Knowledge, attitudes, convenience and practice of self-medication among university students of Bangladesh: Structural equation modeling

Knowledge, attitudes, convenience and practice of self-medication among university students of Bangladesh: Structural equation modeling | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Knowledge, attitudes, convenience and practice of self-medication among university students of Bangladesh: Structural equation modeling Mortuja Mahamud Tohan, Faysal Ahmed, Israt Jahan Juie, Anamul Kabir, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3327159/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 12 May, 2024 Read the published version in Scientific Reports → Version 1 posted 8 You are reading this latest preprint version Abstract Self-medication is a prevalent practice among university students globally and is a significant public health concern. However, previous research has been limited in scope, focusing primarily on specific student groups or the general public, leaving a gap in understanding the causal relationships associated with self-medication; this study aims to investigate the factors influencing self-medication practices among university students in Bangladesh by developing a comprehensive causal model. Data from 417 students across five public universities were collected using the random walk technique by a team of 10 members. The study utilized constructs of knowledge, attitude, and convenience related to self-medication as independent variables, with self-medication practice as the dependent variable. One-way ANOVA and structural equation modeling were employed to develop a causal model of self-medication practice among university students in Bangladesh. The findings revealed that students with better medication knowledge and adverse drug reactions (ADRs) were more likely to practice self-medication. A positive attitude towards self-medication and ADRs was also significantly associated with higher self-medication practice scores. Additionally, those who perceived self-medication as convenient and prescribed medication as inconvenient had higher self-medication practice scores. The attitude towards self-medication had the most substantial negative effect on self-medication practice, followed by the inconvenience of prescribed medication and the convenience of self-medication. The model explained 87% of the variance in self-medication practice, indicating a good fit for the data. University students in Bangladesh possess intermediate knowledge of medication and primary knowledge of ADRs. They exhibit a positive attitude towards self-medication and ADRs. Physical convenience favors self-medication, while the inconvenience of prescribed medication contributes to its lower preference. Policymakers should focus on evidence-based guidelines for self-medication and enhance the quantity and accessibility of prescribed medications to address the issue effectively. Health sciences/Health care Health sciences/Medical research Health sciences/Risk factors Knowledge attitudes practice self-medication students Bangladesh Figures Figure 1 Background Self-medication, defined as the practice of diagnosing and treating one's own illnesses without seeking professional medical advice, is a common practice among university students worldwide and is considered a significant public health concern ( 1 – 3 ). While self-medication is considered a convenient way to address common health issues, it poses significant health risks, such as adverse drug reactions, drug interactions, and treatment failure ( 4 – 6 ). Self-medication can also lead to antibiotic resistance, a global health challenge ( 7 ). The misuse and ineffective utilization of medications are significant issues worldwide, with approximately 68% of European countries and 42% of American nations reporting such problems ( 4 , 8 ). Both developed, and developing countries commonly engage in self-medication, although the prevalence is higher in developing nations ( 5 ). The occurrence of self-medication in developing countries exhibits a wide range, spanning from 12.7–95% ( 9 ). South Asian countries, in particular, demonstrate higher rates of self-medication. For instance, Nepal has a rate of 59%, Pakistan has 51%, and Bangladesh shows rates of 81.3% among the younger population and 78.5% among the elderly ( 10 ). If self-mediation is used responsibly, it can help conserve limited medical resources by addressing minor ailments, the burden on healthcare facilities, and reduce costs and time associated with seeking professional care for minor illnesses ( 11 ). Due to that, WHO has pointed out that appropriate self-medication can be beneficial in treating acute ailments that do not require medical consultation. But it also has a flip side which can cause serious problems such as adverse drug reactions, treatment failure, antimicrobial resistance, etc. In Bangladesh, antimicrobial resistance is a significant issue, primarily attributed to unethical drug sales practices. A recent petition filed in the High Court of Bangladesh aimed to address this problem by seeking legal action against the immoral selling of drugs( 12 ). It was highlighted that as much as 80% of deaths caused by infections were linked to antimicrobial resistance( 13 ). Although recently the healthcare system of Bangladesh has expanded its coverage and infrastructure has also improved substantially still it is considered suffering a budget shortage as only 5.4% of the GDP is allocated for its national healthcare system. ( 14 ). Consequently, there is a lack of accessible health insurance, both at the national and private levels ( 15 ). In addition, the prevalence of self-medication in the country is exacerbated by the presence of unethical drug sellers, inadequate regulatory measures, and the widespread availability of prescription drugs without the requirement of a prescription ( 16 ). These factors collectively contribute to the high prevalence of self-medication practices in Bangladesh. University students, particularly in developing countries, are highly susceptible to self-medication due to influential factors such as media and internet exposure promoting this behavior. Additionally, factors such as low perception of associated risks, easy access to the internet, increased pharmaceutical advertising without regulation, availability of drugs, level of education, and social status contribute to this trend ( 17 , 18 ). Previous studies have reported high prevalence rates of self-medication among university students, including rates of approximately 76% in Karachi, Pakistan ( 17 ), 87% in India ( 19 ), 98% in Palestine ( 20 ), and 43.2% in Ethiopia ( 21 ). Among university students, the prevalence of self-medication is notably high ( 22 ). However, irresponsible self-medication can lead to various negative consequences. It is crucial to identify the influences on self-medication practices among university students, considering that they are generally knowledgeable about medication yet still susceptible to engaging in high levels of self-medication. Factors such as knowledge and literacy ( 23 , 24 ), attitude ( 25 , 26 ), and the convenience of self-medication ( 27 , 28 ) have a significant impact on self-medication practices. However, how these variables specifically affect university students nationwide remains uncertain. Additionally, the inconvenience of prescribed medication (e.g., high cost, unavailability) in Bangladesh may also play a distinct role in self-medication practices among university students ( 15 , 16 ). Previous studies in Bangladesh have primarily focused on self-medication among medical or medical-related students ( 9 , 29 , 30 ) or the general public ( 13 , 31 ), lacking a comprehensive understanding of the causal relationships among self-medication practices and other factors. Addressing this research gap, this study aims to investigate the factors (knowledge, attitudes, and convenience) influencing self-medication practices among university students in Bangladesh by developing a causal model. Methods and materials Study Design and source of data This cross-sectional descriptive study utilized primary data collected from March 21 to April 29, 2023 using a pre-structured questionnaire. This research incorporates quantitative method to analyse data using various statistical modelling techniques, including the application of structural equation modelling (SEM). The data was obtained through face-to-face interview techniques. Study area and population This study includes students from five public universities in Bangladesh. These universities are located in different regions of Bangladesh, and their students come from diverse backgrounds and cultures. Those universities have approximately 78000 students in undergraduate and graduation program ( supplementary table 1 ). This study includes both undergraduate and graduate students. The inclusion criteria are that the person needs to be 1: an enrolled student from one of the selected universities, 2: currently continuing their study, 3: Is willing to participate in the data collection process. Any student who is physically incapable of providing the required information is disregarded from this study. Questionnaire development Researchers used a structured five-part questionnaire where each question was considered vital for the research. Questionnaires were first translated into Bangla and then again transformed into English to maintain meaning and consistency. Researchers translated the questionnaire to ask the questions to the participants. As suggested by previous studies, the questionnaires were pre-tested within Khulna University with 30 students before finalizing them for data acquisition ( 32 , 33 ). Dependent variable This study's dependent variable comprises three parts, each indicating critical aspects of self-medication practice. The first part ( Code: PR-1 ) includes a question about the problem for which the respondent takes self-medication. The problems are divided into three body sections: head, main body, and leg area, with 12 problems for each section which are more prevalent in developing nations ( 34 ). Respondents choose the problems for which they take self-medication, and the researcher sums up all the reasons, giving a range of 0 to 36, with a higher number indicating a greater self-medication practice ( supplementary table 2 ). The second part ( Code: PR-2 ) includes a self-medication practice scale comprising 8 questions with a 5-point Likert scale ( supplementary table 3 ). The questions are structured positively with no reverse questions. Researchers sum up the end result within a range of 8 to 40, with a higher score indicating a higher level of self-medication practice. The third part ( Code: PR-3 ) includes questions about the drugs used for self-medication, with 10 different medicine groups most frequently used worldwide ( supplementary table 4 ). The researcher incorporated a 5-point Likert scale to measure the practice of consuming those medicines without a prescription. The final score of this scale is also counted by summing up all the individual questions ranging from 10 to 50, with a higher score indicating a greater level of self-medication practice. Independent variables The study examines the holistic model of self-medication among varsity students by considering four independent variables: knowledge, attitude, convenience of self-medication, and inconvenience of prescribed medication. Each independent variable is assessed using multiple questions presented with a 5-point Likert scale. The internal consistency and reliability of each construct were measured and found to be within the recommended level. Respondents' knowledge is divided into two dimensions: knowledge of medication and medicine groups and knowledge about adverse drug reactions (ADR). Similarly, attitude is divided into two parts: attitude towards self-medication and attitude towards ADR. In Bangladesh, the convenience of self-medication is considered in two phases: convenience of self-medication and inconvenience of prescribed medication. For the Analysis of Variance, the researcher categorizes each construct into three ordinal categories based on the total score of that construct. To obtain a holistic view, the structured equation model includes all elements of each dimension that have a factor loading score of > 0.5 . Table 1 demonstrates the constructs of the independent variables. The study disregards demographic characteristics from the primary model due to their inconsistency with the research objectives. Table 1 Construct of independent variables Variables Codes Groups Knowledge about medication Kn-1-1 Primary (6–14), Moderate (15–22), Advanced (23–30) a) Content Not at all, A little, Some, Quite a bit, Very much b) Doze c) Regimen (Time) d) Duration of therapy e) Precautions f) Effectiveness Knowledge about medicine group Kn-1-2 Primary (10–25), Moderate (26–40), Advanced (41–50) a) Painkillers ( Ex: Diclofenac, Aspirin) Not at all, A little, Some, Quite a bit, Very much b) Anti-acids (Ex: Maxpro, Sergel, Seclo) c) Paracetamol (Ex: Napa, Ace plus) d) Sleeping pills (Ex: Rivotril, Milam) e) Antibiotics (Ex: Gmax, Amodis, Flazil) f) Vitamins (Ex: Dextram gold, E-cap) g) Anti-allergies (Ex: Encilor, Rupa) h) Cough-syrup (Ex: Dexpoten, Bashok) i) Herbal (Ex: Sinkara) j) Anti-Migraine (Ex: Tafnil, Pyrinol) Knowledge about ADR KN-2 Primary (6–14), Moderate (15–22), Advanced (23–30) Knowledge about Adverse Drug Reactions (ADR) Kn-2-1 Not at all, A little, Some, Quite a bit, Very much Knowledge about the difference between Side Effects and Adverse Events related to drugs Kn-2-2 Knowledge about the cause of ADR Kn-2-3 Knowledge about buying and consuming medicines without a prescription Kn-2-4 Knowledge about ADR due to not completing or missing the timing of medicine dose. Kn-2-5 Attitude towards self-medication AT-1 Positive (6–17), Undecided (18–23), Negative (24–36) Self-medication is not acceptable AT-1-1 Strongly disagree, Disagree, Unsure, Agree, Strongly agree Students do not have ability to treat symptoms AT-1-2 Self-medication would be harmful AT-1-3 Medical license is essential for medication AT-1-4 Pharmacist is a better source of advice AT-1-5 We should be careful with non-prescribed medicine AT-1-6 Attitude towards ADR AT-2 Positive (4–9), Undecided (10–14), Negative (15–20) ADR reporting by the public is necessary AT-2-1 Strongly disagree, Disagree, Unsure, Agree, Strongly agree People made aware about ADR reporting. AT-2-2 Attend a pharmacovigilance awareness program AT-2-3 Concerned about counterfeit medicines AT-2-4 Physical convenience of self-medication CN-1 Slightly (5–11), Moderately (12–18), Highly (19–25) Buy and store medicine without prescription is easy CN-1-1 Not at all, A little, Some, Quite a bit, Very much Google can provide necessary information CN-1-2 Previous prescription can suggest CN-1-3 Self-medication is very time saving CN-1-4 Self-medication gives quick relief CN-1-5 Physical inconvenience of prescribed-medication CN-2 Slightly (5–11), Moderately (12–18), Highly (19–25) Health care centers are in a distant position CN-2-1 Not at all, A little, Some, Quite a bit, Very much Pharmacies are not always readily available CN-2-2 Pharmacy drug provider have limited knowledge CN-2-3 Cost of private medical or doctors is very high CN-2-4 Using health call centers is not convenient CN-2-5 Sample size determination The cross-sectional survey was conducted from March 21 to April 29, 2023, utilizing Taro Yamane's (1967) technique to determine the sample size. Considering a 10% non-response rate, 436 respondents were selected, with a 98% confidence level and a 5% margin of error. Eventually, after sorting all the incomplete and faulty datasets, responses from 417 respondents were collected and included for analysis. Data collection procedure The data collection technique employed in this study was a random walk, which was the most suitable technique for clusters based on previous research ( 35 , 36 ). A team of ten trained members carried out the survey. Before data collection, the group underwent a full-day training session covering the data collection procedure, ethics, and obtaining consent. The final sample consisted of 436 participants, and it was divided proportionately among five selected universities based on their student populations. Upon approaching each university, the data collection team divided the campus into blocks and initiated data collection from the main entrance. They proceeded clockwise for one minute and approached the nearest respondent, who fulfilled all the inclusion criteria. This process was repeated until the predetermined quota was achieved. In cases where a selected respondent declined to cooperate, the team labeled it a non-response and continued with the data collection process. The same technique was applied consistently throughout the entire data collection phase. Statistical analysis During the data curation process, the interviewer reported a non-response rate of approximately 3%. Additionally, 8 respondents were disregarded due to missing or improper data, resulting in 417 data sets being considered for analysis. The data were stored, coded with appropriate weights, and categorized based on knowledge, attitude, convenience, and practice segments. Descriptive analysis was performed to present the data, followed by one-way ANOVA with post-hoc Least Significant Difference (LSD) to identify any mean differences among groups, showing which group used more self-medication. Finally, a Structural Equation Model (SEM) was developed to assess the causal relationship between self-medication practice with knowledge, attitude, and convenience. This model was used to identify the holistic causal relationship to get a better and more decisive view of the factors behind self-medication. The internal consistency of the questions for each section was assessed using Composite reliability and Average variance extracted (AVE). The results for every scale used were within the recommended levels (Composite reliability > 0.8 and AVE > 0.50). Hypotheses According to previous research, there is a significant association between knowledge, attitudes, and self-medication practices ( 6 , 24 – 26 , 30 ). Some studies suggest that individuals with higher knowledge and positive attitudes towards self-medication are more likely to practice it ( 37 , 38 ), while others argue that these factors may act alternatively ( 39 ). Nonetheless, there is a strong interconnection among these factors. Moreover, the convenience of self-medication and the inconvenience of using prescribed medication are among the main reasons for its widespread practice ( 13 , 16 ). However, the relationship between these factors may vary among individuals, and their nature cannot be predicted with certainty. Therefore, this