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Background: Self-medication among medical students is common worldwide and may contribute to inappropriate drug use and antimicrobial resistance. MBBS students, due to their medical knowledge, may be more prone to self-prescription, making it important to assess their practices and influencing factors. Objectives: To determine the prevalence, pattern, reasons, and associated factors of self-medication among MBBS undergraduates. Methods: A cross-sectional questionnaire-based survey was conducted among 44 MBBS students. Information on demographic characteristics, self-medication practices in the preceding six months, indications, drug classes, sources of information, reasons, and safety behaviours was collected. Chi-square test was applied to identify factors associated with self-medication. Results: Participants’ mean age was 20.5 ± 1.4 years, with 54.5% females and 59.1% in clinical years. The prevalence of self-medication was 68.2%, with 60.0% reporting one episode and 40.0% reporting ≥2 episodes in the past six months (Table 2). Common indications included headache/musculoskeletal pain (66.7%), common cold/URI (53.3%), and allergic symptoms (33.3%) (Table 3). The most used drug classes were NSAIDs/analgesics (63.6%), antipyretics (61.4%), and antibiotics (27.3%) (Table 4). Primary information sources were previous prescriptions (56.7%) and pharmacists (50.0%) (Table 5). Common reasons were perceived minor illness (66.7%) and convenience (53.3%) (Table 6). Safety behaviours included checking expiry dates (90.0%) and reading labels (56.7%) (Table 7). Clinical-year students had higher self-medication rates than pre-clinical peers (76.9% vs 55.6%, p = 0.0837) (Table 8). Antibiotic self-medication was lower among those with prior antimicrobial stewardship training (20.0% vs 33.3%, p = 0.3009) (Table 9). Conclusion: Self-medication is highly prevalent among MBBS students, mainly for minor ailments, with NSAIDs and antibiotics frequently used. Educational strategies promoting rational drug use and discouraging inappropriate antibiotic practices are warranted.
Self-medication refers to the use of medicines by individuals to treat self-recognised illnesses or symptoms without professional supervision. While it is considered part of self-care when done responsibly, inappropriate self-medication may lead to misdiagnosis, masking of serious diseases, drug interactions, and increased risk of antimicrobial resistance [1,2].
Globally, self-medication prevalence among university students ranges from 45% to 98%, with medical students often demonstrating higher rates compared to non-medical peers [3,4]. This tendency is attributed to easier access to medical information, greater drug familiarity, and confidence in self-diagnosis [5]. Analgesics, antipyretics, antihistamines, and antibiotics are among the most frequently used drugs in this population [6,7]. Although medical students are expected to possess better knowledge of rational drug use, studies have shown that even they may engage in unsafe practices, such as antibiotic misuse, improper dosing, and storing leftover medicines [8].
In India, easy over-the-counter availability of many prescription medicines, coupled with cultural acceptance of self-treatment, contributes to widespread self-medication practices [9]. The problem is particularly relevant among MBBS students, who are in a transitional phase of acquiring clinical knowledge and may develop prescribing habits that persist into professional life [10]. Understanding their self-medication behaviour, including factors influencing drug choice and safety measures, is critical to designing targeted educational interventions, especially in the context of antimicrobial stewardship.
The present study aims to determine the prevalence, patterns, reasons, and factors associated with self-medication among MBBS undergraduates, with a focus on drug classes used and safety-related behaviours.
Study design and setting:
A cross-sectional, questionnaire-based survey was conducted at the Government Medical College, Mehboob Nagar, Telangana, a tertiary-level teaching institution catering to urban and rural populations.
Study period:
The study was carried out over a period of four months, from October 2024 to January 2025.
Study population:
The target population comprised MBBS undergraduate students enrolled in the institution during the study period. Students from all academic years were eligible, but only MBBS students who provided informed consent were included.
Sample size and sampling technique:
A total of 44 MBBS students participated in the study. Participants were recruited using convenience sampling, ensuring representation from both pre-clinical (Years 1–2) and clinical phases (Years 3–final).
Inclusion criteria:
Currently enrolled MBBS students at Government Medical College, Mehboob Nagar.
Willing to participate and provide informed consent.
Exclusion criteria:
Students absent during the data collection period.
Interns and postgraduate medical trainees.
