Reversing the Expected Pattern: Atypical Socio-demographic and Social-media predictors of Self-medication among Community Pharmacy Clients in Southern Nigeria

Abstract

Background: The international literature consistently reports self-medication to be more prevalent among younger, less-educated and lower-income individuals, with gender patterns that are more variable but generally skewed toward higher self-medication among women. Objective: To characterise the socio-demographic and informational predictors of self-medication among community pharmacy clients in Yenagoa Local Government Area (LGA), Bayelsa State, Nigeria, and to examine the extent to which these predictors depart from the directionality typically reported elsewhere. Methods: A cross-sectional descriptive survey of 554 adult community pharmacy clients was conducted using stratified random sampling and a structured questionnaire. Multiple linear regression was used to assess the joint and relative contributions of age, gender, education and monthly income to the level of self-medication; independent-samples t-tests assessed the influence of knowledge and attitude on practice; descriptive statistics characterised information sources. Results: Age, gender, education and monthly income jointly explained 83.1% of the variance in the level of self-medication (R² = 0.831, F(4,327) = 396.581, p < 0.05). Contrary to the directionality typically reported in the international and Nigerian literature, self-medication in this sample increased with age (β = 0.487) rather than decreasing, was more prevalent among men (β = 0.587, the strongest predictor) rather than women, and increased with both income (β = 0.133) and education (β = 0.062) rather than being concentrated among poorer or less-educated groups. Respondents with poor self-medication knowledge self-medicated significantly more than those with good knowledge (mean = 3.21 versus 1.44; mean difference = 1.77, 95% CI 1.55–1.98, p < 0.001), and respondents with a positive attitude self-medicated significantly more than those with a negative attitude. Social media was the leading information source underlying self-medication (33.9%), ahead of personal knowledge (31.5%) and professional advice (17.4%). Conclusion: In this population, self-medication is not concentrated among the socio-economically disadvantaged, as is commonly assumed, but rather among older, better-resourced and better-educated men whose information environment is dominated by social media rather than professional consultation. This reversal challenges the assumption that self-medication interventions should be targeted primarily at low-resource or low-literacy groups, and instead points to a resourced, socially mediated behaviour that requires a different intervention logic.