study proposes six different hypotheses: H1: Students with higher knowledge of self-medication are more likely to practice it compared to those with less knowledge. H2: Students with higher knowledge of Adverse Drug Reactions (ADR) are more likely to practice self-medication compared to those with less knowledge. H3: Students with a positive attitude towards self-medication are more likely to practice it than their counterparts. H4: Students with a positive attitude towards Adverse Drug Reaction (ADR) are more likely to practice it than their counterparts. H5: Students who find self-medication more convenient are more likely to practice self-medication than others. H6: Students who find prescribed medication more inconvenient are more likely to practice self-medication than others Results Table 2 presents the demographic characteristics of the respondents. Most participants are male, accounting for 64% of the sample. No significant differences were observed between males and females regarding self-medication in any dimension. The CGPA of the respondents exhibited a significant difference in the real-life practice of self-medication. Individuals with a low CGPA had a higher mean score for self-medication (mean RP: 23.45; P = 0.003). However, there were no differences in drug usage or disease treatment associated with self-medication among different CGPA groups. The year of study did not have any effect on the self-medication practices of the students. Regardless of their academic year, all students demonstrated similar patterns of self-medication. The study area was found to have a significant effect on self-medication practices. Surprisingly, students studying pure science or applied science reported significantly higher self-medication levels than other groups. They treated more diseases with self-medication, used a greater variety of drugs, and had higher overall self-medication scores. Science students are assumed to have more knowledge about medication and its potential adverse effects, yet they still engage in self-medication. The convenience of self-medication over prescribed medication may play a significant role in this regard. Economic dependence did not significantly affect self-medication practices among the respondents. Table 2 Demographic profile of the respondents Diseases treated (DT) Real life practice (RP) Drug used (DU) Variables Frequency (Percentage) Mean Sig. Mean Sig. Mean Sig. Sex of the respondents Male 265 (64) 14.22 0.241 22.11 0.092 28.19 0.117 Female 152 (36) 14.89 21.78 29.31 CGPA Below 2.00 32 (7.03) 12.47 0.121 23.45 0.003 27.81 0.096 2.01-3.00 119 (28.89) 13.15 21.88 27.56 3.01–3.50 172 (41.95) 14.24 22.91 28.90 3.51-4.00 89 (22.11) 12.27 20.97 29.23 Year of study Undergraduate 238 (57.28) 14.01 0.335 23.14 0.271 28.67 0.421 Master’s program 136 (31.90) 13.66 22.56 28.10 PHD or other 43 (10.80) 13.80 21.92 29.59 Study area Pure science 94 (22.36) 16.13 0.002 25.34 < 0.001 30.14 0.019 Applied science 137 (30.90) 15.76 26.11 29.35 Social Science 98 (22.86) 13.60 20.25 26.18 Arts 44 (9.54) 12.92 21.67 25.74 Business 57 (14.32) 14.22 19.92 28.02 Economic dependence Dependent on others 261(62.58) 14.01 0.248 24.12 0.345 27.58 0.076 Self-dependent 156 (37.41) 14.92 23.87 28.79 Table 3 One way ANOVA test results Diseases treated (DT) Real life practice (RP) Drug used (DU) Variables Frequency Mean SD Sig. Mean SD Sig. Mean SD Sig. Knowledge about medication Primary 104 13.25 3.346 < 0.001 17.56 6.026 < 0.001 24.40 5.263 < 0.001 Intermediate 233 17.65 3.456 23.57 5.224 29.07 6.066 Advance 80 15.60 4.815 21.86 8.327 31.61 8.662 Knowledge about medicine groups Primary 126 13.92 3.722 < 0.001 18.31 5.971 < 0.001 26.20 5.888 < 0.001 Intermediate 209 16.11 3.371 22.01 5.846 29.28 6.702 Advance 82 19.71 4.185 26.32 6.444 33.26 7.353 Knowledge about adverse drug reaction Primary 199 13.92 3.620 < 0.001 19.41 6.478 0.005 26.56 7.096 0.002 Intermediate 181 17.66 3.432 23.23 6.027 31.19 6.282 Advance 37 20.84 2.609 27.00 4.679 32.89 4.881 Attitude towards self-medication Positive 197 18.39 3.274 0.011 26.39 4.066 < 0.001 32.51 5.881 < 0.001 Undecided 86 15.92 3.312 20.42 5.157 26.69 6.774 Negative 134 13.04 3.736 15.76 5.095 25.73 6.460 Attitude towards adverse effect of self-medication Positive 167 18.72 3.158 0.007 26.34 4.574 < 0.001 32.35 5.979 < 0.001 Undecided 104 16.47 3.050 21.44 4.784 29.96 6.729 Negative 146 13.01 3.722 16.69 5.901 24.86 6.144 Physical convenience of self-medicating Slightly 70 13.03 4.177 < 0.001 16.19 6.493 0.003 23.21 6.972 0.015 Moderately 101 14.41 3.761 19.44 6.185 25.50 6.612 Highly 246 17.77 3.456 24.27 5.400 32.30 5.176 Physical inconvenience of prescribed-medication Slightly 101 13.61 4.108 < 0.001 18.26 6.580 < 0.001 22.18 6.966 < 0.001 Moderately 108 16.12 3.642 21.00 5.701 27.46 4.850 Highly 208 17.41 3.863 23.82 6.277 33.37 4.530 Source : Field survey 2023 Table 3 presents those individuals with intermediate knowledge about medication (mean DT: 17.65) who diagnose significantly more diseases with self-medication than other groups. Post hoc LSD results show that they treat more diseases than those with higher medication knowledge (mean DT: 15.60). Similarly, those with intermediate medication knowledge (mean RP: 23.57) have the highest level of self-medication practice, even more than those with higher medication knowledge (mean RP: 21.86). However, those with intermediate knowledge of medication do not use a variety of medicine groups for treating many diseases. Table 4.6 shows that those with the highest knowledge about medication (mean DU: 31.61) use a variety of medicine groups in self-medication. Post hoc LSD results reveal a positive relationship between knowledge about medication and variety of medicine intake. Knowledge about different medicine groups: Individuals with higher knowledge about other medicine groups (mean DT: 19.71) treat more diseases with self-medication. Their mean score is significantly higher than the second-highest group, indicating the impact of knowledge on self-medication effectiveness. Individuals with a positive attitude towards self-medication practice it more frequently (mean RP: 26.39), diagnose more diseases (mean DT: 18.39), and take different medicine (mean DU: 32.51). Those with a negative attitude or uncertainty about self-medication show no significant differences in practice scales. Individuals with a negative attitude towards adverse drug reactions have lower scores in all practice scales (mean DT: 13.01, mean DU: 24.86, mean RP: 16.69). Those with a positive attitude practice more self-medication and take a greater variety of medicines. Respondents who find self-medication highly convenient or prescribed medication highly inconvenient practice self-medication more frequently. Physical convenience or inconvenience plays a significant role in shaping the practice of self-medication. Those who find prescribed medication slightly inconvenient (mean DT: 13.61, mean RP: 18.26, mean DU: 22.28) score significantly lower in all self-medication practice scales. The physical inconvenience of prescribed medication plays a more significant role in pushing people towards self-medication than the convenience of self-medication. Challenges associated with obtaining prescribed medication contribute to the prevalence of self-medication in Bangladesh. Measurement model (Model fit indices) Confirmatory factor analysis (CFA) Confirmatory factor analysis (CFA) was performed using AMOS 26 to run the SEM model. All the factors with loading scores (> 0.50) were considered fit for the model. This model is well validated and fit for SEM computation because all the values are under an acceptable threshold. The CMIN/df = 5.023; CFI = 0.902; GFI = 0.911; TLI = 0.901; RMSEA = 0.073 and SRMR = 0.052 (supplementary table 5 ). Composite reliability (CR) and Average Variance (AVE) test In this case, the composite reliability scores ranged from 0.838 to 0.932, which is well above the benchmark of 0.70, indicating that the items used to measure the constructs have high reliability. In this study, the AVE values for all the constructs were above 0.50, indicating that the items used to measure each construct are strongly related to that construct (Table 4 ). Table 4 Composite reliability test results Variables (codes) Factor loading Composite reliability AVE Knowledge about medication (KN-1) KN-1-1 .644 0.838 0.732 KN-1-2 .924 Knowledge about the adverse effect of drug reaction (KN-2) KN-2-1 .793 0.919 0.696 KN-2-2 .838 KN-2-3 .851 KN-2-4 .826 KN-2-5 .861 Attitude towards self-medication (AT-1) AT-1-1 .920 0.932 0.769 AT-1-2 .852 AT-1-3 .921 AT-1-4 .828 AT-1-5 .858 AT-1-6 .879 Attitude towards adverse effect of drug reaction (AT-2) AT-2-1 .800 0.897 0.686 AT-2-2 .796 AT-2-3 .838 AT-2-4 .875 Physical convenience of self-medication (CN-1) CN-1-1 .806 0.915 0.684 CN-1-2 .860 CN-1-3 .786 CN-1-4 .840 CN-1-5 .841 Physical inconvenience of prescribed medication (CN-2) CN-2-1 .863 0.926 0.777 CN-2-2 .901 CN-2-3 .893 CN-2-4 .881 CN-2-5 .869 Self-medication practice (PR) PR-1 .750 0.849 0.653 PR-2 .852 PR-3 .819 *Source : Field Survey 2023 Discriminant validity test Two criteria were utilized to assess the discriminant validity of the measurement model: Fornell and Larcker's criterion and the Heterotrait-Monotrait (HTMT) ratio. The outcomes of the Fornell and Larcker criterion, displayed in supplementary table 6 , reveal that the square root of the AVE for each construct is higher than its correlation with other constructs. This signifies that discriminant validity has been established for all the constructs. All the HTMT ratios were below 0.85, ranging from 0.273 to 0.762 ( supplementary table 7 ), which indicates that discriminant validity is established for the measurement model according to the HTMT ratio criterion. Structural equation model (SEM) The researcher initially developed a hypothesized structural model to investigate self-medication practice. However, upon evaluating the modification indices and parameter estimates, some paths in the model were identified as non-significant. As a result, the researcher removed those non-significant paths and added several covariance paths, as suggested by the modification indices. The final model showed a better fit compared to the hypothesized model. In the paper, six hypotheses were presented regarding self-medication practice, all supported by the presented Structural Equation Model (Fig. 1 ). To assess the model's fit, Table 5 is presented, which displays the model's fit and estimates for the constructs. The table shows that the model is acceptable and is a good fit for the data, as indicated by the following fit indices: CMIN/df = 4.728, CFI = 0.923, GFI = 0.916, RMSEA = 0.070, and SRMR = 0.0511. These findings suggest that the model is reliable and valid for investigating self-medication practices. Table 5: Hypothesis testing results for Structural equation model (SEM) Hypothesis (Relationships) β t-value p-value Hypothesis results SDE SIE STE KN-1 → PR .160 3.610 <0.001 Accepted .160 .072 .232 KN-2 → PR .176 4.773 <0.001 Accepted .176 0 .176 AT-1 → PR -.340 -6.066 <0.001 Accepted -.340 -.140 -.480 AT-2 → PR -.235 -5.041 <0.001 Accepted -.235 0 -.235 CN-1 → PR .235 5.987 <0.001 Accepted .235 0 .235 CN-2 → PR .252 6.529 <0.001 Accepted .252 0 .252 Fit indexes: CMIN/df= 4.728; CFI= 0.923; GFI= 0.916; RMSEA= 0.070; SRMR=.0511 * SDE: Standardized direct effect * SIE: Standardized indirect effect * STE: Standardized total effect The final measurement model found that attitude towards self-medication had the highest significant effect (β= -0.340; t= -6.066) on self-medication practice, indicating a negative correlation. Those with a negative attitude towards self-medication were found to practice self-medication less. Table 5 further demonstrated that attitude towards self-medication had the highest standardized direct (β = -0.340; p = < 0.001) and indirect effect (β = -0.140; p = 0.005) on self-medication practice, suggesting that individuals who view self-medication as unacceptable tend to practice it less compared to others. Similarly, a negative attitude towards adverse drug reactions (β= -0.235; t= -5.041) was found to have a significant negative effect on self-medication practice. The physical inconvenience of prescribed medication had the second highest effect (β = 0.252; t = 6.529) on self-medication practice, indicating that those who find the prescribed medication process inconvenient in Bangladesh tend to practice self-medication more. Physical convenience of self-medication had the third largest effect (β = 0. .235; t = 6.529) on self-medication, indicating that the convenience of self-medication is one of the main factors behind the high prevalence of self-medication in Bangladesh. Furthermore, knowledge about medication (β = 0.160; t = 3.610) and adverse drug reactions (β = 0.176; t = 4.773) had significant positive effects on self-medication practice, which was surprising as it was expected that individuals with greater knowledge about medication and its adverse effects would be less likely to self-medicate. Discussion The study's findings indicate a moderate to a high level of self-medication practice among university students in Bangladesh, consistent with previous studies ( 29 , 30 , 37 , 40 , 41 ). Several factors contribute to this practice, including limited access to healthcare services, cost-effectiveness, cultural beliefs, and the convenience of purchasing medications without a prescription from pharmacies and drug stores ( 42 ). The researcher focused on two types of knowledge among university students in Bangladesh: knowledge about medication and knowledge about adverse drug reactions (ADRs). Knowledge about medication was assessed based on medication doses, content, and related aspects, as well as knowledge of different medicine groups. The findings revealed that most students possessed intermediate knowledge about medication, with a relatively higher level of knowledge about medicine groups, consistent with previous studies conducted in different cities ( 43 ). This observation could be attributed to the country's heavy marketing efforts of pharmaceutical companies. Surprisingly, most students exhibited only basic knowledge of ADRs. Previous research indicated that students often hold misconceptions, believing that non-severe illnesses cannot lead to serious consequences ( 44 ). This knowledge gap regarding the risks associated with self-medication might be one of the reasons for the high prevalence of self-medication among university students in Bangladesh. The limited awareness about ADRs among students could be attributed to the insufficient emphasis on pharmacovigilance in the country. The structural equation model (SEM) presented in Fig. 1 reveals a positive causal relationship between knowledge about self-medication and adverse drug reactions (ADRs) and the practice of self-medication. Previous research ( 45 – 47 ) supports this by indicating that individuals who engage in self-medication within the last 12 months tend to have a higher level of knowledge about self-medication. Furthermore, the SEM suggests that knowledge about medication indirectly affects self-medication by influencing knowledge about ADRs. Thus, those with greater knowledge about self-medication are likely to possess more knowledge about ADRs and higher self-medication practice. The belief that self-medication is an effective and convenient way to manage minor health problems, coupled with university students' confidence in their medication knowledge ( 48 ), may play a role. Additionally, in Bangladesh, the easy availability of over-the-counter medicine and the convenience of storing it ( 48 , 49 ) make self-medication a preferred choice. Conversely, obtaining prescribed medication is more difficult and inconvenient ( 48 ), as observed in this study. Consequently, knowledgeable individuals may opt for the convenient, easily accessible, and quick relief self-medication provides. Contrasting findings were presented by a study conducted in Portugal ( 50 ) found no positive connection between knowledge and the practice of self-medication. Similarly, a study in Nepal ( 51 ) revealed that individuals with higher knowledge about medication safety were less likely to engage in self-medication. Additionally, a study in Nigeria ( 45 ) showed a negative correlation between knowledge about ADRs and self-medication practices among university students. These findings highlight the complex nature of the relationship between knowledge and self-medication, suggesting that various factors influence it. While university students in Bangladesh continue to engage in self-medication despite understanding the associated risks, others may avoid it due to their awareness of potential consequences. The results of this study indicate that most university students in the country have a positive attitude towards self-medication and adverse drug reactions (ADRs). Previous studies on general university and medical students have also shown that most of them hold a positive attitude toward self-medication ( 17 , 27 , 41 , 44 , 49 , 52 ). However, some studies suggest that students generally have a negative attitude toward self-medication ( 43 , 52 , 53 ) and are cautious about recommending self-medication to friends and family members ( 54 ). These studies further suggest that students may develop this mindset due to increased awareness about medications and ADRs during their time in university ( 25 , 43 ). Moonajilin et al. ( 13 ) found that, on average, only 26.3% of Bangladeshi people seek healthcare facilities for treatment, indicating a significant shortage in healthcare infrastructure. This shortage could be a prominent reason for the positive attitude towards self-medication and ADRs. Additionally, cultural and traditional beliefs have been identified as influential factors in shaping attitudes towards self-medication ( 42 , 55 ), and the cultural and traditional beliefs in Bangladesh may have played a significant role in this context. Moreover, the present study has shown that students have limited knowledge about ADRs and their potential risks, which could contribute to these unique findings. This study reinforces the consistent finding from previous studies ( 25 , 41 , 50 ) that individuals with a positive attitude towards self-medication and adverse drug reactions (ADRs) tend to engage in self-medication more frequently. In contrast, those with a negative attitude are less inclined to do so. Among university students, except for some instances presented by James ( 25 ), a positive attitude towards self-medication is a common factor ( 48 , 56 ). The SEM (Fig. 1 ) used in this study also confirms that a positive attitude towards self-medication has the strongest influence on the actual practice (β= -0.34; p-value < 0.001) encouraging the use of various medicine