Table
4, there is almost no difference in the numbers in the two
conditions. The most common complaints of both
periods are fever, flu, headache and cough.
Table 4. Frequency of Respondents Based on
Complaints Often Treated with Self-medication
Before and During the COVID-19 Pandemic
Health Complaint
Before COVID-
19 Pandemic
During COVID-
19 Pandemic
n
%
n
%
Fever
172
22,1
162
21,5
Flu
146
18,7
147
19,5
Headache
138
17,7
137
18,2
Cough
115
14,7
107
14,2
Diarrhea
82
10,5
79
10,5
Pain
68
8,7
77
10,2
Nausea and vomiting
51
6,5
37
4,9
Dyspepsia
8
1
8
1,1
Total
780*
100
754*
100
4 Discussion
The period from when SARS CoV 2 infections was
declared to be a national disaster on April 13, 2020
until the end of data collection (January 10, 2021),
some self-medication related behavior by students
of the Faculty of Medicine, University of Lampung
changed. These changed behaviors included 67
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2022.18.34
Rasmi Zakiah Oktarlina,
Laurensius Amedeo Sitindaon,
Efriyan Imantika, Liana Sidharti
E-ISSN: 2224-3496
343
Volume 18, 2022
(26.6%) respondents who initially did not take
supplements prior to the pandemic changing to
taking supplements during the pandemic to improve
physical/cognitive performance for the first time,
10.7% of people who had never previously
purchased them. medicines before they are needed,
do it, and as many as 16.3% of respondents with
worrisome symptoms who previously would have
checked with a doctor, chose to refrain from
visiting a doctor during the pandemic.
4.1 Difference in the Number of Self-
Medication-Related Behaviors Conducted
before and during the COVID-19 Pandemic
There is a difference in the average number of self-
medication behaviors revealed by respondents.
Before the COVID-19 pandemic, the average
number of self-medication behaviors was 3.48,
whereas the average before the COVID-19
pandemic was 3. Makowoska et al., [12] also found
an increase in the number of self-medication
behaviors before and during the COVID-19
pandemic in their study. In a study by Makowoska
et al. [12], the mean of behavior related to self-
medication increased from 0.94 to 2.1. However,
data on the significance of these changes cannot be
obtained from this mean value. Therefore, in this
study, statistical data processing was carried out to
see this. Referring to the data presented in Table 1,
the statistical test results show a significant
difference. This means that the COVID-19
pandemic has had an impact on changing student
attitudes in doing self-medication. So this research
actually strengthens the results of research
conducted by Makowoska et al. related to changes
in the number of people's cell-medication attitudes
before and during the pandemic.
The increase in the average number of self-
medicated behaviors prior to and during the
COVID-19 pandemic is considered to be linked to
the health-care system's situation. This was
confirmed during an interview session with several
participants, where they said that they were more
likely to take self-medication as prevention and
treatment because health facilities were limited with
a large number of patients. They see that all health
workers are overwhelmed, so they are afraid that
they will not be served optimally in hospitals or
other health care facilities. Of course, this seems to
be a reasonable reason because changes in the
health system coupled with limited resources cause
anxiety, especially in seeking treatment to health
services [2]. Changes in the health service system
situation during the COVID-19 pandemic in the
form of doctors reducing their practice hours and
fear of visiting clinics or hospitals believing that
they may be in contact with infected patients or
contaminated objects [10]. These things support an
increase in the number of behaviors related to self-
medication.
4.2 Behavior Consuming Supplements to
Improve Physical and/or Cognitive Ability
Supplements are products that are consumed to
complement daily nutritional needs. The content in
the supplement is one or more of the following
ingredients: vitamins, minerals, plants or
ingredients derived from plants, amino acids,
materials used to increase the nutritional adequacy
rate [13].
According to research results, both before and
during the pandemic had been carried out by 38.1%
(96) respondents. Changes in behavior in 67
(26.6%) respondents who initially did not take
supplements prior to the pandemic changed to
taking supplements during the pandemic. Self-
medicated supplements were not carried out both
before and during the COVID-19 pandemic by 86
(34.1%) other respondents. The value of the change
in the percentage of consumption of this
supplement has a very significant increase during
the pandemic. In the interview session, information
was obtained that they felt anxious about their
health condition during a pandemic, so they tended
to immediately protect themselves by taking
supplements.
