AUCTORES
Globalize your Research
Research Article
*Corresponding Author: Lemlem Niguse, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Ethiopia.
Citation: L Niguse, T Sosengo. (2021) Knowledge and Reasons for Use of Analgesic Medications among Haramaya University College of Health and Medical Science Students, Harar Town, East Ethiopia. Journal of Clinical Surgery and Research. 2(2) DOI: 10.31579/2768-2757/012
Copyright: ©2021 Lemlem Niguse, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 07 March 2021 | Accepted: 23 April 2021 | Published: 30 April 2021
Keywords: analgesic medications; paracetamol; ibuprofen; diclofenac
Background: Analgesics, NSAIDs and opioids, commonly known as painkillers, are substances which work in various ways to relieve different types of pain experienced in the body. Approximately 25% of the patients taking non-steroidal anti-inflammatory drugs face several adverse events even in case of prescribed drug and several cases of deaths are reported.
Objective: The aim of this study is to assess knowledge and reasons for use of analgesic medications at Haramaya University, College of Health and Medical Science students of Harar town, Eastern Ethiopia from March 1 2020 to February, 2021.
Method: Institution based cross sectional study was conduct from March 1, 2020 to February 30, 2021. Data was collected using self-administered structured questionnaire prepared in English. Stratified sampling and simple random sampling was used to select the study participants. A total sample size of 317 was taken. Then the collected data was coded, entered and analyzed by using statistical package for social science version 23. The result is presented using tables.
Results: The 90.5% of participants had used analgesic in their life time and the 63.8% them had used analgesic in the last six months. The analgesic usage prevalence in of the study is Ibuprofen (28.7%), Diclofenac (25.7%) and Paracetamol (21.7%). The 78.5% of the respondents reported that large dose of Paracetamol may cause liver. With regard to the use of alcohol with paracetamol, the 77.8% of the respondents replied that alcohols should be avoided when Paracetamol is being taken. The 60.7% of the respondents were aware of the daily maximum dose of Paracetamol. The 78.3% of respondents replied that long time use of codeine can cause addiction. In the current study the 32.4%, 13.2%, and 12.5 %, of the respondents took analgesics for the reason of headache, menstrual pain and fever pain management respectively. The 38.7% of the respondents chose the analgesics due to previous experience, the 19.9% by reading a publication and the 17.5% based on recommendations from others.
Conclusion: This study showed the majority of the participants used analgesics for different reasons mainly for management of headache, menstrual pain and fever. Significant proportions of the study participants lack the appropriate knowledge about analgesics usage of analgesics.
Analgesics, NSAIDs and opioids, commonly known as painkillers, are substances which work in various ways to relieve different types of pain experienced in the body. They are also drugs which reduce or relieve the sensation of pain without producing loss of consciousness or parallel depression of other senses [1].
Non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol (acetaminophen), are the most commonly used over the-counter (OTC) drugs in the world. Over-the-counter analgesics represent a convenient solution for self-care and are generally safe if used in appropriate dosage [2]. Opioids are often the next logical step following NSAIDs in the management of acute pain and cancer-related chronic pain. They also may be an effective treatment option in the management of chronic non-cancer pain [3].
Treatment with analgesic drugs for longer period and/or with a dose exceeding maximum recommended doses has been associated with cardiovascular (CV), renal, myocardial infarction and kidney disease, both acute and chronic kidney diseases and GI complications including bleeding gastric or duodenal ulcers and GI obstructions and perforations [4, 5].
In a retrospective analysis of a rheumatoid arthritis patient database done in Stanford university school of medicine in California, USA, showed OTC ibuprofen and naproxen users had a relative risk for serious GI complications of approximately 3.5 compared with NSAID nonusers and it is estimated that 1%–2% of continuous NSAID users experience a clinically significant upper GI event per year [6].
Prevalence of analgesic drugs use related peptic ulcer has significantly increased and has been associated with increased morbidity and mortality [7, 8].
Significant proportion of NSAIDs users takes the drugs at a dosage exceeding the maximum dose, a warning or contraindication for the use of the drugs or concurrently with interacting medications [9].
