中国中老年人自我药疗发生率及影响因素研究:基于CHARLS 2011年,2013年和2015年的面板数据（英文）
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摘要
自我药疗行为越来越普遍,对中国中老年人健康有着重要影响。本研究分析了中国中老年人自我药疗的发生率,并探讨了自我药疗行为的影响因素。自我药疗发生率的计算方式为自我药疗的人数除以整个人群的数量。使用面板数据随机效应模型分析自我药疗行为的影响因素。数据来自2011年、2013年和2015年中国健康与养老追踪调查数据库,删除缺失值后, 2011年、2013年和2015年的样本量分别为16 962、17 876、19 572。计算得到三年自我药疗的平均发生率为45.52%。平均11.70%的受访者使用处方药进行了自我药疗。生活在城市(P=0.009)和西部地区(P=0.000)的调查对象自我药疗发生率较高。政府应对自我药疗发生率较高的中老年人群体,如生活在中西部地区和城市的人,加强合理使用自我药疗的指导。
Self-medication is an increasingly frequent phenomenon worldwide and has an important influence on health. In this study, we analyzed the self-medication prevalence rate in Chinese middle-aged and elderly people, and explored the influence factors. The data from China Health and Retirement Longitudinal Study(CHARLS) in 2011, 2013 and 2015 were used. Self-medication prevalence was calculated as the number of whole people divided by the number of people taking self-medication. The influence factors of self-medication were analyzed by panel data random effect model. We excluded observations with missing values in our analysis, leaving 16 962, 17 876 and 19 572 observations in 2011, 2013 and 2015, respectively. The average 3-year self-medication prevalence was 45.52%. Moreover, 11.70% of respondents practiced self-medication with prescription medicine in 2011, 2013 and 2015. Respondents living in non-rural areas(P = 0.009) and western region(P = 0.000) took more self-medication. Self-medication was a common phenomenon among middle-aged and elderly population in China. The government should strengthen the guidance for the middle-aged and elderly people who took more self-medication, such as those living in urban and western region.
Self-medication is an increasingly frequent phenomenon worldwide and has an important influence on health. In this study, we analyzed the self-medication prevalence rate in Chinese middle-aged and elderly people, and explored the influence factors. The data from China Health and Retirement Longitudinal Study(CHARLS) in 2011, 2013 and 2015 were used. Self-medication prevalence was calculated as the number of whole people divided by the number of people taking self-medication. The influence factors of self-medication were analyzed by panel data random effect model. We excluded observations with missing values in our analysis, leaving 16 962, 17 876 and 19 572 observations in 2011, 2013 and 2015, respectively. The average 3-year self-medication prevalence was 45.52%. Moreover, 11.70% of respondents practiced self-medication with prescription medicine in 2011, 2013 and 2015. Respondents living in non-rural areas(P = 0.009) and western region(P = 0.000) took more self-medication. Self-medication was a common phenomenon among middle-aged and elderly population in China. The government should strengthen the guidance for the middle-aged and elderly people who took more self-medication, such as those living in urban and western region.
引文
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[24]Montgomery,A.J.;Bradley,C.;Rochfort,A.;Panagopoulou,E.A review of self-medication in physicians and medical students.Occup.Med(Lond).2011,61,490-497.
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[26]de Oliveira,M.A.;Francisco,P.M.;Costa,K.S.;Barros,M.B.Self-medication in the elderly population of Campinas,S?o Paulo State,Brazil:prevalence and associated factors.Cad.Saude Publica.2012,28,335-345.
[27]Ramalhinho,I.;Cordeiro,C.;Cavaco,A.;Cabrita,J.Assessing determinants of self-medication with antibiotics among Portuguese people in the Algarve Region.Int.J.Clin.Pharm.2014,36,1039-1047.
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[29]Awad,A.I.;Eltayeb,I.B.;Capps,P.A.Self-medication practices in Khartoum state,Sudan.Eur.J.Clin.Pharmacol.2006,62,317-324.
[30]World Health Organization.Guidelines for the medical assessment of drugs for use inself-medication.WHO,Regional for Europe,1986[J].
[31]Dong,C.L.Study on the Current Situation and Influencing Factors of Self-medication of Permanent Residents in Shanghai Rural Areas.Ph.D.thesis,The Second Military Medical University,2012.
[32]Kumar,A.;Vandana,,Aslami,A.N.Analgesics selfmedication and its association with sleep quality among medical undergraduates.J.Clin.Diagn.Res.2016,10,FC07-FC11.
[33]Arrais,P.S.D.;Fernandes,M.E.P.;da Silva dal Pizzol,T.;Ramos,L.R.;Mengue,S.S.;Luiza,V.L.;Tavares,N.U.L.;Farias,M.R.;Oliveira,M.A.;Bertoldi,A.D.Prevalence of self-medication in Brazil and associated factors.Rev.Saude.Publica.2016,50(suppl 2),1s-11s.
[34]Ma,J.J.Public Health Expenditure,Health Capital and Economic Growth--An Empirical Analysis of Western Region of China.Ph.D.thesis,Central University of Finance and Economics,2015.