The results of this study have strengthened the
results of several other studies related to the
behavior of taking supplements in self-medication.
Even in this study, the increase in respondents
taking supplements during the pandemic reached
more than 20%. This value is almost the same as
the research data conducted by Sadio et al.
Research conducted on Polish society (1013
respondents) during the COVID-19 pandemic
lockdown, for example, 10.8% of respondents
chose to take drugs to improve physical/cognitive
performance for the first time during the pandemic.
Based on this, the change in the behavior of
supplement self-medication for the first time was
greater in students of the Faculty of Medicine,
University of Lampung. Concerning the use of
supplements during the COVID-19 pandemic.
Sadio et al., [9], found that in the high-risk group
exposed to COVID-19 infection in the Republic of
Togo, nearly a third of respondents (27.6%) chose
to take vitamin C during the pandemic, due mainly
to several studies supports the benefits of high
doses of vitamin C.
Supplements that also function to improve
cognitive and/or physical abilities, so that, health
remains good, is one of the preventive measures for
the transmission of COVID-19 carried out by health
students. especially in vitamin C which is widely
consumed during the pandemic. This is because
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2022.18.34
Rasmi Zakiah Oktarlina,
Laurensius Amedeo Sitindaon,
Efriyan Imantika, Liana Sidharti
E-ISSN: 2224-3496
344
Volume 18, 2022
based on data from interviews with several
respondents, the type of supplement that is mostly
consumed by them is vitamin C. This is because of
the function of vitamin C as an antioxidant and can
increase endurance. This was stated in the research
presented by Khasawneh et al., [14], maintaining
and paying attention to physical health was
something that was often done by 53.4% of
respondents during the COVID-19 pandemic.
Supplements are widely used to
improve/maintain overall health and fitness, prevent
disease, and correct nutritional deficiencies in food.
During the COVID-19 pandemic, there was an
increase in the advertising of dietary supplements in
the media, which are considered to be helpful in the
treatment and prevention of COVID-19. This
resulted in the increase in supplement purchases
reaching three times the usual amount. During the
COVID-19 pandemic, most individuals used
supplements to boost their immunity, improve their
general health and wellbeing, and cover nutritional
gaps in their diet. People who began supplementing
during a pandemic did so to increase their immunity
and/or protect themselves from COVID-19 [15].
During COVID-19, public interest in the usage
of self-medicated supplements has increased, as
seen by an increase in dietary supplement
purchases. Self-medicated supplements may have
increased due to behaviors, beliefs, and other
psychological constructs associated with medication
and dietary supplements, as well as various health
problems, during the COVID-19 pandemic [16].
4.3 Behavior Buying Drugs Just in Case if
Needed
The behavior of buying drugs just in case if needed
was carried out for the first time by 10.7% of
respondents with the other 69% doing it before and
during the COVID-19 pandemic. Actually, this is
similar to the reason for the increase in the number
of supplement consumption. Several informants
said that the purchase of medicines was one of the
preventive measures during the pandemic due to
activity restrictions. In addition, several cases of
students who were confirmed to be infected with
COVID-19 also stated that the preparation of these
drugs was very helpful in their healing process,
especially for those who experienced symptoms.
Generally, medicines purchased as preparations are
paracetamol and cold medicine. But some of them
get a prescription from a doctor.
The results of this study turned out to produce
the same tendency as other studies. Generally, there
is an increase in the purchase of medicines by the
public as an effort to anticipate transmission.
Research conducted on the Polish public (1013
respondents) during the COVID 19 pandemic
lockdown, provides similar results. This behavior
was carried out by 15.5% of respondents who had
never bought prescription drugs before they were
needed, did so during the COVID-19 pandemic.
Changes in behavior related to self-medication in
the behavior of buying drugs if needed do not
always indicate that they will always do self-
medication, but will increase the likelihood of self-
medication [12].