Data collection tool:
A pre-validated, structured questionnaire was used, adapted from previous studies on self-medication practices. The tool collected data on demographic details, self-medication episodes in the last six months, indications, drug classes, sources of information, reasons for self-medication, and safety-related behaviours.
Data collection procedure:
Questionnaires were distributed in person after explaining the study objectives. Anonymity was maintained, and participants completed the forms without faculty supervision to minimise social desirability bias.
Statistical analysis:
Data were entered into Microsoft Excel and analysed using SPSS version XX. Descriptive statistics (mean, standard deviation, frequencies, percentages) were calculated. Associations between self-medication and participant characteristics were tested using the chi-square (χ²) test, with p < 0.05 considered statistically significant.
A total of 44 MBBS students were included in the study, with a mean age of 20.5 ± 1.4 years. Females constituted 54.5% of the sample, and the majority were in the clinical years (59.1%) and residing in hostels (63.6%) (Table 1).
Table 1. Baseline characteristics of MBBS participants (n = 44)
|
Variable |
Category |
n |
% |
|
Age (years) |
Mean ± SD |
20.5 ± 1.4 |
— |
|
Sex |
Male |
20 |
45.5 |
|
|
Female |
24 |
54.5 |
|
Year of study |
Pre-clinical (1–2) |
18 |
40.9 |
|
|
Clinical (3–final) |
26 |
59.1 |
|
Residence |
Hostel |
28 |
63.6 |
|
|
Day scholar |
16 |
36.4 |
The prevalence of self-medication within the past six months was 68.2% (30/44). Among these, 60.0% reported a single episode, while 40.0% had two or more episodes during the reference period (Table 2).
Table 2. Prevalence and frequency of self-medication in the past 6 months
|
Variable |
n |
% |
|
Self-medication reported |
30 |
68.2 |
|
1 episode |
18 |
60.0* |
|
≥2 episodes |
12 |
40.0* |
*Percentage calculated among self-medicators (n = 30).
The most frequent indications for self-medication were headache/musculoskeletal pain (66.7%), common cold/upper respiratory infection (53.3%), and allergic symptoms (33.3%), followed by dyspepsia (26.7%) and diarrhea (16.7%) (Table 3).
Table 3. Indications for self-medication (multiple responses allowed; n = 30)
|
Indication |
n |
% |
|
Headache / musculoskeletal pain |
20 |
66.7 |
|
Common cold / URI |
16 |
53.3 |
|
Allergic symptoms |
10 |
33.3 |
|
Dyspepsia / acid peptic symptoms |
8 |
26.7 |
|
Diarrhea |
5 |
16.7 |
Analgesics and NSAIDs (63.6%) were the most commonly used drug classes, followed by antipyretics (61.4%), antihistamines (43.2%), and antibiotics (27.3%) (Table 4).
Table 4. Commonly used medicine classes (multiple responses allowed; n = 44)
|
Drug class |
n |
% |
|
NSAIDs / analgesics |
28 |
63.6 |
|
Antipyretics |
27 |
61.4 |
|
Antihistamines |
19 |
43.2 |
|
Antibiotics |
12 |
27.3 |
|
Proton-pump inhibitors / H2 blockers |
10 |
22.7 |
|
Cough suppressants / expectorants |
8 |
18.2 |
|
ORS / antidiarrheals |
6 |
13.6 |
|
Topical agents |
5 |
11.4 |
The leading sources of information guiding self-medication were previous prescriptions (56.7%) and advice from retail pharmacists (50.0%), with fewer students relying on internet/social media (26.7%) or peers/family (10.0%) (Table 5).
Table 5. Sources of information for self-medication (multiple responses allowed; n = 30)
|
Source of information |
n |
% |
|
Previous prescription |
17 |
56.7 |
|
Advice from retail pharmacist |
15 |
50.0 |
|
Internet / social media |
8 |
26.7 |
|
Peers / family |
3 |
10.0 |
The most frequently cited reasons for self-medication were the perception of illness as minor (66.7%) and time-saving/convenience (53.3%), followed by cost considerations (30.0%) and previous benefit with the same drug (26.7%) (Table 6).