[35]Ivanovska,V.;Zdravkovska,M.;Bosevska,G.;Angelovska,B.Antibiotics for upper respiratory infections:public knowledge,beliefs and self-medication in the Republic of Macedonia.Pril(Makedon Akad Nauk Umet Odd Med Nauki).2013,34,59-70.
[36]Amoako,E.P.;Richardson-Campbell,L.;KennedyMalone,L.Self-medication with over-the-counter drugs among elderly adults.J.Gerontol.Nurs.2003,29,10-15.
[37]Sapkota,A.R.;Coker,M.E.;Rosenberg Goldstein,R.E.;Atkinson,N.L.;Sweet,S.J.;Sopeju,P.O.;Ojo,M.T.;Otivhia,E.;Ayepola,O.O.;Olajuyigbe,O.O.;Shireman,L.;Pottinger,P.S.;Ojo,K.K.Self-medication with antibiotics for the treatment of menstrual symptoms in southwest Nigeria:a cross-sectional study.BMC Public.Health.2010,10,610.
[38]Sawalha,A.F.A descriptive study of self-medication practices among Palestinian medical and nonmedical university students.Res.Social Adm.Pharm.2008,4,164-172.
[39]Hu,Y.H.Study on Self-Medication Behavior of the Citizens.Ph.D.thesis,Huazhong University of Science and Technology,2007.
[2]Machado-Alba,J.E.;Echeverri-Cata?o,L.F.;Londo?o-Builes,M.J.;Moreno-Gutiérrez,P.A.;Ochoa-Orozco,S.A.;Ruiz-Villa,J.O.Social,cultural and economic factors associated with self-medication.Biomedica.2014,34,580-588.
[3]Hughes,C.M.;McElnay,J.C.;Fleming,G.F.Benefits and risks of self medication.Drug Saf.2001,24,1027-1037.
[4]Ruiz,M.E.Risks of self-medication practices.Curr.Drug Saf.2010,5,315-323.
[5]Mumtaz,Y,;Jahangeer,S.M.A.;Mujtaba,T.Self medication among university students of Karachi.J.Liaquat Uni.Med.Health Sci.2011,10,102-105.
[6]Alavi,N.M.;Alami,L.;Taefi,S.;Sadafi,Z.Self treatment in diabetes mellitus in Kashan.Iran.J.Endocrinol.Metab.2010,12,237-242,312.
[7]Awad,A.I.;Eltayeb,I.B.Self-medication practices with antibiotics and antimalarials among Sudanese undergraduate university students.Ann.Pharmacother.2007,41,1249-1255.
[8]Ouédraogo,L.T.;Somé,I.T.;Diarra,M.;Guissou,I.P.Self-medication in the treatment of acute malaria:study based on users of private health drug stores in Ouagadougou,Burkina Faso.Bull.Soc.Pathol.Exot.2008,101,124-127.
[9]Nayir,T.;Okyay,R.A.;Yesilyurt,H.;Akbaba,M.;Nazl?can,E.;Ac?k,Y.;Akkus,H.I.Assessment of rational use of drugs and self-medication in Turkey:A pilot study from Elaz?g and its suburbs.Pak.J.Pharm.Sci.2016,29,1429-1435.
[10]Papakosta,M.;Zavras,D.;Niakas,D.Investigating factors of self-care orientation and self-medication use in a Greek rural area.Rural Remote Health.2014,14,2349.
[11]Balamurugan,E.;Ganesh,K.Prevalence and pattern of self medication use in coastal regions of south india.Br.J.Med.Pract.2011,4,428-430.
[12]Okumura,J.;Wakai,S.;Umenai,T.Drug utilisation and self-medication in rural communities in Vietnam.Soc.Sci.Med.2002,54,1875-1886.
[13]Fuentes Albarrán,K.;Villa Zapata,L.Analysis and quantification of self-medication patterns of customers in community pharmacies in southern Chile.Pharm.World.Sci.2008,30,863-868.
[14]Yusuff,K.B.;Omarusehe,L.D.Determinants of self medication practices among pregnant women in Ibadan,Nigeria.Int.J.Clin.Pharm.2011,33,868-875.
[15]Figueiras,A.;Caama?o,F.;Gestal-Otero,J.J.Sociodemographic factors related to self-medication in Spain.Eur.J.Epidemiol.2000,16,19-26.
[16]Grigoryan,L.;Burgerhof,J.G.;Degener,J.E.;Deschepper,R.;Lundborg,C.S.;Monnet,D.L.;Scicluna,E.A.;Birkin,J.;Haaijer-Ruskamp,F.M.Self-Medication with Antibiotics and Resistance(SAR)Consortium.Determinants of self-medication with antibiotics in Europe:the impact of beliefs,country wealth and the healthcare system.J.Antimicrob.Chemother.2008,61,1172-1179.
[17]Peng,Y.C.;Chang,W.H.;Zhou,H.Q.;Hu,H.P.;Liang,W.N.Factors associated with health-seeking behavior among migrant workers in Beijing,China.BMC Health Serv.Res.2010,10,69.