Changes in the functioning of health services,
as well as the worry of not being able to contact
doctors, may have contributed to these people's
desire to protect themselves through this preventive
purchase of medications [12]. Precautionary
medication purchases are typically made to treat
minor diseases without having to see a doctor.
Over-the-Counter (OTC) medicines are often
utilized. OTC medicines are often used since they
do not require a prescription and do not have a
specific administrative procedure in their
acquisition [17].
4.4 Behavior Refrain From Consulting a
Doctor Even though Had Disturbing Health
Symptoms
In this category, the results are quite surprising,
where as many as 41.7% of respondents chose not
to consult a doctor during the pandemic. Even
though they feel symptoms on their bodies.
However, it turns out that this result has
strengthened the tendency of people's attitudes to
consult with doctors studied by other researchers.
Research conducted on Polish society (1013
respondents) during the pandemic lockdown
COVID-19, showed a similar result. This behavior
is carried out by 12.1% of respondents with
worrying symptoms who previously would have
checked with a doctor, choosing not to do it [12].
Behavioral changes related to self-medication
were also found in the behavior of seeking medical
help for health complaints and buying medicines if
needed. Choosing not to visit a doctor despite
experiencing worrisome symptoms and/or
purchasing prescription medications before they are
needed does not always indicate self-medication,
but delaying to see a doctor while sick and having
access to medication both raise the chance of self-
medication [12].
Respondents had different reasons when they
refrained from seeking doctor's help for health
complaints before and during the COVID-19
pandemic. The most common reason stated by
respondents before the COVID-19 pandemic was
that the illness or complaints they experienced were
not serious followed by experiences with these
complaints so they knew how to treat them. A study
of medical students at the University of Gondar in
Ethiopia also found that previous experience and
the non-seriousness of the disease were the top two
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2022.18.34
Rasmi Zakiah Oktarlina,
Laurensius Amedeo Sitindaon,
Efriyan Imantika, Liana Sidharti
E-ISSN: 2224-3496
345
Volume 18, 2022
variables cited as reasons for self-medication [18].
According to Nasir et al. [19], this reason arises
because self-medication can provide an alternative
for those who are "underprivileged" to avoid high
costs in clinical services and are also supported by
many drugs that are sold freely (OTC) without a
doctor's prescription.
The most common reason for holding back
from seeking doctor's help for health complaints
durinh COVID-19 pandemic was that the illness or
complaint is not serious (see Table 3), followed by
the fear of visiting a clinic or home because it may
be in contact with an infected patient or object
contaminated with the SARS CoV virus 2. The
emergence of this reason occurs because of fear of
corona virus [12]. People were also hesitant to call
an ambulance, according to media accounts, and
often phoned late because they were terrified of
being infected by the virus by paramedics or at the
hospital. The same opinion was also shared by Patil
et al., [10], with the risk of being infected with the
virus, people were frightened of coming into
contact with infected patients or contaminated
objects if they went to clinics or hospitals. The
COVID-19 pandemic has also led to border
activities in number of locations, as well as a
reduction in the number of work hours several
doctors.
4.5 Self-medicated Behavior to Address
Health Complaints/Symptoms
Data were obtained regarding the response to self-
medication behavior to overcome health
complaints/symptoms. As many as 81.3% (205) of
respondents did self-medication to deal with their
health complaints both before and during the
COVID-19 pandemic. Meanwhile, this behavior
was only done for the first time during the COVID-
19 pandemic as many as 3.2% (8) of respondents.
This is because students are one of the most
perpetrators of self-medication, including medical
students [1]. This is evidenced from several
previous studies. According to research conducted
by Helal and Abou-ElWafa [11], out of 900
university students in Monsuara, Egypt, 62.9% had
self-medicated. Research conducted by Tesfaye et
al. [20] discovered that 64.5% of students practiced
self-medication out of a total 425 students who
participated in the study. This is also supported by
research conducted by Subashini and Udayanga [3],
of 700 students, 78% of them did self-medication.