In both developed and developing countries, there is a growing problem of OTC NSAIDs misuse has been reported especially among high school and university students due to the lack of knowledge regarding their proper use [10]. Studies conducted to assess students’ knowledge on the use of NSAIDs have been conducted worldwide shows a lack of sufficient knowledge regarding correct use of NSAIDs among University students [11-13]. Lack of knowledge about proper use of NSAIDs lead to increased morbidity and mortality, increased risk of unwanted effects such as adverse drug reactions, unnecessary hospital admissions and visits and many other consequences.
Despite this fact, no study has been done that assess knowledge and reason about use NSAIDs Haramaya University, college of health and medical sciences students. Therefore, this study assessed knowledge and reasons for use of analgesics among CHMS students.
Study area and Period
The study was conduct from February 1, 2020 to February, 2021 among College of Health Medical Science students in Harar town, Haramaya University, Eastern Ethiopia. Harar town is located at 525 kilometers east of the capital city, Addis Ababa. Currently a total of 1130 as regular students at Haramaya University CHMS.
Study design
Institution based cross sectional study design was conducted to assess knowledge and reasons for use of analgesic medications among Haramaya University College of Health and Medical Science.
Population
Source population
All students who were attending their education at Haramaya University College of Health and Medical Science
Study population
All selectee students who were attending their education at College of Health and Medical Science and willing to participate in the study.
Sample size determination
The required sample size is calculated by formula:
n =(Zα/2)2 P(1-P)d2n =(1.96)2×0.5(1-0.5)(0.05)2= 384
Where:
Prevalence (p) use analgesic 50%, (Z) = standard normal distribution value at 95% confidence level of Z = 1.96 and margin of error (d) = 5%.
Since the total study population is less than 10,000, correction formula is used to determine the sample size.
Finite population correction (FPC) = n1+nN
Where n= 384
N=Total population of our study= 1130
FPC = 3841+3841130 = 288
To compensate for possible missing of information and errors, 10% of the size was add. Hence sample the final sample size = 288 + 28.8= 317
Sampling technique
The first sample was select using lottery methods. Using a proportionate allocation, a total sample size were divide to each regular program departments of CHMS.
ni= NiN×n
where i = 1, 2, ..., k where, k is the number of strata and
ni is sample size of the ith stratum
Ni is population size of the ith stratum
N is the total number of students in CHMS
n is the total sample size
Based on that, the required sample from each department;
Nurse = 89/1130 * 317 = 25
Midwifery =103 /1130*317 = 29
Clinical pharmacy =114/1130 *317 =32
Medical Laboratory Science =84/1130*317 =24
Environmental health =64/1130*317 =18
Psychiatry nurse =66/1130*317 =18
Public health =83/1130*317 = 25
Medicine =520/1130*317 = 146
Finally, simple random sampling was use to select the study participants for this study.
Data collection instrument and technique
Data was collect using self-administered structured questionnaire which is prepared in English. Participation was on voluntary basis and confidentiality was maintained.
Data quality control
To ensure data quality, the questionnaire was pretested on selected sample and subsequent correction and modification was done depending up on the finding. Finally, the collected data was reviewed and checked for completeness before the data analysis.
Data processing and analysis
The collected data was coded and analyzed by using SPSS version 24. The result was presented by tables, graphs and charts.
Ethical consideration
Before commencing data collection ethical clearance & approval letter was obtained from College of Health and Medical Sciences Haramaya University and was submitted to each department and then the permission letter was obtained from the respective deparments. The researcher has given full information on the purpose and objectives of the study to the study participants in order to empower the study participants to make informed decisions on whether to participate or not.
Operational definition
Analgesic: substances which work in various ways to relieve different types of pain experienced in the body.
Assessment: Evaluation and measurement of knowledge and practice about a particular matter.
Knowledge: Awareness or understanding about something overall information.
Reason: The motive or rationale for the use or application of particular subject.