groups, treating different diseases through self-medication, and increasing the frequency of self-medication. Furthermore, the study reveals that the attitude toward self-medication indirectly impacts the practice by influencing the attitude toward adverse drug reactions (ADRs). This suggests that individuals who perceive self-medication as acceptable also subconsciously acknowledge the potential negative consequences, despite recognizing its effectiveness. It can be attributed to self-medication as a convenient and cost-effective option to get quick relief from minor health issues ( 42 , 50 ). Additionally, from a psychological perspective, one can argue that university students, being mature and knowledgeable individuals, possess optimism while accepting the reality of self-medication. This acknowledgment demonstrates their understanding that their choices can have both positive and negative outcomes, and they are willing to accept the responsibility that comes with it. This study highlights the widespread perception among students that self-medication is highly convenient. They report that buying and storing medicine in Bangladesh is easy, consistent with previous studies ( 42 , 57 , 58 ) conducted in Bangladesh and other countries ( 54 , 59 , 60 ). Those over-the-counter (OTC) medications are commonly used for self-medication. Students also emphasize that self-medication saves time and offers quick relief, which has consistently emerged as primary motivation for self-medication in previous studies ( 7 , 61 , 62 ). Additionally, the convenience of self-medication in Bangladesh is attributed to the knowledge gained from previous prescriptions and the online availability of medical information. These factors have also been reported as key drivers of self-medication ( 48 , 52 , 57 ). The structural equation model (SEM) shows a significant positive causal relationship between the convenience of self-medication (β = 0.23; p-value < .001) and its practice. As the convenience of self-medication increases, so does its prevalence. This finding is consistent with earlier studies ( 25 , 27 , 28 , 37 – 40 ) highlighting the positive influence of easy access to self-medication on its practice. One possible explanation for the convenience of self-medication is the proliferation of health-related resources on the internet. This enables individuals to independently research symptoms, diagnoses, and potential treatments, leading to a sense of autonomy and confidence in making health decisions without consulting a healthcare professional. Additionally, easy access to medical information allows students to become more knowledgeable about common ailments, symptoms, and treatments, thereby reinforcing the practice of self-medication ( 48 , 52 , 57 ). This study highlights the significant inconvenience half of the students face when accessing prescribed medicine in Bangladesh, shedding light on the challenges associated with healthcare services in the country. The reasons identified by the study, including distance to government healthcare centers, unavailability of pharmacies, high cost of private medical care, and inadequate health call centers, are all significant barriers to accessing healthcare services. Previous studies conducted in Bangladesh ( 57 , 58 ) have also reported difficulties obtaining advice from healthcare professionals, further exacerbating the problem. This situation can be directly attributed to the low healthcare budget in Bangladesh, which is one of the lowest in South Asia, accounting for only 5.4% of the total GDP ( 14 ). The study reveals a positive causal relationship between the physical inconvenience of obtaining prescribed medication and the practice of self-medication, as indicated by the structural equation model (SEM) analysis (β = 0.25; p-value < .001). Consequently, the practice of self-medication among university students increases with the growing inconvenience of accessing prescribed medication. These findings align with previous research ( 42 , 48 , 49 , 54 , 55 ) that has identified difficulties in obtaining proper treatment as a significant contributing factor to the practice of self-medication. Earlier, this study stated that students with a higher level of medication knowledge resort to self-medication may be due to the significant inconvenience associated with obtaining prescribed medication. This inconvenience can also be attributed to the accepting attitude of students towards the potential negative consequences that may arise due to self-medication. Students in Bangladesh may prefer to avoid the hassle of seeking health professionals' suggestions, which contributes to this phenomenon. Policy Recommendations Despite existing regulations and healthcare facilities, effective and evidence-based guidelines are needed to improve self-medication practices. While self-medication can be beneficial if appropriately directed, but specific actions are needed. To strengthen prescribed medication practices, standardized guidelines should be developed, covering dosage recommendations, regimen instructions, and considerations for potential adverse effects. Healthcare providers should undergo continuous education on evidence-based medicine and patient safety, with mechanisms in place to monitor and evaluate adherence to guidelines. Enhancing the quantity and accessibility of prescribed medication requires collaboration between governments, healthcare providers, and pharmaceutical companies. Measures include ensuring an adequate supply of medications, reducing costs through bulk purchasing agreements and promoting generics, and improving accessibility through pharmacy networks, home delivery, and telemedicine. Improving government medical services entails increased funding for infrastructure, equipment, and staff capacity. Reducing waiting times and implementing electronic health record systems can enhance patient satisfaction and care coordination. Educating the public is vital. Public awareness campaigns should highlight self-medication risks, while collaboration with educational institutions and healthcare providers can deliver targeted programs on proper medication usage. Leveraging communication channels is essential to disseminate accurate information and discourage self-medication. Strengthening regulation and enforcement involves monitoring and controlling the availability and sales of over-the-counter medications, deterring unauthorized prescription sales, and raising awareness of legal and health consequences. Conclusion In conclusion, university students in Bangladesh possess intermediate medication knowledge and primary knowledge of Adverse Drug Reactions (ADRs). They exhibit a positive attitude towards both self-medication and ADRs. Physical convenience favors self-medication, while the inconvenience of prescribed medication contributes to its lower preference. Students with advanced medication knowledge and positive attitudes toward self-medication are more likely to engage in it. This research is crucial for self-medicating students and policymakers seeking to improve control measures. Further research should explore age-specific factors such as individual beliefs, cultural influences, and socio-economic factors that drive self-medication preferences. Declarations Acknowledgement We thank all the patients who took the time to participate in this survey. Authors’ contributions MMT and MAR conceptualized and designed the study. MMT carried out the statistical analyses. MMT, MFA, AK , IJJ conducted data collection and data inputs. MMT and MAR drafted the initial manuscript. MFA, AK , IJJ also helped in preparing the first draft of the manuscript . MAR and MHH reviewed and finalized the manuscript. MAR supervised the whole study and approved for final submission. All authors contributed to the article and approved the submitted version. MMT is responsible for the overall analysis. as a guarantor Funding No financial support was received for this study. Ethics approval Khulna University Ethical Clearance Committee has been approved this study protocol ( KUECC-2023-09-61 ). This study was carried out in order to partially fulfillment of the Master’s degree in Development Studies (MDS) from Khulna University, Bangladesh. All methods were carried out in accordance with relevant guidelines and regulations. Informed Consent Statement All participants in this study provided written informed consent to participate in the study and to have their data published in a scientific journal. The study was approved by the Khulna University Ethical Clearance Committee ( KUECC-2023-09-61 ). Competing interests The authors declare that they have no competing interests. Data availability The datasets used and/or analysed during the current study available from the corresponding author on reasonable request. References Ayalew MB. Self-medication practice in Ethiopia: A systematic review. Vol. 11, Patient Preference and Adherence. 2017. Abebe D, Tenaw G, Dessalegn H, Franelee AZ. Knowledge, attitude and practice of self-medication among health science students at Debre Markos University, Northwest Ethiopia. J Public Health Epidemiol. 2017;9(5). Ali AN, Kai JTTK, Keat CC, Dhanaraj S. Self-medication practices among health care professionals in a Private University, Malaysia. International Current Pharmaceutical Journal. 2012;1(10). Latifi A, Ramezankhani A, Rezaei Z, Ashtarian H, Salmani B, Yousefi MR, et al. Prevalence and associated factors of self-medication among the college students in Tehran. J Appl Pharm Sci. 2017;7(7). Flaiti M Al, Badi K Al, Hakami WO, Khan SA. Evaluation of self-medication practices in acute diseases among university students in Oman. Journal of Acute Disease. 2014;3(3). Dnyanesh Limaye, Vaidehi Limaye, Gerard Krause, Gerhard Fortwenge. A Systematic Review of the Literature to Assess Self-medication Practices. Ann Med Health Sci Res. 2017;7(1). Pal J, Ahmad S, Pal P, Chatterjee D. Prevalence and pattern of self-medication among undergraduate students in a medical college of Kolkata. Int J Community Med Public Health. 2017;4(10). Mosaddek ASM, Haque M, Islam MZ, Sharmin ZR, Sharmin R, Rahman MF, et al. Practice of self-medication among students of a selected medical college of Dhaka City, Bangladesh. International Medical Journal. 2017;24(2). Islam B, Hossain MA. Prevalence of self medication practice among students of a medical college. Bangladesh Medical Journal Khulna. 2020;52(1–2). Chari HS, Kadeangadi DM, Chari HS. Practice of Self Medication Among Urban Households-a Community Based Cross Sectional Study. National Journal of Community Medicine│Volume. 2015;6(2). Hughes CM, McElnay JC, Fleming GF. Benefits and risks of self medication. Vol. 24, Drug Safety. 2001. Take steps to stop sale of antibiotics without prescriptions [Internet]. [cited 2023 Jun 1]. Available from: https://www.thedailystar.net/city/take-steps-to-stop-sale-of-antibiotics-without-prescriptions-1734625 Moonajilin MS, Mamun MA, Rahman ME, Mahmud MF, Al Mamun AHMS, Rana MS, et al. Prevalence and drivers of self-medication practices among savar residents in Bangladesh: A cross-sectional study. Risk Manag Healthc Policy. 2020;13. (PDF) Health Budget of Bangladesh in the Fiscal Year 2022-2023 [Internet]. [cited 2023 Jun 1]. Available from: https://www.researchgate.net/publication/362036566_Health_Budget_of_Bangladesh_in_the_Fiscal_Year_2022-2023 Joarder T, Chaudhury TZ,, Mannan I. Universal health coverage in Bangladesh: activities, challenges, and suggestions. . Adv Public Health. 2019; Factors contributing to the purchase of Over The Counter (OTC) drugs in Bangladesh: An Empirical study. The Internet Journal of Third World Medicine. 2012;6(2). Zafar SN, Syed R, Waqar S, Zubairi AJ, Vaqar T, Shaikh M, et al. Self-medication amongst university students of Karachi: Prevalence, knowledge and attitudes. J Pak Med Assoc. 2008;58(4). Burak LJ, Damico A. College students’ use of widely advertised medications. J Am Coll Health Assoc. 2000;49(3). Verma RK, Mohan L, Pandey M. Evaluation of self medication among professional students in North India: Proper statutory drug control must be implemented. Asian Journal of Pharmaceutical and Clinical Research. 2010;3(1). Sawalha AF. A descriptive study of self-medication practices among Palestinian medical and nonmedical university students. Research in Social and Administrative Pharmacy. 2008;4(2). Gupta V, Bansal P, Manhas R, Singh Z, Ghaiye P. PREFERRED SYSTEM OF MEDICINE AND REASONS OF SELF MEDICATION AMONG COLLEGE STUDENTS IN MALWA REGION OF PUNJAB. Journal of Drug Delivery and Therapeutics. 2011;1(2). Idris T, Khanum S, Uddin Md, Asaduzzaman Md, Islam M, Nasrin F, et al. Study on Self-medication Practices among University Students of Bangladesh. Br J Med Med Res. 2016;14(6). Donkor ES, Tetteh-Quarcoo PB, Nartey P, Agyeman IO. Self-medication practices with antibiotics among tertiary level students in Accra, Ghana: A cross-sectional study. Int J Environ Res Public Health. 2012;9(10). Musa YK, Awosan M, Ibrahim, Zayyanu, Abdullahi, Mohammed M., et al. Knowledge and practice of self-medication among undergraduate students of Usmanu Danfodiyo University, Sokoto." ,. Ann Int Med Den Res 2. 2016; James H, Handu SS, Al Khaja KAJ, Otoom S, Sequeira RP. Evaluation of the knowledge, attitude and practice of self-medication among first-year medical students. Medical Principles and Practice. 2006;15(4). El-Ezz NFA, Ez-Elarab HS. Knowledge, attitude and practice of medical students towards self medication at Ain Shams University, Egypt. J Prev Med Hyg. 2011;52(4). Azhar MIM, Gunasekaran K, Kadirvelu A, Gurtu S, Sadasivan S, Kshatriya BM. Self-medication : Awareness and Attitude among Malaysian Urban Population. Int J Collab Res Intern Med Public Health. 2013;5(6). Kumar V, Mangal A, Yadav G, Raut D, Singh S. Prevalence and pattern of self-medication practices in an urban area of Delhi, India. Medical Journal of Dr DY Patil University. 2015;8(1). Alam N, Saffoon N, Uddin R. Self-medication among medical and pharmacy students in Bangladesh. BMC Res Notes. 2015;8(1). Khan A, Sultana A, Ahammad B, Nahar S, Khanam S. Self-Medication Practice among Medical Students of a Tertiary Teaching Hospital in Dhaka City. Journal of Current and Advance Medical Research. 2019;6(1). M N, M M, ASM C, T Z, RA P. Prevalence, Pattern and Impact of Self Medication of Anti-infective Agents During COVID-19 Outbreak in Dhaka City. Glob J Med Res. 2020; McColl E. Cognitive Interviewing. A Tool for Improving Questionnaire Design. Quality of Life Research. 2006;15(3). Presser S, Couper MP, Lessler JT, Martin E, Martin J, Rothgeb JM, et al. Methods for testing and evaluating survey questions. Public Opin Q. 2004;68(1). Mumtaz Y, Ashraf Jahangeer SM, Mujtaba T, Zafar S, Adnan S. Self medication among university students of Karachi. Journal of the Liaquat University of Medical and Health Sciences. 2011;10(3). Satta A, Puddu M, Venturini S, Giupponi C. Assessment of coastal risks to climate change related impacts at the regional scale: The case of the Mediterranean region. International Journal of Disaster Risk Reduction. 2017;24. WHO. World Health Organization Vaccination Coverage Cluster Surveys: Reference Manual. Who. 2018; Bhattarai AK, Karki PK. Knowledge, attitude and practice of self-medication among medical students during exam time. Journal of Chitwan Medical College. 2020;10(3). Islam T. Cross-sectional survey to assess the knowledge, attitude and practice regarding adverse drug reactions of students of a private university . Doctoral dissertation, Brac University. 2021; Shah K, Halder S, Haider SS. Assessment of knowledge, perception, and awareness about self-medication practices among university students in Nepal. Heliyon. 2021;7(1). B Badiger A, Kundapur R, Jain A, Kumar A, Pattanshetty S, Thakolkaran N, et al. SELF‐MEDICATION PATTERNS AMONG MEDICAL STUDENTS IN SOUTH INDIA. Australasian Medical Journal. 2012;05(04). Sunitha M, P S. KNOWLEDGE, ATTITUDE AND PRACTICE OF SELF-MEDICATION AMONG MEDICAL COLLEGE STUDENTS IN KERALA. Journal of Evidence Based Medicine and Healthcare. 2016;3(41). Biswas M, Roy MN, Manik MIN, Hossain MS, Tapu STA, Moniruzzaman M, et al. Self medicated antibiotics in Bangladesh: A cross-sectional health survey conducted in the Rajshahi City. BMC Public Health. 2014;14(1). Parihar A, Sharma D, Malhotra P. Questionnaire based assessment of knowledge attitude and practice of self medication among medical undergraduates of a medical college in North India. JK Science. 2018;20(2). Mehta RK,, Sharma S. Knowledge, attitude and practice of self-medication among medical students. . Age (years), 20(49). 2015; Oshikoya KA, Awobusuyi JO. Perceptions of doctors to adverse drug reaction reporting in a teaching hospital in Lagos, Nigeria. BMC Clin Pharmacol. 2009;9. Corrêa Da Silva MG, Soares MCF, Muccillo-Baisch AL. Self-medication in university students from the city of Rio Grande, Brazil. BMC Public Health. 2012;12(1). Mustafa OM, Rohra DK. Patterns and determinants of self-medication among university students in Saudi Arabia. Journal of Pharmaceutical Health Services Research. 2017;8(3). Nasir M, Zahan T,, Parvin RA. Comparative study on knowledge, attitude and practice of selfmedication among the medical and non-medical undergraduate students in Dhaka city. WJPLS. 2017; Siam MHB, Imran A, Limon MBH, Zahid MH, Hossain MA, Siddique MA, et al. Antibiotic abuse: A cross-sectional study on knowledge, attitude, and behavior among the university students in Dhaka, Bangladesh. Electronic Journal of General Medicine. 2021;18(3). Alves RF, Precioso J, Becoña E. Knowledge, attitudes and practice of self-medication among university students in Portugal: A cross-sectional study. NAD Nordic Studies on Alcohol and Drugs. 2021;38(1). Gyawali S, Ravi Shankar P, Poudel PP, Saha A. Knowledge, attitude and practice of self-medication among basic science undergraduate medical students in a medical school in Western Nepal. Journal of Clinical and Diagnostic Research. 2015;9(12). Al-Qahtani AM, Shaikh IA, Shaikh MAK, Mannasaheb BA, Al-Qahtani FS. Prevalence, Perception, and Practice, and Attitudes Towards Self-Medication Among Undergraduate Medical Students of Najran University, Saudi Arabia: A Cross-Sectional Study. Risk Manag Healthc Policy. 2022;15. Gutema GB, Gadisa DA, Kidanemariam ZA, Berhe DF, Berhe AH, Hadera MG, et al. Self-medication practices among health sciences students: The case of mekelle university. J Appl Pharm Sci. 2011;1(10). Kumar N, Kanchan T, Unnikrishnan B, Rekha T, Mithra P, Kulkarni V, et al. Perceptions and Practices of Self-Medication among Medical Students in Coastal South India. PLoS One. 2013;8(8). Istúriz RE, Carbon C. Antibiotic Use in Developing Countries. Infect Control Hosp Epidemiol. 2000;21(6). Agrawal R, Sharma SK, Jaiswal MK, Sharma R, Ali SS. Evaluation of knowledge, attitude and practice of self medication among second year undergraduate students in Bastar Region: a questionnaire based study. Int J Basic Clin Pharmacol. 