Self-medicated behavior is used to overcome
several health problems. There is no difference in
the types of complaints that are often mentioned by
self-medication by respondents. These complaints
are fever, flu, headache, cough, diarrhea, pain,
nausea and vomiting, and ulcers. Helal and Abou-
ElWafa [11] came to the same conclusion, stating
that medications meant to cure fever, flu, headache,
sore throat, intestinal colic, and cramps are
commonly utilized in self-medication. The same
result was conveyed in a study conducted on
medical students of University of Gondar, Ethiopia,
where fever and headaches were the most often
self-treated illnesses followed by coughs and colds
[18].
4.6 Self-medicated Behavior by Consuming
Remaining Drugs of a Doctor's Prescription
The behavior of consuming leftover medicines from
a doctor's prescription can lead to irrational self-
medication. Only a few respondents did this
behavior related to self-medication involving the
consumption of leftover medicines from a doctor's
prescription for the first time during the COVID-19
pandemic. This behavior was not carried out, both
before and during the COVID-19 pandemic by
65.1% (164). Irrational self-medication can cause
harm to health, one of which is drug side reactions.
The emergence of drug side effects is due to a lack
of vigilance in the use of self-medicated drugs
regarding potential side effects, drug interactions
[21]. Self-medicated practices must be supported by
the empirical medical knowledge/information to
avoid irrational drug usage which in turn can lead to
waste of resources, increase pathogen resistance
and poses severe health risks such such as
prolonged illness, adverse drug reactions and drug
dependence [22].
4.7 Behavior Suggesting Family or Close
Friends to Overcome Complaints of Health
with Medicines without a Doctor's
Recommendation
Behavior suggesting family or close friends to
overcome complaints of health with medicines
without a doctor's recommendation was carried out
by 28.6% (72) of people both before and during the
covid 19 pandemic. Total l6.3% (16) of respondents
did this for the first time during the pandemic and
2.4% (6) of respondents stopped at pandemic
period. As many as 62.7% (158) of respondents did
not recommend self-medication to their family or
close friends. The behavior of providing
information for self-medication was rarely done by
students of the Faculty of Medicine, University of
Lampung. This relates to behavior, beliefs, and
other psychological constructs associated with self-
medication [16].
The behavior of suggesting family or close
friends to resolve complaints was rarely done by
students of the Faculty of Medicine, University of
Lampung, in line with research conducted by
Fuaddah [23]. This may be related to the indirect
influence of the family. Family can indirectly
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2022.18.34
Rasmi Zakiah Oktarlina,
Laurensius Amedeo Sitindaon,
Efriyan Imantika, Liana Sidharti
E-ISSN: 2224-3496
346
Volume 18, 2022
influence self-medicated behavior. Family
influences through the habits of other family
members in doing self-medication, both from the
type of drug to the way of consuming it. Other
indirect effects, related to the influence of the
family on the type of medicine can also occur,
where the family usually has provided medicines at
home to be used if needed. So that one family tends
to choose the same type/brand of medicine for
certain health complaints. This is like a suggestion
on a certain brand of medicine that has been felt by
previous people in the family so that they provide
recommendations and even prepare the drug for use
by other family members if they experience the
same disease. This is why the behavior of giving
advice to family members is less common [23].
5 Conclusion
The conclusion obtained in this study is that there
are differences in behavior related to self-
medication before and during the COVID-19
pandemic. There is a difference in the average
number of behaviors related to self-medication
carried out before as well as in the COVID 19
pandemic by students of the Faculty of Medicine,
University of Lampung. This can be seen in the
results of the analysis using the chi square test
where the Asymp value. Sig. < α (0.05). Different
behaviors include the behavior of taking
supplements to improve physical and/or cognitive
abilities, the behavior of buying drugs just in case if
needed, and behaviors and reasons for refraining
from visiting doctors despite having disturbing
health symptoms.
