Evaluation of Rational Drug Use Among Medical Students in Turkey

Abstract

The use of pharmaceuticals is an indispensable part of healthcare services. Rational drug use (RDU) refers to a set of principles that ensure patients receive medications appropriate to their clinical needs, in correct dosages, for an adequate duration, and at the lowest cost to both themselves and society. This study aims to investigate the RDU practices of third-year medical students through a sample representative of Turkey. This cross-sectional study was conducted during the 2018-2019 academic year with third-year medical students who had not yet entered clinical practice and had not received RDU training. A medical school was randomly selected from each geographic region of Turkey, and students were chosen using the stratified random sampling method. The sample size was calculated as 730 students, and a total of 800 students were included to account for potential losses. Of these, 705 (88.1%) students participated in the study.  Participants were administered a questionnaire consisting of three questions assessing sociodemographic characteristics and 21 questions investigating their medication use habits. To minimize recall bias, the questions covered the previous year.

Participants reported a median of 3 (2-5) medical consultations in the past year, with their most recent consultation occurring a median of 2 (1-4) months prior, and their last medication use occurring a median of 1 (1-2) months prior. A total of 88 (12.5%) participants reported having at least one chronic health condition, the most common of which were allergies (24.4%), reflux/gastritis (11.4%), and headaches (9.1%). Among the students, 23.4% reported using vitamin or mineral supplements, and 22.3% reported using non-pharmaceutical products, with herbal products being the most commonly used (64.3%).  Furthermore, 89% of students reported using medications at some point without a doctor’s recommendation. Of these, 76.9% had used pain relievers, 64.7% had used cold and flu medications, and 5.8% had used antibiotics. The sources of information for non-prescription drug use were drug package inserts (44.8%), recommendations from acquaintances (23.5%), and advice from pharmacists (20%). The high frequency of non-prescription drug use and reliance on unreliable sources of information among the students in this study underscores the need for RDU-related education to be incorporated into their curriculum from the early stages of medical training. Supporting theoretical education with practical training through diverse learning methods is a crucial step that should be taken.