2019;8(4). Self-Medications Among Higher Educated Population In Bangladesh: An Email-Based Exploratory Study. The Internet Journal of Health. 2012;5(2). Islam MS. Therapeutic drug use in Bangladesh: policy versus practice. Vol. 5, Indian journal of medical ethics. 2008. Parakh R, Sharma N, Choudhary V, Parakh KK, Parakh R,, Gour PA. Comparative study of Self-Medication Practice among Medical and Engineering students in a private university in North India. , . World J Pharmacy and Pharmaceutical Sciences. 2014; Ehigiator O, Azodo CC, Ehizele AO, Ezeja EB, Ehigiator L, Madukwe IU. Self-medication practices among dental, midwifery and nursing students. European J Gen Dent. 2013;2(01). Albusalih F, Naqvi A, Ahmad R, Ahmad N. Prevalence of Self-Medication among Students of Pharmacy and Medicine Colleges of a Public Sector University in Dammam City, Saudi Arabia. Pharmacy. 2017;5(4). Helal RM, Abou-Elwafa HS. Self-medication in university students from the city of mansoura, Egypt. J Environ Public Health. 2017;2017. Supplementary tables Supplementary tables 1 to 7 are not available with this version. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 12 May, 2024 Read the published version in Scientific Reports → Version 1 posted Editorial decision: Revision requested 22 Feb, 2024 Reviews received at journal 29 Dec, 2023 Reviewers agreed at journal 27 Dec, 2023 Reviewers invited by journal 27 Dec, 2023 Editor assigned by journal 14 Dec, 2023 Editor invited by journal 02 Nov, 2023 Submission checks completed at journal 02 Nov, 2023 First submitted to journal 05 Sep, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3327159","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":245295898,"identity":"09005e1d-316f-4ed2-8b63-c7376a843a57","order_by":0,"name":"Mortuja Mahamud Tohan","email":"","orcid":"","institution":"Khulna University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mortuja","middleName":"Mahamud","lastName":"Tohan","suffix":""},{"id":245295900,"identity":"8c11c712-de00-4147-a3cd-165b9b171f10","order_by":1,"name":"Faysal Ahmed","email":"","orcid":"","institution":"Khulna University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Faysal","middleName":"","lastName":"Ahmed","suffix":""},{"id":245295902,"identity":"1ea0c736-5d56-4226-ad5e-2b418a55efe6","order_by":2,"name":"Israt Jahan Juie","email":"","orcid":"","institution":"Khulna University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Israt","middleName":"Jahan","lastName":"Juie","suffix":""},{"id":245295904,"identity":"3e4fe31c-0322-4f88-84c5-7dbfa77507a7","order_by":3,"name":"Anamul Kabir","email":"","orcid":"","institution":"Khulna University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Anamul","middleName":"","lastName":"Kabir","suffix":""},{"id":245295906,"identity":"fd75b12e-11ba-4577-bf87-9e24dfbca49d","order_by":4,"name":"Md. Hasan Howlader","email":"","orcid":"","institution":"Khulna University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Md.","middleName":"Hasan","lastName":"Howlader","suffix":""},{"id":245295907,"identity":"d91c43cc-5703-4205-8c9c-004003dc6e40","order_by":5,"name":"Md. Ashfikur Rahman","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA20lEQVRIie2RoQ7CMBBAr8EOZothv9CFZECA8CtdJmYWcOhiNgPBlr8Ag+6yBMwAW7l5BBJJSzAINnCIPtncS95dAQyGv8SCGxUANlBA7PWCaxTEtdJmPymgFCK+Vez1KWVFns26x7BAmxgcmzVTWaVgOfUZldlgn18J2sXgctEK+pVd0uoV9JYRT0aAyhjQFiyvMsy55C7TSperMKVMahUiIleHEYLpM8yvVVyplTwkWO2S8jMOeFazS0eFLe6HIbGTsCyX89F4nayqL/aGAP0jja/nDQaDwfCJB8q+UGuLuWRiAAAAAElFTkSuQmCC","orcid":"","institution":"Khulna University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Md.","middleName":"Ashfikur","lastName":"Rahman","suffix":""}],"badges":[],"createdAt":"2023-09-05 09:59:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3327159/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3327159/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-024-60931-9","type":"published","date":"2024-05-12T21:17:29+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":46027105,"identity":"279e01a7-1bb2-465c-8aed-4751c9115a4c","added_by":"auto","created_at":"2023-11-07 17:39:38","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":349047,"visible":true,"origin":"","legend":"\u003cp\u003eStructured Equation Model for Self-Medication Practice\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3327159/v1/12f299390bdd1ed8b1df54e4.png"},{"id":56488063,"identity":"0734e416-8609-49b9-8d99-3827aad0d76f","added_by":"auto","created_at":"2024-05-14 21:28:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1868777,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3327159/v1/5f856456-d5fe-4363-9374-56a6f115b256.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge, attitudes, convenience and practice of self-medication among university students of Bangladesh: Structural equation modeling","fulltext":[{"header":"Background","content":"\u003cp\u003eSelf-medication, defined as the practice of diagnosing and treating one's own illnesses without seeking professional medical advice, is a common practice among university students worldwide and is considered a significant public health concern (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). While self-medication is considered a convenient way to address common health issues, it poses significant health risks, such as adverse drug reactions, drug interactions, and treatment failure (\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Self-medication can also lead to antibiotic resistance, a global health challenge (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe misuse and ineffective utilization of medications are significant issues worldwide, with approximately 68% of European countries and 42% of American nations reporting such problems (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Both developed, and developing countries commonly engage in self-medication, although the prevalence is higher in developing nations (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The occurrence of self-medication in developing countries exhibits a wide range, spanning from 12.7\u0026ndash;95% (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). South Asian countries, in particular, demonstrate higher rates of self-medication. For instance, Nepal has a rate of 59%, Pakistan has 51%, and Bangladesh shows rates of 81.3% among the younger population and 78.5% among the elderly (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIf self-mediation is used responsibly, it can help conserve limited medical resources by addressing minor ailments, the burden on healthcare facilities, and reduce costs and time associated with seeking professional care for minor illnesses (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Due to that, WHO has pointed out that appropriate self-medication can be beneficial in treating acute ailments that do not require medical consultation. But it also has a flip side which can cause serious problems such as adverse drug reactions, treatment failure, antimicrobial resistance, etc. In Bangladesh, antimicrobial resistance is a significant issue, primarily attributed to unethical drug sales practices. A recent petition filed in the High Court of Bangladesh aimed to address this problem by seeking legal action against the immoral selling of drugs(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). It was highlighted that as much as 80% of deaths caused by infections were linked to antimicrobial resistance(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlthough recently the healthcare system of Bangladesh has expanded its coverage and infrastructure has also improved substantially still it is considered suffering a budget shortage as only 5.4% of the GDP is allocated for its national healthcare system. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Consequently, there is a lack of accessible health insurance, both at the national and private levels (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). In addition, the prevalence of self-medication in the country is exacerbated by the presence of unethical drug sellers, inadequate regulatory measures, and the widespread availability of prescription drugs without the requirement of a prescription (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). These factors collectively contribute to the high prevalence of self-medication practices in Bangladesh.\u003c/p\u003e \u003cp\u003eUniversity students, particularly in developing countries, are highly susceptible to self-medication due to influential factors such as media and internet exposure promoting this behavior. Additionally, factors such as low perception of associated risks, easy access to the internet, increased pharmaceutical advertising without regulation, availability of drugs, level of education, and social status contribute to this trend (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Previous studies have reported high prevalence rates of self-medication among university students, including rates of approximately 76% in Karachi, Pakistan (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), 87% in India (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), 98% in Palestine (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), and 43.2% in Ethiopia (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAmong university students, the prevalence of self-medication is notably high (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). However, irresponsible self-medication can lead to various negative consequences. It is crucial to identify the influences on self-medication practices among university students, considering that they are generally knowledgeable about medication yet still susceptible to engaging in high levels of self-medication. Factors such as knowledge and literacy (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e), attitude (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), and the convenience of self-medication (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e) have a significant impact on self-medication practices. However, how these variables specifically affect university students nationwide remains uncertain. Additionally, the inconvenience of prescribed medication (e.g., high cost, unavailability) in Bangladesh may also play a distinct role in self-medication practices among university students (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Previous studies in Bangladesh have primarily focused on self-medication among medical or medical-related students (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) or the general public (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e), lacking a comprehensive understanding of the causal relationships among self-medication practices and other factors. Addressing this research gap, this study aims to investigate the factors (knowledge, attitudes, and convenience) influencing self-medication practices among university students in Bangladesh by developing a causal model.\u003c/p\u003e"},{"header":"Methods and materials","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and source of data\u003c/h2\u003e \u003cp\u003eThis cross-sectional descriptive study utilized primary data collected from March 21 to April 29, 2023 using a pre-structured questionnaire. This research incorporates quantitative method to analyse data using various statistical modelling techniques, including the application of structural equation modelling (SEM). The data was obtained through face-to-face interview techniques.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy area and population\u003c/h2\u003e \u003cp\u003eThis study includes students from five public universities in Bangladesh. These universities are located in different regions of Bangladesh, and their students come from diverse backgrounds and cultures. Those universities have approximately 78000 students in undergraduate and graduation program (\u003cb\u003esupplementary table 1\u003c/b\u003e).\u003c/p\u003e \u003cp\u003eThis study includes both undergraduate and graduate students. The inclusion criteria are that the person needs to be 1: an enrolled student from one of the selected universities, 2: currently continuing their study, 3: Is willing to participate in the data collection process. Any student who is physically incapable of providing the required information is disregarded from this study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eQuestionnaire development\u003c/h2\u003e \u003cp\u003eResearchers used a structured five-part questionnaire where each question was considered vital for the research. Questionnaires were first translated into Bangla and then again transformed into English to maintain meaning and consistency. Researchers translated the questionnaire to ask the questions to the participants. As suggested by previous studies, the questionnaires were pre-tested within Khulna University with 30 students before finalizing them for data acquisition (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eDependent variable\u003c/h2\u003e \u003cp\u003eThis study's dependent variable comprises three parts, each indicating critical aspects of self-medication practice. The first part (\u003cb\u003eCode: PR-1\u003c/b\u003e) includes a question about the problem for which the respondent takes self-medication. The problems are divided into three body sections: head, main body, and leg area, with 12 problems for each section which are more prevalent in developing nations (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Respondents choose the problems for which they take self-medication, and the researcher sums up all the reasons, giving a range of 0 to 36, with a higher number indicating a greater self-medication practice (\u003cb\u003esupplementary table 2\u003c/b\u003e).\u003c/p\u003e \u003cp\u003eThe second part (\u003cb\u003eCode: PR-2\u003c/b\u003e) includes a self-medication practice scale comprising 8 questions with a 5-point Likert scale (\u003cb\u003esupplementary table 3\u003c/b\u003e). The questions are structured positively with no reverse questions. Researchers sum up the end result within a range of 8 to 40, with a higher score indicating a higher level of self-medication practice.\u003c/p\u003e \u003cp\u003eThe third part (\u003cb\u003eCode: PR-3\u003c/b\u003e) includes questions about the drugs used for self-medication, with 10 different medicine groups most frequently used worldwide (\u003cb\u003esupplementary table 4\u003c/b\u003e). The researcher incorporated a 5-point Likert scale to measure the practice of consuming those medicines without a prescription. The final score of this scale is also counted by summing up all the individual questions ranging from 10 to 50, with a higher score indicating a greater level of self-medication practice.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eIndependent variables\u003c/h2\u003e \u003cp\u003eThe study examines the holistic model of self-medication among varsity students by considering four independent variables: knowledge, attitude, convenience of self-medication, and inconvenience of prescribed medication. Each independent variable is assessed using multiple questions presented with a 5-point Likert scale. The internal consistency and reliability of each construct were measured and found to be within the recommended level.\u003c/p\u003e \u003cp\u003eRespondents' knowledge is divided into two dimensions: knowledge of medication and medicine groups and knowledge about adverse drug reactions (ADR). Similarly, attitude is divided into two parts: attitude towards self-medication and attitude towards ADR. In Bangladesh, the convenience of self-medication is considered in two phases: convenience of self-medication and inconvenience of prescribed medication.\u003c/p\u003e \u003cp\u003eFor the Analysis of Variance, the researcher categorizes each construct into three ordinal categories based on the total score of that construct. To obtain a holistic view, the structured equation model includes all elements of each dimension \u003cb\u003ethat have a factor loading score of \u0026gt;\u0026thinsp;0.5\u003c/b\u003e. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e demonstrates the constructs of the independent variables. The study disregards demographic characteristics from the primary model due to their inconsistency with the research objectives.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eConstruct of independent variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCodes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGroups\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eKnowledge about medication\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKn-1-1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary (6\u0026ndash;14), Moderate (15\u0026ndash;22), Advanced (23\u0026ndash;30)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ea) Content\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eNot at all, A little, Some, Quite a bit, Very much\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eb) Doze\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ec) Regimen (Time)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ed) Duration of therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ee) Precautions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ef) Effectiveness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eKnowledge about medicine group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eKn-1-2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ePrimary (10\u0026ndash;25), Moderate (26\u0026ndash;40), Advanced (41\u0026ndash;50)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ea) \u003cb\u003ePainkillers (\u003c/b\u003eEx: Diclofenac, Aspirin)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"9\" rowspan=\"10\"\u003e \u003cp\u003eNot at all, A little, Some, Quite a bit, Very much\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eb) \u003cb\u003eAnti-acids\u003c/b\u003e (Ex: Maxpro, Sergel, Seclo)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ec) \u003cb\u003eParacetamol\u003c/b\u003e (Ex: Napa, Ace plus)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ed) \u003cb\u003eSleeping pills\u003c/b\u003e (Ex: Rivotril, Milam)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ee) \u003cb\u003eAntibiotics\u003c/b\u003e (Ex: Gmax, Amodis, Flazil)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ef) \u003cb\u003eVitamins\u003c/b\u003e (Ex: Dextram gold, E-cap)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eg) \u003cb\u003eAnti-allergies\u003c/b\u003e (Ex: Encilor, Rupa)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eh) \u003cb\u003eCough-syrup\u003c/b\u003e (Ex: Dexpoten, Bashok)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ei) \u003cb\u003eHerbal\u003c/b\u003e (Ex: Sinkara)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ej) \u003cb\u003eAnti-Migraine\u003c/b\u003e (Ex: Tafnil, Pyrinol)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eKnowledge about ADR\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eKN-2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ePrimary (6\u0026ndash;14), Moderate (15\u0026ndash;22), Advanced (23\u0026ndash;30)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKnowledge about Adverse Drug Reactions (ADR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKn-2-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eNot at all, A little, Some, Quite a bit, Very much\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKnowledge about the difference between Side Effects and Adverse Events related to drugs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKn-2-2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKnowledge about the cause of ADR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKn-2-3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKnowledge about buying and consuming medicines without a prescription\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKn-2-4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKnowledge about ADR due to not completing or missing the timing of medicine dose.