The results of this study can have implications
for several parties, such as health service
institutions and government. The data in this study
provide an illustration of the pattern of community
attitudes in dealing with pandemic conditions. So
that through the results of this study, several efforts
can be made by the government and health service
institutions, such as: 1) preparing a special hospital
for handling COVID-19 because there is a tendency
for people to be afraid of getting infected if they
check themselves in a hospital that handles
COVID-19 patients; 2) condition the supply of
supplements and medicines to be sufficient; and 3)
providing technology-based services related to the
purchase of medicines or supplements, such as
online sales, so that the public will remain supplied
without much contact with other people.
References:
[1]
Imtiaz, S., Salam, N.A., Kamran, Conditions,
frequencies, and sociodemographic factors leading
self-medication practice in Sargodha Area of
Punjab Pakistan, Journal of Applied Pharmacy,
Vol. 5, No. 4, 2013, pp. 151-158.
[2]
Onchonga, D., Omwoyo, J., and Nyamamba, D.,
Assessing the prevalence of self-medication among
healthcare workers before and during the 2019
SARS-CoV-2 (COVID-19) pandemic in Kenya,
Saudi Pharmaceutical Journal, Vol. 28, No. 10,
2020, pp. 1149-1154.
[3]
Subashini, N., Udayanga, L., Demographic, socio-
economic and other associated risk factors for self-
medication behaviour among university students of
Sri Lanka : A cross sectional study, BMC Public
Health, Vol. 8, 2020, pp. 1–13.
[4]
Bennadi, Self-medication: a current challenge,
Journal of Basic and Clinical Pharmacy, Vol. 5,
No. 1, 2014, pp. 19-25.
[5]
Dhama, K., et al., Coronavirus Disease 2019-
COVID-19, Clinical Microbiology Reviews, Vol.
33, No. 4, 2020.
[6]
Cai, J. and Revesz, P.Z., A Novel Spatiotemporal
Method for Predicting Covid-19 Cases, WSEAS
Transactions on Mathematics, Vol. 20, 2021, pp.
300-311.
[7]
Amirudin, et al., Investigating the COVID-19 Self-
Isolation Policy and Its Impact on Socioeconomic
of Vulnerable Groups: An application of Rational
and Non-Rational Thinking Models, WSEAS
Transactions on Mathematics, Vol. 17, 2021, pp.
604-613.
[8]
Machii, N., et al., Walking speed is the sole
determinant criterion of sarcopenia of mild
cognitive impairment in Japanese elderly patients
with type 2 diabetes mellitus, Journal of Clinical
Medicine, Vol. 9, No. 2133, 2020, pp. 1-13.
[9]
Sadio A.J., et al., Assessment of self-medication
practices in the context of COVID-19 outbreak in
Togo, BMC Public Health, Vol. 21, No. 58, 2021.
[10]
Patil, A.D., Sharma, H., and Tetarbe, T., COVID-
19 and concerns related to self-medication,
International Journal of Basic Clinical
Pharmacology, Vol. 9, No. 9, 2020, pp. 1475-1476.
[11]
Helal, R.M. and Abou-ElWafa, H.S., Self-
medication in university students from the city of
mansoura, Egypt, Journal of Environmental and
Public Health, Vol. 2017, 2017, pp. 1-7.
[12]
Makowska, M., Bguszewski, R., Nowakowski, M.,
and Podkowinska, M., Self-medication-related
behaviors and poland’s COVID-19 lockdown,
International Journal of Environmental. Research
and Public Health, Vol. 17, No. 22, 2020, pp. 1-19.
[13]
Ramadani, M., Konsumsi suplemen makanan dan
faktor-faktor yang berhubungan pada remaja SMA
Islam Al Azhar 3 Jakarta Selatan tahun 2005,
Jurnal Kesehatan Masyarakat Andalas, Vol 1, No.
2, 2007, pp. 78-82.
[14]
Khasawneh, A.I., et al., Medical students and
COVID-19: knowledge, attitudes, and
precautionary measures. a descriptive study from
Jordan, Frontier in Public Health, Vol. 8, 2020, pp.
253.
[15]
Hamulka, J., et al., Dietary supplements during
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2022.18.34
Rasmi Zakiah Oktarlina,
Laurensius Amedeo Sitindaon,
Efriyan Imantika, Liana Sidharti
E-ISSN: 2224-3496
347
Volume 18, 2022
COVID-19 outbreak. results of google trends
analysis supported by Plifecovid-19 online studies.
