Prevalence and Patterns of Self-medication in Adults of Suburban South India: A Sequential Explanatory Mixed-method Study

Abstract Introduction: The Ottawa charter recognizes responsible self-medication as a component of self-care, particularly in resource-limited settings. However, irresponsible self-medication can lead to adverse drug interactions, polypharmacy, and delayed diagnosis, posing significant public health concerns. Understanding local drivers of self-medication is essential to guide context-specific interventions. Methodology: This mixed-methods study aimed to assess the prevalence, patterns, and determinants of self-medication among adults in suburban Central Kerala. A sequential explanatory design was employed, combining a community-based cross-sectional survey using EpiCollect5 with in-depth interviews of local pharmacists. Multistage sampling was used, and a sample size of 164 was calculated using (1.96)² PQ / R ². Quantitative data were analyzed through IBM SPSS 20 and Qualitative data using an inductive thematic approach in Quirkos software. Results: The study included 162 participants; the nonresponse rate was only 1.2%. The prevalence of self-medication was 39.6% (95% confidence interval [CI]: 32–47.5). Antipyretics (49.1%) and nonsteroidal anti-inflammatory drugs (38.6%) were the most commonly used medications, primarily for symptoms such as fever (69.3%). Self-medication was found to be uniformly prevalent across all sociodemographic and health-related variables, including marital status ( P = 0.63), education level ( P = 0.51), type of healthcare visits ( P = 0.18), health insurance status ( P = 0.25), distance to hospital ( P = 0.90), and chronic disease status ( P = 0.45). Qualitative findings revealed that a perceived familiarity with medications, high consultation costs, long waiting times, and the persuasive influence of pharmaceutical marketing were key factors motivating self-medication. Conclusion: These findings emphasize the high and uniform prevalence of self-medication across different population groups in central Kerala. They highlight the urgent need for targeted public health strategies that encourage responsible self-medication practices while simultaneously addressing existing challenges in healthcare access and delivery.