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKn-2-5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAttitude towards self-medication\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eAT-1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ePositive (6\u0026ndash;17), Undecided (18\u0026ndash;23), Negative (24\u0026ndash;36)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-medication is not acceptable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAT-1-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eStrongly disagree, Disagree, Unsure, Agree, Strongly agree\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudents do not have ability to treat symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAT-1-2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-medication would be harmful\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAT-1-3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical license is essential for medication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAT-1-4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacist is a better source of advice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAT-1-5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWe should be careful with non-prescribed medicine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAT-1-6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAttitude towards ADR\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eAT-2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ePositive (4\u0026ndash;9), Undecided (10\u0026ndash;14), Negative (15\u0026ndash;20)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eADR reporting by the public is necessary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAT-2-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eStrongly disagree, Disagree, Unsure, Agree, Strongly agree\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePeople made aware about ADR reporting.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAT-2-2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttend a pharmacovigilance awareness program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAT-2-3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eConcerned about counterfeit medicines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAT-2-4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical convenience of self-medication\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eCN-1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eSlightly (5\u0026ndash;11), Moderately (12\u0026ndash;18), Highly (19\u0026ndash;25)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBuy and store medicine without prescription is easy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCN-1-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eNot at all, A little, Some, Quite a bit, Very much\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGoogle can provide necessary information\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCN-1-2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrevious prescription can suggest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCN-1-3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-medication is very time saving\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCN-1-4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-medication gives quick relief\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCN-1-5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical inconvenience of prescribed-medication\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eCN-2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eSlightly (5\u0026ndash;11), Moderately (12\u0026ndash;18), Highly (19\u0026ndash;25)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealth care centers are in a distant position\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCN-2-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eNot at all, A little, Some, Quite a bit, Very much\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacies are not always readily available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCN-2-2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacy drug provider have limited knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCN-2-3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCost of private medical or doctors is very high\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCN-2-4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUsing health call centers is not convenient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCN-2-5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eSample size determination\u003c/h2\u003e \u003cp\u003eThe cross-sectional survey was conducted from March 21 to April 29, 2023, utilizing Taro Yamane's (1967) technique to determine the sample size. Considering a 10% non-response rate, 436 respondents were selected, with a 98% confidence level and a 5% margin of error. Eventually, after sorting all the incomplete and faulty datasets, responses from 417 respondents were collected and included for analysis.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData collection procedure\u003c/h2\u003e \u003cp\u003eThe data collection technique employed in this study was a random walk, which was the most suitable technique for clusters based on previous research (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). A team of ten trained members carried out the survey. Before data collection, the group underwent a full-day training session covering the data collection procedure, ethics, and obtaining consent.\u003c/p\u003e \u003cp\u003eThe final sample consisted of 436 participants, and it was divided proportionately among five selected universities based on their student populations. Upon approaching each university, the data collection team divided the campus into blocks and initiated data collection from the main entrance. They proceeded clockwise for one minute and approached the nearest respondent, who fulfilled all the inclusion criteria. This process was repeated until the predetermined quota was achieved. In cases where a selected respondent declined to cooperate, the team labeled it a non-response and continued with the data collection process. The same technique was applied consistently throughout the entire data collection phase.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eDuring the data curation process, the interviewer reported a non-response rate of approximately 3%. Additionally, 8 respondents were disregarded due to missing or improper data, resulting in 417 data sets being considered for analysis. The data were stored, coded with appropriate weights, and categorized based on knowledge, attitude, convenience, and practice segments. Descriptive analysis was performed to present the data, followed by one-way ANOVA with post-hoc Least Significant Difference (LSD) to identify any mean differences among groups, showing which group used more self-medication.\u003c/p\u003e \u003cp\u003eFinally, a Structural Equation Model (SEM) was developed to assess the causal relationship between self-medication practice with knowledge, attitude, and convenience. This model was used to identify the holistic causal relationship to get a better and more decisive view of the factors behind self-medication. The internal consistency of the questions for each section was assessed using Composite reliability and Average variance extracted (AVE). The results for every scale used were within the recommended levels (Composite reliability\u0026thinsp;\u0026gt;\u0026thinsp;0.8 and AVE\u0026thinsp;\u0026gt;\u0026thinsp;0.50).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eHypotheses\u003c/h2\u003e \u003cp\u003eAccording to previous research, there is a significant association between knowledge, attitudes, and self-medication practices (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan additionalcitationids=\"CR25\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). Some studies suggest that individuals with higher knowledge and positive attitudes towards self-medication are more likely to practice it (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e), while others argue that these factors may act alternatively (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). Nonetheless, there is a strong interconnection among these factors. Moreover, the convenience of self-medication and the inconvenience of using prescribed medication are among the main reasons for its widespread practice (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). However, the relationship between these factors may vary among individuals, and their nature cannot be predicted with certainty.\u003c/p\u003e \u003cp\u003eTherefore, this study proposes six different hypotheses:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eH1: Students with higher knowledge of self-medication are more likely to practice it compared to those with less knowledge.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eH2: Students with higher knowledge of Adverse Drug Reactions (ADR) are more likely to practice self-medication compared to those with less knowledge.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eH3: Students with a positive attitude towards self-medication are more likely to practice it than their counterparts.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eH4: Students with a positive attitude towards Adverse Drug Reaction (ADR) are more likely to practice it than their counterparts.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eH5: Students who find self-medication more convenient are more likely to practice self-medication than others.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eH6: Students who find prescribed medication more inconvenient are more likely to practice self-medication than others\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents the demographic characteristics of the respondents. Most participants are male, accounting for 64% of the sample. No significant differences were observed between males and females regarding self-medication in any dimension.\u003c/p\u003e \u003cp\u003eThe CGPA of the respondents exhibited a significant difference in the real-life practice of self-medication. Individuals with a low CGPA had a higher mean score for self-medication (mean RP: 23.45; P\u0026thinsp;=\u0026thinsp;0.003). However, there were no differences in drug usage or disease treatment associated with self-medication among different CGPA groups. The year of study did not have any effect on the self-medication practices of the students. Regardless of their academic year, all students demonstrated similar patterns of self-medication.\u003c/p\u003e \u003cp\u003eThe study area was found to have a significant effect on self-medication practices. Surprisingly, students studying pure science or applied science reported significantly higher self-medication levels than other groups. They treated more diseases with self-medication, used a greater variety of drugs, and had higher overall self-medication scores. Science students are assumed to have more knowledge about medication and its potential adverse effects, yet they still engage in self-medication. The convenience of self-medication over prescribed medication may play a significant role in this regard. Economic dependence did not significantly affect self-medication practices among the respondents.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic profile of the respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eDiseases treated (DT)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eReal life practice (RP)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eDrug used (DU)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (Percentage)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSig.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSig.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSig.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003eSex of the respondents\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e265 (64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.241\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.092\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e28.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.117\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e152 (36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e29.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eCGPA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow 2.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (7.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e27.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.096\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.01-3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e119 (28.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e27.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.01\u0026ndash;3.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e172 (41.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e28.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.51-4.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e89 (22.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e29.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYear of study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e238 (57.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.335\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.271\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e28.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.421\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster\u0026rsquo;s program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e136 (31.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e28.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePHD or other\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (10.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e29.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStudy area\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePure science\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94 (22.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e30.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eApplied science\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e137 (30.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e29.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSocial Science\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98 (22.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e26.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eArts\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44 (9.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e25.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBusiness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57 (14.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e28.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEconomic dependence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDependent on others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e261(62.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.345\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e27.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-dependent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e156 (37.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e28.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eOne way ANOVA test results\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003eDiseases treated (DT)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c9\" namest=\"c7\"\u003e \u003cp\u003eReal life practice (RP)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c12\" namest=\"c10\"\u003e \u003cp\u003eDrug used (DU)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSig.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSig.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eSig.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"12\" nameend=\"c12\" namest=\"c1\"\u003e \u003cp\u003eKnowledge about medication\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.346\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e24.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.263\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntermediate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5.224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e29.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdvance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.815\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8.327\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e31.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e8.662\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"12\" nameend=\"c12\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eKnowledge about medicine groups\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.722\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5.971\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e26.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.888\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntermediate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.371\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5.846\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e29.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.702\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdvance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e26.