Nutrients, Vol. 13, No. 54, 2021, pp. 1-17.
[16]
Karbownik, M.S., et al., Health-, medication- and
dietary supplement-related behaviors and beliefs
relatively unchanged during the COVID-19
pandemic lockdown, Research in Social and
Administrative Pharmacy, Vol. 17, No. 8, 2020, pp.
1501-1506.
[17]
Cirstea, S.D., Teselios, M.C., and Iancu, A.I.,
Analysis of Factors that Influence OTC Purchasing
Behavior, International Conference on
Advancements of Medicine and Health Care
through Technology, 2017, 12th - 15th October
2016, Cluj-Napoca, Romania.
[18]
Abay, S., and Amelo, W., Assessment of self-
medication practice among medical, pharmacy, and
health science student in Gondar University,
Ethiopia, Journal of Young Pharmacists, Vol. 2,
No. 3, 2010, pp. 306-310.
[19]
Nasir, M., Chowdhurry, A.S.M., and Zahan, T.,
Self-medication during COVID-19 outbreak: a
cross sectional online survey in Dhaka city,
International Journal of Basic Clinical
Pharmacology, Vol. 9, No. 9, 2020, pp. 1325-1330.
[20]
Tesfaye, Z.T., Ergena, A.E., and Yimer, B.T., Self-
Medication among Medical and Nonmedical
Students at the University of Gondar, Northwest
Ethiopia : A Cross-Sectional Study, Hindawi, Vol.
2020, 2020.
[21]
Jajuli, M., dan Sinuraya, R.K., Artikel tinjauan:
faktor-faktor yang mempengaruhi dan risiko
pengobatan swamedikasi, Farmaka, Vol. 16, No. 1,
2018, 48-53.
[22]
Kasulkar, A.A., and Gupta, M., Self-Medication
Practices among Medical Students of a Private
Institute, Indian Journal of Pharmaceutical
Sciences, Vol. 77, No. 2, 2015, pp. 178-182.
[23]
Fuaddah, A.T., Description of self-medication
behavior in community of subdistrict Purbalingga,
district Purbalingga, Jurnal kesehatan masyarakat,
Vol. 3, No. 1, 2015, pp. 610-620.
Contribution of Individual Authors to the
Creation of a Scientific Article
(Ghostwriting Policy)
For research articles with several authors, a short
paragraph specifying their individual contributions
must be provided. The following statements should
be used “Conceptualization, Rasmi Zakiah
Oktarlina and Laurensius Amedeo Sitindaon;
methodology, Laurensius Amedeo Sitindaon and
Efriyan Imantika; validation, Rasmi Zakiah
Oktarlina and Laurensius Amedeo Sitindaon;
formal analysis, Rasmi Zakiah Oktarlina;
investigation, Rasmi Zakiah Oktarlina and
Laurensius Amedeo Sitindaon; resources, Rasmi
Zakiah Oktarlina, Efriyan Imantika, and Laurensius
Amedeo Sitindaon; data curation, Rasmi Zakiah
Oktarlina and Laurensius Amedeo Sitindaon;
writing—original draft preparation, Rasmi Zakiah
Oktarlina; writing—review and editing, Rasmi
Zakiah Oktarlina; supervision, Rasmi Zakiah
Oktarlina; project administration, Laurensius
Amedeo Sitindaon and Efriyan Imantika. All
authors have read and agreed to the published
version of the manuscript.
Sources of Funding for Research Presented
in a Scientific Article or Scientific Article
Itself
This research received no external funding
Creative Commons Attribution License 4.0
(Attribution 4.0 International, CC BY 4.0)
This article is published under the terms of the
Creative Commons Attribution License 4.0
https://creativecommons.org/licenses/by/4.0/deed.e
n_US
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2022.18.34
Rasmi Zakiah Oktarlina,
Laurensius Amedeo Sitindaon,
Efriyan Imantika, Liana Sidharti
E-ISSN: 2224-3496
348
Volume 18, 2022