Socio demographic characteristics
In this study 317 respondents were included. The 169 (53.30%) and 148(46.7%) of the respondents were male and female respectively. The majority, 97.4% of the study participants were at age group of 21 to 27 years. The 288(90.9%) of them were single and the 29(9.1%) them were married.
The 146(46.1%), 32(10.1%) and 29(9.1%) of the participants were from medicine, pharmacy and midwifery nurse departments respectively. The majority, 141(44.5%) and 83(26.2%) of the study participants were of fourth and fifth year students (Table 2).Socio demographic characteristics
In this study 317 respondents were included. The 169 (53.30%) and 148(46.7%) of the respondents were male and female respectively. The majority, 97.4% of the study participants were at age group of 21 to 27 years. The 288(90.9%) of them were single and the 29(9.1%) them were married.
The 146(46.1%), 32(10.1%) and 29(9.1%) of the participants were from medicine, pharmacy and midwifery nurse departments respectively. The majority, 141(44.5%) and 83(26.2%) of the study participants were of fourth and fifth year students (Table 2).
Prevalence of analgesics usage
The 288(90.8%) had used analgesics in their life time. And 201(63.8%) of the study participants had used an analgesic in the last six months.
From the participants who had used analgesics in the last six months, the 28.7%, 25.7%, 21.7% and 13.9% of the respondents used Ibuprofen, Diclofenac, Paracetamol and Tramadol respectively (Table 3).
The 277(87.3%) of the respondents stated that Paracetamol, Ibuprofen, Diclofenac, and Aspirin can be used to relieve pain. The 164(51.7%) respondents replied that Paracetamol, Ibuprofen, Diclofenac, and Aspirin are equally effective for relieving pain associated with inflammation. The 78.5% of the respondents reported that large dose of Paracetamol causes liver damage.
With regard to the use of alcohol with paracetamol, the 77.8% of the respondents replied that alcohols should be avoided when Paracetamol is being taken to decrease the risk of liver damage. The 60.7% of the respondents were aware of the daily maximum dose of Paracetamol.
In the present study, the 77.8% of the participants reported that alcohol should be avoided to decrease the risk of gastric irritation while taking Ibuprofen, Diclofenac, and Aspirin. The majority, 66.5%, of the respondents in this study replied that aspirin should not be used for the treatment of pain in patients with asthma and peptic ulcer disease. With respect to the use of opioids, the 78.3% of the respondents stated long time use of codeine can cause addiction. The 64.2% of respondents replied that they read the leaflet before taking analgesic (Table 4).
Reason for analgesic use
In the current study the 32.4%, 13.2%, and 12.5 % of the respondents took analgesics for the reason of headache, menstrual pain and fever pain management respectively. The 38.7% of the respondents chose the analgesics due to previous experience, the 19.9% by reading a publication and the 17.5% based on recommendations from others. With respect to a drug selection for the pain management, the 29.1% and 26.8 % of the respondents in this study reported that Paracetamol and Ibuprofen as drugs that they prefer for a pain management (Table 5).
This study showed the majority of the participants used analgesics for different reasons mainly for management of headache, menstrual pain and fever. Significant proportions of the study participants lack the appropriate knowledge about analgesics usage of analgesics. The study also showed that the majority of the participants used analgesics without a health professional consultation. Paracetamol is the most preferred drug for pain management in this study. The major reason for the choice of analgesics is primary the previous experience with the drug. All stakeholders including the college, CHMS, researchers, governments and all concerned bodies should give a better attention to close the knowledge gap about analgesics use seen in this study.
The author acknowledges Harmaya University College of health and medical Sciences for all positive co-operations for the undertaking of this study.
Declarations
Consent to publish: Not applicable
Funding: None
Competing interests: The author declare no competing interest.
Conflict of Interest: The authors declare no conflict of interest.
Author Lemlem Niguse involved in the conception and design of the study, participated in the literature searches, supervised data collection and analyzed data. Author Teshome Sosengo involved in the conception and design of the study, participated in the literature searches, analyzed data and wrote the manuscript. Both the authors approved the final manuscript.
Availability of data: All the data are available with the corresponding author, Lemlem Niguse.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