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.444\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e33.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7.353\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"12\" nameend=\"c12\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eKnowledge about adverse drug reaction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.620\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.478\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e26.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7.096\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntermediate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.432\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e31.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdvance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.609\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e27.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.679\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e32.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.881\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"12\" nameend=\"c12\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAttitude towards self-medication\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e26.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e32.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.881\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndecided\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.312\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5.157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e26.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.774\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.736\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e15.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e25.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.460\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"12\" nameend=\"c12\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAttitude towards adverse effect of self-medication\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e26.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.574\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e32.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.979\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndecided\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.784\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e29.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.729\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.722\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5.901\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e24.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"12\" nameend=\"c12\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical convenience of self-medicating\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSlightly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.493\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e23.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.972\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eModerately\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.761\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e25.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.612\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHighly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5.400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e32.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"12\" nameend=\"c12\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical inconvenience of prescribed-medication\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSlightly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.580\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e22.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eModerately\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.642\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5.701\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e27.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.850\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHighly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.863\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.277\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e33.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.530\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"12\" nameend=\"c12\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSource\u003c/b\u003e: Field survey 2023\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents those individuals with intermediate knowledge about medication (mean DT: 17.65) who diagnose significantly more diseases with self-medication than other groups. Post hoc LSD results show that they treat more diseases than those with higher medication knowledge (mean DT: 15.60). Similarly, those with intermediate medication knowledge (mean RP: 23.57) have the highest level of self-medication practice, even more than those with higher medication knowledge (mean RP: 21.86). However, those with intermediate knowledge of medication do not use a variety of medicine groups for treating many diseases. Table\u0026nbsp;4.6 shows that those with the highest knowledge about medication (mean DU: 31.61) use a variety of medicine groups in self-medication. Post hoc LSD results reveal a positive relationship between knowledge about medication and variety of medicine intake.\u003c/p\u003e \u003cp\u003eKnowledge about different medicine groups: Individuals with higher knowledge about other medicine groups (mean DT: 19.71) treat more diseases with self-medication. Their mean score is significantly higher than the second-highest group, indicating the impact of knowledge on self-medication effectiveness.\u003c/p\u003e \u003cp\u003eIndividuals with a positive attitude towards self-medication practice it more frequently (mean RP: 26.39), diagnose more diseases (mean DT: 18.39), and take different medicine (mean DU: 32.51). Those with a negative attitude or uncertainty about self-medication show no significant differences in practice scales. Individuals with a negative attitude towards adverse drug reactions have lower scores in all practice scales (mean DT: 13.01, mean DU: 24.86, mean RP: 16.69). Those with a positive attitude practice more self-medication and take a greater variety of medicines.\u003c/p\u003e \u003cp\u003eRespondents who find self-medication highly convenient or prescribed medication highly inconvenient practice self-medication more frequently. Physical convenience or inconvenience plays a significant role in shaping the practice of self-medication. Those who find prescribed medication slightly inconvenient (mean DT: 13.61, mean RP: 18.26, mean DU: 22.28) score significantly lower in all self-medication practice scales. The physical inconvenience of prescribed medication plays a more significant role in pushing people towards self-medication than the convenience of self-medication. Challenges associated with obtaining prescribed medication contribute to the prevalence of self-medication in Bangladesh.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eMeasurement model (Model fit indices)\u003c/h2\u003e \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e \u003ch2\u003eConfirmatory factor analysis (CFA)\u003c/h2\u003e \u003cp\u003eConfirmatory factor analysis (CFA) was performed using AMOS 26 to run the SEM model. All the factors with loading scores (\u0026gt;\u0026thinsp;0.50) were considered fit for the model. This model is well validated and fit for SEM computation because all the values are under an acceptable threshold. The CMIN/df\u0026thinsp;=\u0026thinsp;5.023; CFI\u0026thinsp;=\u0026thinsp;0.902; GFI\u0026thinsp;=\u0026thinsp;0.911; TLI\u0026thinsp;=\u0026thinsp;0.901; RMSEA\u0026thinsp;=\u0026thinsp;0.073 and SRMR\u0026thinsp;=\u0026thinsp;0.052 \u003cb\u003e(supplementary table 5\u003c/b\u003e).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eComposite reliability (CR) and Average Variance (AVE) test\u003c/h2\u003e \u003cp\u003eIn this case, the composite reliability scores ranged from 0.838 to 0.932, which is well above the benchmark of 0.70, indicating that the items used to measure the constructs have high reliability. In this study, the AVE values for all the constructs were above 0.50, indicating that the items used to measure each construct are strongly related to that construct (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComposite reliability test results\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVariables (codes)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFactor loading\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eComposite reliability\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAVE\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eKnowledge about medication (KN-1)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKN-1-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.644\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.838\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.732\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKN-1-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.924\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eKnowledge about the adverse effect of drug reaction (KN-2)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKN-2-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.793\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.919\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.696\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKN-2-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.838\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKN-2-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.851\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKN-2-4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.826\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKN-2-5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.861\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAttitude towards self-medication (AT-1)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAT-1-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.920\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.932\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.769\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAT-1-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.852\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAT-1-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.921\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAT-1-4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.828\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAT-1-5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.858\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAT-1-6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.879\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAttitude towards adverse effect of drug reaction (AT-2)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAT-2-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.800\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.897\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.686\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAT-2-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.796\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAT-2-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.838\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAT-2-4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.875\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical convenience of self-medication (CN-1)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCN-1-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.806\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.915\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.684\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCN-1-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.860\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCN-1-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.786\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCN-1-4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.840\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCN-1-5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.841\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical inconvenience of prescribed medication (CN-2)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCN-2-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.863\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.926\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.777\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCN-2-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.901\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCN-2-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.893\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCN-2-4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.881\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCN-2-5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.869\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-medication practice (PR)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePR-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.750\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.849\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.653\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePR-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.852\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePR-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.819\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003e*Source\u003c/b\u003e: Field Survey 2023\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eDiscriminant validity test\u003c/h2\u003e \u003cp\u003eTwo criteria were utilized to assess the discriminant validity of the measurement model: Fornell and Larcker's criterion and the Heterotrait-Monotrait (HTMT) ratio. The outcomes of the Fornell and Larcker criterion, displayed in \u003cb\u003esupplementary table 6\u003c/b\u003e, reveal that the square root of the AVE for each construct is higher than its correlation with other constructs. This signifies that discriminant validity has been established for all the constructs. All the HTMT ratios were below 0.85, ranging from 0.273 to 0.762 (\u003cb\u003esupplementary table 7\u003c/b\u003e), which indicates that discriminant validity is established for the measurement model according to the HTMT ratio criterion.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eStructural equation model (SEM)\u003c/h2\u003e \u003cp\u003eThe researcher initially developed a hypothesized structural model to investigate self-medication practice. However, upon evaluating the modification indices and parameter estimates, some paths in the model were identified as non-significant. As a result, the researcher removed those non-significant paths and added several covariance paths, as suggested by the modification indices. The final model showed a better fit compared to the hypothesized model.\u003c/p\u003e \u003cp\u003eIn the paper, six hypotheses were presented regarding self-medication practice, all supported by the presented Structural Equation Model (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). To assess the model's fit, Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e is presented, which displays the model's fit and estimates for the constructs. The table shows that the model is acceptable and is a good fit for the data, as indicated by the following fit indices: CMIN/df\u0026thinsp;=\u0026thinsp;4.728, CFI\u0026thinsp;=\u0026thinsp;0.923, GFI\u0026thinsp;=\u0026thinsp;0.916, RMSEA\u0026thinsp;=\u0026thinsp;0.070, and SRMR\u0026thinsp;=\u0026thinsp;0.0511. These findings suggest that the model is reliable and valid for investigating self-medication practices.\u003c/p\u003e \n\u003cp\u003eTable 5:\u0026nbsp;Hypothesis testing results for Structural equation model (SEM)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypothesis (Relationships)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003et-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypothesis results\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSDE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSIE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSTE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003eKN-1 \u0026nbsp;\u0026rarr; \u0026nbsp; PR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e.160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e3.610\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003eAccepted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e.160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e.232\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003eKN-2 \u0026nbsp; \u0026rarr; \u0026nbsp;PR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e4.773\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003eAccepted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e.176\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003eAT-1 \u0026nbsp;\u0026rarr; \u0026nbsp; PR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e-.340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\"\u003e\n \u003cp\u003e-6.066\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003eAccepted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e-.340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e-.140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e-.480\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003eAT-2 \u0026nbsp;\u0026rarr; \u0026nbsp; PR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e-.235\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e-5.041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003eAccepted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e-.235\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e-.235\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003eCN-1 \u0026nbsp;\u0026rarr; \u0026nbsp; PR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e.235\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e5.987\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003eAccepted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e.235\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e.235\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003eCN-2 \u0026nbsp;\u0026rarr; \u0026nbsp; PR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e.252\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e6.529\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.473684210526315%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003eAccepted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e.252\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.368421052631579%\" valign=\"top\"\u003e\n \u003cp\u003e.252\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"8\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFit indexes:\u003c/strong\u003e CMIN/df= 4.728; CFI= 0.923; GFI= 0.916; RMSEA= 0.070; SRMR=.0511\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"8\" valign=\"top\"\u003e\n \u003cp\u003e*\u003cstrong\u003eSDE:\u003c/strong\u003e Standardized direct effect\u003c/p\u003e\n \u003cp\u003e*\u003cstrong\u003eSIE:\u0026nbsp;\u003c/strong\u003eStandardized indirect effect\u003c/p\u003e\n \u003cp\u003e*\u003cstrong\u003eSTE:\u003c/strong\u003e Standardized total effect\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe final measurement model found that attitude towards self-medication had the highest significant effect (β= -0.340; t= -6.066) on self-medication practice, indicating a negative correlation. Those with a negative attitude towards self-medication were found to practice self-medication less. Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e further demonstrated that attitude towards self-medication had the highest standardized direct (β = -0.340; p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and indirect effect (β = -0.140; p\u0026thinsp;=\u0026thinsp;0.005) on self-medication practice, suggesting that individuals who view self-medication as unacceptable tend to practice it less compared to others. Similarly, a negative attitude towards adverse drug reactions (β= -0.235; t= -5.041) was found to have a significant negative effect on self-medication practice. The physical inconvenience of prescribed medication had the second highest effect (β\u0026thinsp;=\u0026thinsp;0.252; t\u0026thinsp;=\u0026thinsp;6.529) on self-medication practice, indicating that those who find the prescribed medication process inconvenient in Bangladesh tend to practice self-medication more. Physical convenience of self-medication had the third largest effect (β\u0026thinsp;=\u0026thinsp;0. .235; t\u0026thinsp;=\u0026thinsp;6.529) on self-medication, indicating that the convenience of self-medication is one of the main factors behind the high prevalence of self-medication in Bangladesh. Furthermore, knowledge about medication (β\u0026thinsp;=\u0026thinsp;0.160; t\u0026thinsp;=\u0026thinsp;3.610) and adverse drug reactions (β\u0026thinsp;=\u0026thinsp;0.176; t\u0026thinsp;=\u0026thinsp;4.773) had significant positive effects on self-medication practice, which was surprising as it was expected that individuals with greater knowledge about medication and its adverse effects would be less likely to self-medicate.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study's findings indicate a moderate to a high level of self-medication practice among university students in Bangladesh, consistent with previous studies (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). Several factors contribute to this practice, including limited access to healthcare services, cost-effectiveness, cultural beliefs, and the convenience of purchasing medications without a prescription from pharmacies and drug stores (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe researcher focused on two types of knowledge among university students in Bangladesh: knowledge about medication and knowledge about adverse drug reactions (ADRs). Knowledge about medication was assessed based on medication doses, content, and related aspects, as well as knowledge of different medicine groups. The findings revealed that most students possessed intermediate knowledge about medication, with a relatively higher level of knowledge about medicine groups, consistent with previous studies conducted in different cities (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). This observation could be attributed to the country's heavy marketing efforts of pharmaceutical companies. Surprisingly, most students exhibited only basic knowledge of ADRs. Previous research indicated that students often hold misconceptions, believing that non-severe illnesses cannot lead to serious consequences (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). This knowledge gap regarding the risks associated with self-medication might be one of the reasons for the high prevalence of self-medication among university students in Bangladesh. The limited awareness about ADRs among students could be attributed to the insufficient emphasis on pharmacovigilance in the country.\u003c/p\u003e \u003cp\u003eThe structural equation model (SEM) presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e reveals a positive causal relationship between knowledge about self-medication and adverse drug reactions (ADRs) and the practice of self-medication. Previous research (\u003cspan additionalcitationids=\"CR46\" citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e) supports this by indicating that individuals who engage in self-medication within the last 12 months tend to have a higher level of knowledge about self-medication. Furthermore, the SEM suggests that knowledge about medication indirectly affects self-medication by influencing knowledge about ADRs. Thus, those with greater knowledge about self-medication are likely to possess more knowledge about ADRs and higher self-medication practice. The belief that self-medication is an effective and convenient way to manage minor health problems, coupled with university students' confidence in their medication knowledge (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e), may play a role. Additionally, in Bangladesh, the easy availability of over-the-counter medicine and the convenience of storing it (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e) make self-medication a preferred choice. Conversely, obtaining prescribed medication is more difficult and inconvenient (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e), as observed in this study. Consequently, knowledgeable individuals may opt for the convenient, easily accessible, and quick relief self-medication provides.\u003c/p\u003e \u003cp\u003eContrasting findings were presented by a study conducted in Portugal (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e) found no positive connection between knowledge and the practice of self-medication. Similarly, a study in Nepal (\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e) revealed that individuals with higher knowledge about medication safety were less likely to engage in self-medication. Additionally, a study in Nigeria (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e) showed a negative correlation between knowledge about ADRs and self-medication practices among university students. These findings highlight the complex nature of the relationship between knowledge and self-medication, suggesting that various factors influence it. While university students in Bangladesh continue to engage in self-medication despite understanding the associated risks, others may avoid it due to their awareness of potential consequences. The results of this study indicate that most university students in the country have a positive attitude towards self-medication and adverse drug reactions (ADRs). Previous studies on general university and medical students have also shown that most of them hold a positive attitude toward self-medication (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e). However, some studies suggest that students generally have a negative attitude toward self-medication (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e) and are cautious about recommending self-medication to friends and family members (\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e). These studies further suggest that students may develop this mindset due to increased awareness about medications and ADRs during their time in university (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMoonajilin et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) found that, on average, only 26.3% of Bangladeshi people seek healthcare facilities for treatment, indicating a significant shortage in healthcare infrastructure. This shortage could be a prominent reason for the positive attitude towards self-medication and ADRs. Additionally, cultural and traditional beliefs have been identified as influential factors in shaping attitudes towards self-medication (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e), and the cultural and traditional beliefs in Bangladesh may have played a significant role in this context. Moreover, the present study has shown that students have limited knowledge about ADRs and their potential risks, which could contribute to these unique findings. This study reinforces the consistent finding from previous studies (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e) that individuals with a positive attitude towards self-medication and adverse drug reactions (ADRs) tend to engage in self-medication more frequently. In contrast, those with a negative attitude are less inclined to do so. Among university students, except for some instances presented by James (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), a positive attitude towards self-medication is a common factor (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e). The SEM (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) used in this study also confirms that a positive attitude towards self-medication has the strongest influence on the actual practice (β= -0.34; p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001) encouraging the use of various medicine groups, treating different diseases through self-medication, and increasing the frequency of self-medication.\u003c/p\u003e \u003cp\u003eFurthermore, the study reveals that the attitude toward self-medication indirectly impacts the practice by influencing the attitude toward adverse drug reactions (ADRs). This suggests that individuals who perceive self-medication as acceptable also subconsciously acknowledge the potential negative consequences, despite recognizing its effectiveness. It can be attributed to self-medication as a convenient and cost-effective option to get quick relief from minor health issues (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e). Additionally, from a psychological perspective, one can argue that university students, being mature and knowledgeable individuals, possess optimism while accepting the reality of self-medication. This acknowledgment demonstrates their understanding that their choices can have both positive and negative outcomes, and they are willing to accept the responsibility that comes with it. This study highlights the widespread perception among students that self-medication is highly convenient. They report that buying and storing medicine in Bangladesh is easy, consistent with previous studies (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e) conducted in Bangladesh and other countries (\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e). Those over-the-counter (OTC) medications are commonly used for self-medication. Students also emphasize that self-medication saves time and offers quick relief, which has consistently emerged as primary motivation for self-medication in previous studies (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e). Additionally, the convenience of self-medication in Bangladesh is attributed to the knowledge gained from previous prescriptions and the online availability of medical information. These factors have also been reported as key drivers of self-medication (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe structural equation model (SEM) shows a significant positive causal relationship between the convenience of self-medication (β\u0026thinsp;=\u0026thinsp;0.23; p-value\u0026thinsp;\u0026lt;\u0026thinsp;.001) and its practice. As the convenience of self-medication increases, so does its prevalence. This finding is consistent with earlier studies (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan additionalcitationids=\"CR38 CR39\" citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e) highlighting the positive influence of easy access to self-medication on its practice.\u003c/p\u003e \u003cp\u003eOne possible explanation for the convenience of self-medication is the proliferation of health-related resources on the internet. This enables individuals to independently research symptoms, diagnoses, and potential treatments, leading to a sense of autonomy and confidence in making health decisions without consulting a healthcare professional. Additionally, easy access to medical information allows students to become more knowledgeable about common ailments, symptoms, and treatments, thereby reinforcing the practice of self-medication (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study highlights the significant inconvenience half of the students face when accessing prescribed medicine in Bangladesh, shedding light on the challenges associated with healthcare services in the country. The reasons identified by the study, including distance to government healthcare centers, unavailability of pharmacies, high cost of private medical care, and inadequate health call centers, are all significant barriers to accessing healthcare services. Previous studies conducted in Bangladesh (\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e) have also reported difficulties obtaining advice from healthcare professionals, further exacerbating the problem. This situation can be directly attributed to the low healthcare budget in Bangladesh, which is one of the lowest in South Asia, accounting for only 5.4% of the total GDP (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The study reveals a positive causal relationship between the physical inconvenience of obtaining prescribed medication and the practice of self-medication, as indicated by the structural equation model (SEM) analysis (β\u0026thinsp;=\u0026thinsp;0.25; p-value\u0026thinsp;\u0026lt;\u0026thinsp;.001). Consequently, the practice of self-medication among university students increases with the growing inconvenience of accessing prescribed medication. These findings align with previous research (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e) that has identified difficulties in obtaining proper treatment as a significant contributing factor to the practice of self-medication. Earlier, this study stated that students with a higher level of medication knowledge resort to self-medication may be due to the significant inconvenience associated with obtaining prescribed medication. This inconvenience can also be attributed to the accepting attitude of students towards the potential negative consequences that may arise due to self-medication. Students in Bangladesh may prefer to avoid the hassle of seeking health professionals' suggestions, which contributes to this phenomenon.\u003c/p\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003ePolicy Recommendations\u003c/h2\u003e \u003cp\u003e Despite existing regulations and healthcare facilities, effective and evidence-based guidelines are needed to improve self-medication practices. While self-medication can be beneficial if appropriately directed, but specific actions are needed.\u003c/p\u003e \u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e To strengthen prescribed medication practices, standardized guidelines should be developed, covering dosage recommendations, regimen instructions, and considerations for potential adverse effects. Healthcare providers should undergo continuous education on evidence-based medicine and patient safety, with mechanisms in place to monitor and evaluate adherence to guidelines.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eEnhancing the quantity and accessibility of prescribed medication requires collaboration between governments, healthcare providers, and pharmaceutical companies. Measures include ensuring an adequate supply of medications, reducing costs through bulk purchasing agreements and promoting generics, and improving accessibility through pharmacy networks, home delivery, and telemedicine.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eImproving government medical services entails increased funding for infrastructure, equipment, and staff capacity. Reducing waiting times and implementing electronic health record systems can enhance patient satisfaction and care coordination.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eEducating the public is vital. Public awareness campaigns should highlight self-medication risks, while collaboration with educational institutions and healthcare providers can deliver targeted programs on proper medication usage. Leveraging communication channels is essential to disseminate accurate information and discourage self-medication.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eStrengthening regulation and enforcement involves monitoring and controlling the availability and sales of over-the-counter medications, deterring unauthorized prescription sales, and raising awareness of legal and health consequences.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, university students in Bangladesh possess intermediate medication knowledge and primary knowledge of Adverse Drug Reactions (ADRs). They exhibit a positive attitude towards both self-medication and ADRs. Physical convenience favors self-medication, while the inconvenience of prescribed medication contributes to its lower preference. Students with advanced medication knowledge and positive attitudes toward self-medication are more likely to engage in it. This research is crucial for self-medicating students and policymakers seeking to improve control measures. Further research should explore age-specific factors such as individual beliefs, cultural influences, and socio-economic factors that drive self-medication preferences.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank all the patients who took the time to participate in this survey.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMMT\u003c/strong\u003e and \u003cstrong\u003eMAR\u003c/strong\u003e conceptualized and designed the study. \u003cstrong\u003eMMT\u003c/strong\u003e carried out the statistical analyses. \u003cstrong\u003eMMT, MFA, AK\u003c/strong\u003e, \u003cstrong\u003eIJJ\u003c/strong\u003e conducted data collection and data inputs. \u003cstrong\u003eMMT and\u003c/strong\u003e \u003cstrong\u003eMAR\u003c/strong\u003e drafted the initial manuscript. \u003cstrong\u003eMFA, AK\u003c/strong\u003e, \u003cstrong\u003eIJJ\u0026nbsp;\u003c/strong\u003ealso helped in preparing the first draft of the manuscript\u003cstrong\u003e.