Table 6. Reasons for self-medication (multiple responses allowed; n = 30)
|
Reason |
n |
% |
|
Illness perceived as minor |
20 |
66.7 |
|
Time-saving / convenience |
16 |
53.3 |
|
Cost considerations |
9 |
30.0 |
|
Previous benefit with same drug |
8 |
26.7 |
Regarding safety behaviours, most self-medicators reported always checking expiry dates (90.0%), while 56.7% read dosage labels. A minority (16.7%) stored leftover antibiotics, and 13.3% experienced minor adverse effects (Table 7).
Table 7. Safety-related behaviours among MBBS self-medicators (n = 30)
|
Behaviour |
n |
% |
|
Always read labels |
17 |
56.7 |
|
Always check expiry date |
27 |
90.0 |
|
Keep leftover antibiotics |
5 |
16.7 |
|
Reported adverse effects |
4 |
13.3 |
Bivariate analysis showed a higher prevalence of self-medication among clinical-year students (76.9%) compared to pre-clinical students (55.6%), though the difference was not statistically significant (p = 0.0837). No significant associations were found with residence or sex (Table 8).
Table 8. Factors associated with self-medication among MBBS students (n = 44)
|
Factor |
Self-medication present n (%) |
χ² |
p-value |
|
Year of study |
Pre-clinical: 10 (55.6) |
2.99 |
0.0837 |
|
|
Clinical: 20 (76.9) |
|
|
|
Residence |
Hostel: 20 (71.4) |
0.56 |
0.4543 |
|
|
Day scholar: 10 (62.5) |
|
|
|
Sex |
Male: 15 (75.0) |
1.05 |
0.3050 |
|
|
Female: 15 (62.5) |
|
|
Antibiotic self-medication was lower among students with prior antimicrobial stewardship (AMS) teaching (20.0%) compared to those without (33.3%), but the difference did not reach statistical significance (p = 0.3009) (Table 9).
Table 9. Antibiotic self-medication by prior AMS teaching
|
AMS exposure |
Antibiotic self-medication n (%) |
χ² |
p-value |
|
Yes (n = 20) |
4 (20.0) |
1.07 |
0.3009 |
|
No (n = 24) |
8 (33.3) |
|
|
This study revealed that nearly two-thirds (68.2%) of MBBS undergraduates at Government Medical College, Mehboob Nagar reported practising self-medication within the preceding six months. This prevalence is comparable to findings from similar Indian studies among medical students, where reported rates range from 57% to 76% [1–3], but lower than some international reports exceeding 80% [4,5]. The lower prevalence in our cohort may be attributed to ongoing curricular emphasis on rational drug use and greater awareness regarding antimicrobial resistance.
The most frequent indications for self-medication in our study were headache/musculoskeletal pain, common cold/URI, and allergic symptoms. These align closely with patterns observed in prior studies [6,7], where minor, self-limiting illnesses were the predominant triggers for self-medication. NSAIDs/analgesics and antipyretics were the most commonly used drugs, consistent with earlier findings [8,9]. Of concern, however, was the use of antibiotics by 27.3% of participants, reflecting continued access to prescription-only drugs without medical consultation. This is notable in the context of India’s ongoing challenge with over-the-counter antibiotic sales [10].
Previous prescriptions and pharmacists were the primary sources of information, supporting earlier observations that pharmacy access and prior treatment history are major facilitators of self-medication among medical students [6,8]. While most respondents reported safe practices such as checking expiry dates (90%), unsafe behaviours like storing leftover antibiotics (16.7%) persisted, raising concerns regarding the potential for inappropriate future use.
Though clinical-year students exhibited higher self-medication prevalence compared to pre-clinical peers (76.9% vs 55.6%), the difference did not reach statistical significance. This trend is supported by studies suggesting that increasing clinical exposure enhances confidence in self-prescribing [5,7]. Notably, students with prior antimicrobial stewardship training reported lower antibiotic self-medication, albeit without statistical significance, underscoring the potential role of targeted educational interventions.
This study shows that self-medication is a common practice among MBBS undergraduates, with nearly seven in ten reporting it in the previous six months. Most instances involved minor ailments and non-prescription medicines such as NSAIDs and antipyretics; however, the use of antibiotics by over one-quarter of participants is concerning. Clinical-year students exhibited a higher prevalence than pre-clinical peers, and although awareness of expiry dates was high, unsafe habits such as keeping leftover antibiotics were still noted. These findings highlight the need for sustained education on rational medicine use, strict regulation of antibiotic dispensing, and early integration of antimicrobial stewardship training in the medical curriculum.
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