[18]Wen,Y.;Lieber,E.;Wan,D.;Hong,Y.H.;NIMHCollaborative HIV/STD Prevention Trial Group.A qualitative study about self-medication in the community among market vendors in Fuzhou,China.Health Soc.Care.Community.2011,19,504-513.
[19]The Harmonized CHARLS dataset.http://charls.pku.edu.cn/zh-CN/page/data/harmonized_charls.Accessed 4 Apr.2019.
[20]The CHARLS.http://charls.pku.edu.cn/en.Accessed4 Apr.2009.
[21]Ding,X.J.;Billari,F.C.;Gietel-Basten,S.Health of midlife and older adults in China:the role of regional economic development,inequality,and institutional setting.Int.J.Public.Health.2017,62,857-867.
[22]Guo,X.P.;Ren,D.F.;Shi,J.X.Carbon emissions,logistics volume and GDP in China:empirical analysis based on panel data model.Environ.Sci.Pollut.Res.Int.2016,23,24758-24767.
[23]Chang,H.X.;Yan,Y.;Shan,T.The Application of Panel Data Model about Infant Growth and Development Evaluation.Chin.J.Health Statistics.2015.
[24]Montgomery,A.J.;Bradley,C.;Rochfort,A.;Panagopoulou,E.A review of self-medication in physicians and medical students.Occup.Med(Lond).2011,61,490-497.
[25]Carrasco-Garrido,P.;Hernández-Barrera,V.;López de Andrés,A.;Jiménez-Trujillo,I.;Jiménez-García,R.Sex-Differences on self-medication in Spain.Pharmacoepidem.Drug Saf.2010,19,1293-1299.
[26]de Oliveira,M.A.;Francisco,P.M.;Costa,K.S.;Barros,M.B.Self-medication in the elderly population of Campinas,S?o Paulo State,Brazil:prevalence and associated factors.Cad.Saude Publica.2012,28,335-345.
[27]Ramalhinho,I.;Cordeiro,C.;Cavaco,A.;Cabrita,J.Assessing determinants of self-medication with antibiotics among Portuguese people in the Algarve Region.Int.J.Clin.Pharm.2014,36,1039-1047.
[28]Zhao,Z.J.Global practice of self-medication.China Drug Store.2006,1,56-57.
[29]Awad,A.I.;Eltayeb,I.B.;Capps,P.A.Self-medication practices in Khartoum state,Sudan.Eur.J.Clin.Pharmacol.2006,62,317-324.
[30]World Health Organization.Guidelines for the medical assessment of drugs for use inself-medication.WHO,Regional for Europe,1986[J].
[31]Dong,C.L.Study on the Current Situation and Influencing Factors of Self-medication of Permanent Residents in Shanghai Rural Areas.Ph.D.thesis,The Second Military Medical University,2012.
[32]Kumar,A.;Vandana,,Aslami,A.N.Analgesics selfmedication and its association with sleep quality among medical undergraduates.J.Clin.Diagn.Res.2016,10,FC07-FC11.
[33]Arrais,P.S.D.;Fernandes,M.E.P.;da Silva dal Pizzol,T.;Ramos,L.R.;Mengue,S.S.;Luiza,V.L.;Tavares,N.U.L.;Farias,M.R.;Oliveira,M.A.;Bertoldi,A.D.Prevalence of self-medication in Brazil and associated factors.Rev.Saude.Publica.2016,50(suppl 2),1s-11s.
[34]Ma,J.J.Public Health Expenditure,Health Capital and Economic Growth--An Empirical Analysis of Western Region of China.Ph.D.thesis,Central University of Finance and Economics,2015.
[35]Ivanovska,V.;Zdravkovska,M.;Bosevska,G.;Angelovska,B.Antibiotics for upper respiratory infections:public knowledge,beliefs and self-medication in the Republic of Macedonia.Pril(Makedon Akad Nauk Umet Odd Med Nauki).2013,34,59-70.
[36]Amoako,E.P.;Richardson-Campbell,L.;KennedyMalone,L.Self-medication with over-the-counter drugs among elderly adults.J.Gerontol.Nurs.2003,29,10-15.
[37]Sapkota,A.R.;Coker,M.E.;Rosenberg Goldstein,R.E.;Atkinson,N.L.;Sweet,S.J.;Sopeju,P.O.;Ojo,M.T.;Otivhia,E.;Ayepola,O.O.;Olajuyigbe,O.O.;Shireman,L.;Pottinger,P.S.;Ojo,K.K.Self-medication with antibiotics for the treatment of menstrual symptoms in southwest Nigeria:a cross-sectional study.BMC Public.Health.2010,10,610.
[38]Sawalha,A.F.A descriptive study of self-medication practices among Palestinian medical and nonmedical university students.Res.Social Adm.Pharm.2008,4,164-172.
[39]Hu,Y.H.Study on Self-Medication Behavior of the Citizens.Ph.D.thesis,Huazhong University of Science and Technology,2007.