\u003c/strong\u003e \u003cstrong\u003eMAR\u003c/strong\u003e and \u003cstrong\u003eMHH\u003c/strong\u003e reviewed and finalized the manuscript. \u003cstrong\u003eMAR\u003c/strong\u003e supervised the whole study and approved for final submission. All authors contributed to the article and approved the submitted version. \u003cstrong\u003eMMT\u003c/strong\u003e is responsible for the overall analysis.\u0026nbsp;as a guarantor\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo financial support was received for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKhulna University Ethical Clearance Committee has been approved this study protocol (\u003cstrong\u003eKUECC-2023-09-61\u003c/strong\u003e). This study was carried out in order to partially fulfillment of the Master\u0026rsquo;s degree in Development Studies (MDS) from Khulna University, Bangladesh. All methods were carried out in accordance with relevant guidelines and regulations.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants in this study provided written informed consent to participate in the study and to have their data published in a scientific journal. The study was approved by the Khulna University Ethical Clearance Committee (\u003cstrong\u003eKUECC-2023-09-61\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAyalew MB. Self-medication practice in Ethiopia: A systematic review. Vol. 11, Patient Preference and Adherence. 2017. \u003c/li\u003e\n\u003cli\u003eAbebe D, Tenaw G, Dessalegn H, Franelee AZ. Knowledge, attitude and practice of self-medication among health science students at Debre Markos University, Northwest Ethiopia. J Public Health Epidemiol. 2017;9(5). \u003c/li\u003e\n\u003cli\u003eAli AN, Kai JTTK, Keat CC, Dhanaraj S. Self-medication practices among health care professionals in a Private University, Malaysia. International Current Pharmaceutical Journal. 2012;1(10). \u003c/li\u003e\n\u003cli\u003eLatifi A, Ramezankhani A, Rezaei Z, Ashtarian H, Salmani B, Yousefi MR, et al. Prevalence and associated factors of self-medication among the college students in Tehran. J Appl Pharm Sci. 2017;7(7). \u003c/li\u003e\n\u003cli\u003eFlaiti M Al, Badi K Al, Hakami WO, Khan SA. Evaluation of self-medication practices in acute diseases among university students in Oman. Journal of Acute Disease. 2014;3(3). \u003c/li\u003e\n\u003cli\u003eDnyanesh Limaye, Vaidehi Limaye, Gerard Krause, Gerhard Fortwenge. A Systematic Review of the Literature to Assess Self-medication Practices. Ann Med Health Sci Res. 2017;7(1). \u003c/li\u003e\n\u003cli\u003ePal J, Ahmad S, Pal P, Chatterjee D. Prevalence and pattern of self-medication among undergraduate students in a medical college of Kolkata. Int J Community Med Public Health. 2017;4(10). \u003c/li\u003e\n\u003cli\u003eMosaddek ASM, Haque M, Islam MZ, Sharmin ZR, Sharmin R, Rahman MF, et al. Practice of self-medication among students of a selected medical college of Dhaka City, Bangladesh. International Medical Journal. 2017;24(2). \u003c/li\u003e\n\u003cli\u003eIslam B, Hossain MA. Prevalence of self medication practice among students of a medical college. Bangladesh Medical Journal Khulna. 2020;52(1\u0026ndash;2). \u003c/li\u003e\n\u003cli\u003eChari HS, Kadeangadi DM, Chari HS. Practice of Self Medication Among Urban Households-a Community Based Cross Sectional Study. National Journal of Community Medicine│Volume. 2015;6(2). \u003c/li\u003e\n\u003cli\u003eHughes CM, McElnay JC, Fleming GF. Benefits and risks of self medication. Vol. 24, Drug Safety. 2001. \u003c/li\u003e\n\u003cli\u003eTake steps to stop sale of antibiotics without prescriptions [Internet]. [cited 2023 Jun 1]. Available from: https://www.thedailystar.net/city/take-steps-to-stop-sale-of-antibiotics-without-prescriptions-1734625\u003c/li\u003e\n\u003cli\u003eMoonajilin MS, Mamun MA, Rahman ME, Mahmud MF, Al Mamun AHMS, Rana MS, et al. Prevalence and drivers of self-medication practices among savar residents in Bangladesh: A cross-sectional study. Risk Manag Healthc Policy. 2020;13. \u003c/li\u003e\n\u003cli\u003e(PDF) Health Budget of Bangladesh in the Fiscal Year 2022-2023 [Internet]. [cited 2023 Jun 1]. Available from: https://www.researchgate.net/publication/362036566_Health_Budget_of_Bangladesh_in_the_Fiscal_Year_2022-2023\u003c/li\u003e\n\u003cli\u003eJoarder T, Chaudhury TZ,, Mannan I. Universal health coverage in Bangladesh: activities, challenges, and suggestions. . Adv Public Health. 2019; \u003c/li\u003e\n\u003cli\u003eFactors contributing to the purchase of Over The Counter (OTC) drugs in Bangladesh: An Empirical study. The Internet Journal of Third World Medicine. 2012;6(2). \u003c/li\u003e\n\u003cli\u003eZafar SN, Syed R, Waqar S, Zubairi AJ, Vaqar T, Shaikh M, et al. Self-medication amongst university students of Karachi: Prevalence, knowledge and attitudes. J Pak Med Assoc. 2008;58(4). \u003c/li\u003e\n\u003cli\u003eBurak LJ, Damico A. College students\u0026rsquo; use of widely advertised medications. J Am Coll Health Assoc. 2000;49(3). \u003c/li\u003e\n\u003cli\u003eVerma RK, Mohan L, Pandey M. Evaluation of self medication among professional students in North India: Proper statutory drug control must be implemented. Asian Journal of Pharmaceutical and Clinical Research. 2010;3(1). \u003c/li\u003e\n\u003cli\u003eSawalha AF. A descriptive study of self-medication practices among Palestinian medical and nonmedical university students. Research in Social and Administrative Pharmacy. 2008;4(2). \u003c/li\u003e\n\u003cli\u003eGupta V, Bansal P, Manhas R, Singh Z, Ghaiye P. PREFERRED SYSTEM OF MEDICINE AND REASONS OF SELF MEDICATION AMONG COLLEGE STUDENTS IN MALWA REGION OF PUNJAB. Journal of Drug Delivery and Therapeutics. 2011;1(2). \u003c/li\u003e\n\u003cli\u003eIdris T, Khanum S, Uddin Md, Asaduzzaman Md, Islam M, Nasrin F, et al. Study on Self-medication Practices among University Students of Bangladesh. Br J Med Med Res. 2016;14(6). \u003c/li\u003e\n\u003cli\u003eDonkor ES, Tetteh-Quarcoo PB, Nartey P, Agyeman IO. Self-medication practices with antibiotics among tertiary level students in Accra, Ghana: A cross-sectional study. Int J Environ Res Public Health. 2012;9(10). \u003c/li\u003e\n\u003cli\u003eMusa YK, Awosan M, Ibrahim, Zayyanu, Abdullahi, Mohammed M., et al. Knowledge and practice of self-medication among undergraduate students of Usmanu Danfodiyo University, Sokoto.\u0026quot; ,. Ann Int Med Den Res 2. 2016; \u003c/li\u003e\n\u003cli\u003eJames H, Handu SS, Al Khaja KAJ, Otoom S, Sequeira RP. Evaluation of the knowledge, attitude and practice of self-medication among first-year medical students. Medical Principles and Practice. 2006;15(4). \u003c/li\u003e\n\u003cli\u003eEl-Ezz NFA, Ez-Elarab HS. Knowledge, attitude and practice of medical students towards self medication at Ain Shams University, Egypt. J Prev Med Hyg. 2011;52(4). \u003c/li\u003e\n\u003cli\u003eAzhar MIM, Gunasekaran K, Kadirvelu A, Gurtu S, Sadasivan S, Kshatriya BM. Self-medication : Awareness and Attitude among Malaysian Urban Population. Int J Collab Res Intern Med Public Health. 2013;5(6). \u003c/li\u003e\n\u003cli\u003eKumar V, Mangal A, Yadav G, Raut D, Singh S. Prevalence and pattern of self-medication practices in an urban area of Delhi, India. Medical Journal of Dr DY Patil University. 2015;8(1). \u003c/li\u003e\n\u003cli\u003eAlam N, Saffoon N, Uddin R. Self-medication among medical and pharmacy students in Bangladesh. BMC Res Notes. 2015;8(1). \u003c/li\u003e\n\u003cli\u003eKhan A, Sultana A, Ahammad B, Nahar S, Khanam S. Self-Medication Practice among Medical Students of a Tertiary Teaching Hospital in Dhaka City. Journal of Current and Advance Medical Research. 2019;6(1). \u003c/li\u003e\n\u003cli\u003eM N, M M, ASM C, T Z, RA P. Prevalence, Pattern and Impact of Self Medication of Anti-infective Agents During COVID-19 Outbreak in Dhaka City. Glob J Med Res. 2020; \u003c/li\u003e\n\u003cli\u003eMcColl E. Cognitive Interviewing. A Tool for Improving Questionnaire Design. Quality of Life Research. 2006;15(3). \u003c/li\u003e\n\u003cli\u003ePresser S, Couper MP, Lessler JT, Martin E, Martin J, Rothgeb JM, et al. Methods for testing and evaluating survey questions. Public Opin Q. 2004;68(1). \u003c/li\u003e\n\u003cli\u003eMumtaz Y, Ashraf Jahangeer SM, Mujtaba T, Zafar S, Adnan S. Self medication among university students of Karachi. Journal of the Liaquat University of Medical and Health Sciences. 2011;10(3). \u003c/li\u003e\n\u003cli\u003eSatta A, Puddu M, Venturini S, Giupponi C. Assessment of coastal risks to climate change related impacts at the regional scale: The case of the Mediterranean region. International Journal of Disaster Risk Reduction. 2017;24. \u003c/li\u003e\n\u003cli\u003eWHO. World Health Organization Vaccination Coverage Cluster Surveys: Reference Manual. Who. 2018; \u003c/li\u003e\n\u003cli\u003eBhattarai AK, Karki PK. Knowledge, attitude and practice of self-medication among medical students during exam time. Journal of Chitwan Medical College. 2020;10(3). \u003c/li\u003e\n\u003cli\u003eIslam T. Cross-sectional survey to assess the knowledge, attitude and practice regarding adverse drug reactions of students of a private university . Doctoral dissertation, Brac University. 2021; \u003c/li\u003e\n\u003cli\u003eShah K, Halder S, Haider SS. Assessment of knowledge, perception, and awareness about self-medication practices among university students in Nepal. Heliyon. 2021;7(1). \u003c/li\u003e\n\u003cli\u003eB Badiger A, Kundapur R, Jain A, Kumar A, Pattanshetty S, Thakolkaran N, et al. SELF‐MEDICATION PATTERNS AMONG MEDICAL STUDENTS IN SOUTH INDIA. Australasian Medical Journal. 2012;05(04). \u003c/li\u003e\n\u003cli\u003eSunitha M, P S. KNOWLEDGE, ATTITUDE AND PRACTICE OF SELF-MEDICATION AMONG MEDICAL COLLEGE STUDENTS IN KERALA. Journal of Evidence Based Medicine and Healthcare. 2016;3(41). \u003c/li\u003e\n\u003cli\u003eBiswas M, Roy MN, Manik MIN, Hossain MS, Tapu STA, Moniruzzaman M, et al. Self medicated antibiotics in Bangladesh: A cross-sectional health survey conducted in the Rajshahi City. BMC Public Health. 2014;14(1). \u003c/li\u003e\n\u003cli\u003eParihar A, Sharma D, Malhotra P. Questionnaire based assessment of knowledge attitude and practice of self medication among medical undergraduates of a medical college in North India. JK Science. 2018;20(2). \u003c/li\u003e\n\u003cli\u003eMehta RK,, Sharma S. Knowledge, attitude and practice of self-medication among medical students. . Age (years), 20(49). 2015; \u003c/li\u003e\n\u003cli\u003eOshikoya KA, Awobusuyi JO. Perceptions of doctors to adverse drug reaction reporting in a teaching hospital in Lagos, Nigeria. BMC Clin Pharmacol. 2009;9. \u003c/li\u003e\n\u003cli\u003eCorr\u0026ecirc;a Da Silva MG, Soares MCF, Muccillo-Baisch AL. Self-medication in university students from the city of Rio Grande, Brazil. BMC Public Health. 2012;12(1). \u003c/li\u003e\n\u003cli\u003eMustafa OM, Rohra DK. Patterns and determinants of self-medication among university students in Saudi Arabia. Journal of Pharmaceutical Health Services Research. 2017;8(3). \u003c/li\u003e\n\u003cli\u003eNasir M, Zahan T,, Parvin RA. Comparative study on knowledge, attitude and practice of selfmedication among the medical and non-medical undergraduate students in Dhaka city. WJPLS. 2017; \u003c/li\u003e\n\u003cli\u003eSiam MHB, Imran A, Limon MBH, Zahid MH, Hossain MA, Siddique MA, et al. Antibiotic abuse: A cross-sectional study on knowledge, attitude, and behavior among the university students in Dhaka, Bangladesh. Electronic Journal of General Medicine. 2021;18(3). \u003c/li\u003e\n\u003cli\u003eAlves RF, Precioso J, Beco\u0026ntilde;a E. Knowledge, attitudes and practice of self-medication among university students in Portugal: A cross-sectional study. NAD Nordic Studies on Alcohol and Drugs. 2021;38(1). \u003c/li\u003e\n\u003cli\u003eGyawali S, Ravi Shankar P, Poudel PP, Saha A. Knowledge, attitude and practice of self-medication among basic science undergraduate medical students in a medical school in Western Nepal. Journal of Clinical and Diagnostic Research. 2015;9(12). \u003c/li\u003e\n\u003cli\u003eAl-Qahtani AM, Shaikh IA, Shaikh MAK, Mannasaheb BA, Al-Qahtani FS. Prevalence, Perception, and Practice, and Attitudes Towards Self-Medication Among Undergraduate Medical Students of Najran University, Saudi Arabia: A Cross-Sectional Study. Risk Manag Healthc Policy. 2022;15. \u003c/li\u003e\n\u003cli\u003eGutema GB, Gadisa DA, Kidanemariam ZA, Berhe DF, Berhe AH, Hadera MG, et al. Self-medication practices among health sciences students: The case of mekelle university. J Appl Pharm Sci. 2011;1(10). \u003c/li\u003e\n\u003cli\u003eKumar N, Kanchan T, Unnikrishnan B, Rekha T, Mithra P, Kulkarni V, et al. Perceptions and Practices of Self-Medication among Medical Students in Coastal South India. PLoS One. 2013;8(8). \u003c/li\u003e\n\u003cli\u003eIst\u0026uacute;riz RE, Carbon C. Antibiotic Use in Developing Countries. Infect Control Hosp Epidemiol. 2000;21(6). \u003c/li\u003e\n\u003cli\u003eAgrawal R, Sharma SK, Jaiswal MK, Sharma R, Ali SS. Evaluation of knowledge, attitude and practice of self medication among second year undergraduate students in Bastar Region: a questionnaire based study. Int J Basic Clin Pharmacol. 2019;8(4). \u003c/li\u003e\n\u003cli\u003eSelf-Medications Among Higher Educated Population In Bangladesh: An Email-Based Exploratory Study. The Internet Journal of Health. 2012;5(2). \u003c/li\u003e\n\u003cli\u003eIslam MS. Therapeutic drug use in Bangladesh: policy versus practice. Vol. 5, Indian journal of medical ethics. 2008. \u003c/li\u003e\n\u003cli\u003eParakh R, Sharma N, Choudhary V, Parakh KK, Parakh R,, Gour PA. Comparative study of Self-Medication Practice among Medical and Engineering students in a private university in North India. , . World J Pharmacy and Pharmaceutical Sciences. 2014; \u003c/li\u003e\n\u003cli\u003eEhigiator O, Azodo CC, Ehizele AO, Ezeja EB, Ehigiator L, Madukwe IU. Self-medication practices among dental, midwifery and nursing students. European J Gen Dent. 2013;2(01). \u003c/li\u003e\n\u003cli\u003eAlbusalih F, Naqvi A, Ahmad R, Ahmad N. Prevalence of Self-Medication among Students of Pharmacy and Medicine Colleges of a Public Sector University in Dammam City, Saudi Arabia. Pharmacy. 2017;5(4). \u003c/li\u003e\n\u003cli\u003eHelal RM, Abou-Elwafa HS. Self-medication in university students from the city of mansoura, Egypt. J Environ Public Health. 2017;2017. \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Supplementary tables","content":"\u003cp\u003eSupplementary tables 1 to 7 are not available with this version.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Knowledge, attitudes, practice, self-medication, students, Bangladesh","lastPublishedDoi":"10.21203/rs.3.rs-3327159/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3327159/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eSelf-medication is a prevalent practice among university students globally and is a significant public health concern. However, previous research has been limited in scope, focusing primarily on specific student groups or the general public, leaving a gap in understanding the causal relationships associated with self-medication; this study aims to investigate the factors influencing self-medication practices among university students in Bangladesh by developing a comprehensive causal model. Data from 417 students across five public universities were collected using the random walk technique by a team of 10 members. The study utilized constructs of knowledge, attitude, and convenience related to self-medication as independent variables, with self-medication practice as the dependent variable. One-way ANOVA and structural equation modeling were employed to develop a causal model of self-medication practice among university students in Bangladesh. The findings revealed that students with better medication knowledge and adverse drug reactions (ADRs) were more likely to practice self-medication. A positive attitude towards self-medication and ADRs was also significantly associated with higher self-medication practice scores. Additionally, those who perceived self-medication as convenient and prescribed medication as inconvenient had higher self-medication practice scores. The attitude towards self-medication had the most substantial negative effect on self-medication practice, followed by the inconvenience of prescribed medication and the convenience of self-medication. The model explained 87% of the variance in self-medication practice, indicating a good fit for the data. University students in Bangladesh possess intermediate knowledge of medication and primary knowledge of ADRs. They exhibit a positive attitude towards self-medication and ADRs. Physical convenience favors self-medication, while the inconvenience of prescribed medication contributes to its lower preference. Policymakers should focus on evidence-based guidelines for self-medication and enhance the quantity and accessibility of prescribed medications to address the issue effectively.\u003c/p\u003e","manuscriptTitle":"Knowledge, attitudes, convenience and practice of self-medication among university students of Bangladesh: Structural equation modeling","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-11-07 17:39:33","doi":"10.21203/rs.3.rs-3327159/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-02-22T06:59:56+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-12-29T18:28:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"b7f90526-594b-4e8b-a7bc-2c5341851924","date":"2023-12-27T10:40:11+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-12-27T10:24:17+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-12-14T09:48:48+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2023-11-02T16:07:56+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-11-02T16:01:08+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2023-09-05T09:49:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8f3cbc4a-89df-4778-9205-5d5e3503ab8d","owner":[],"postedDate":"November 7th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":25900773,"name":"Health sciences/Health care"},{"id":25900774,"name":"Health sciences/Medical research"},{"id":25900775,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2024-05-14T21:19:46+00:00","versionOfRecord":{"articleIdentity":"rs-3327159","link":"https://doi.org/10.1038/s41598-024-60931-9","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2024-05-12 21:17:29","publishedOnDateReadable":"May 12th, 2024"},"versionCreatedAt":"2023-11-07 17:39:33","video":"","vorDoi":"10.1038/s41598-024-60931-9","vorDoiUrl":"https://doi.org/10.1038/s41598-024-60931-9","workflowStages":[]},"version":"v1","identity":"rs-3327159","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3327159","identity":"rs-3327159","version":["v1"]},"buildId":"ehx78VzkSd0WSzXnipQa-","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}