Determining Factors in Self-medication with Non-prescribed Antibiotics: A Preliminary Qualitative Study in Cambodian Pharmacy Students based on the Theory of Planned Behavior

Abstract

Objectives: To explore Cambodian pharmacy students’ behavior in relation to self-medication with non-prescribed antibiotics and to adopt the Theory of Planned Behavior (TPB) to elicit determining factors, i.e., their attitudes toward using non-prescribed antibiotics for self-medication, perceived subjective norm of self-medication with antibiotics and perceived behavioral control of self-medication without antibiotics. Method: This was a qualitative study. Twenty pharmacy students year 3 to year 5 from the Faculty of Pharmacy of one university in Cambodia were interviewed online. Data analysis was conducted using content analysis. Result: Sixteen participants used antibiotics for self-medication. The symptoms that they self-treated with antibiotics were sore throat (n=6), diarrhea (n=5), cough (n=3), flu (n=6), infected wound (n=2) and severe acne (n=2). The common sources of antibiotics were from pharmacies and existing supplies at home. Most participants indicated that using antibiotics was beneficial as it saved time and money and helped the symptoms to be cured quickly. However, few participants were of the view that using antibiotics could cause antibiotic resistance. Family members and close friends were their main references in self-medication practice. Most of their reference group self-medicated with antibiotics and suggested that they do so. However, most participants did not feel pressured to follow their reference’s suggestions. They were confident that they can control themselves not to self-medicate with antibiotics if they felt that was preferable. The findings from this study also suggested a hypothesis that, in Cambodian pharmacy students, their positive attitudes toward using antibiotics for self-medication may discourage them from practicing self-medication without antibiotics; subjective norm may not have influence on their practice, where their perceived behavioral control may encourage them to self-medicate without antibiotics. Conclusion: In the next study, we suggest conducting a quantitative study to test this proposed hypothesis. In addition, the findings of this qualitative study elicited useful themes that can be used to develop a scale to measure each component of the TPB for the next quantitative study.