Self-medication for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021

Ambrocio Teodoro Esteves Pairazaman; Daniel Ñañez del Pino; Walter Gregorio Ibarra Fretell; Oscar Arbieto Mamani; Rosmery Sabina Pozo Enciso; Veronica Liset Esteves Cardenas; YSABEL VALVERDE FLORES; ELISABET FIORELA ARIAS ANCHIHUAY; PABLO RAFAEL MANRIQUE CARHUAS

doi:10.12688/f1000research.123308.1

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Research Article

Self-medication for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021

[version 1; peer review: 1 approved with reservations, 1 not approved]

Ambrocio Teodoro Esteves Pairazaman ¹, Daniel Ñañez del Pino¹, Walter Gregorio Ibarra Fretell², [...] Oscar Arbieto Mamani³, Rosmery Sabina Pozo Enciso⁴, Veronica Liset Esteves Cardenas⁵, YSABEL VALVERDE FLORES², ELISABET FIORELA ARIAS ANCHIHUAY¹, PABLO RAFAEL MANRIQUE CARHUAS¹

Ambrocio Teodoro Esteves Pairazaman ¹, Daniel Ñañez del Pino¹, [...] Walter Gregorio Ibarra Fretell², Oscar Arbieto Mamani³, Rosmery Sabina Pozo Enciso⁴, Veronica Liset Esteves Cardenas⁵, YSABEL VALVERDE FLORES², ELISABET FIORELA ARIAS ANCHIHUAY¹, PABLO RAFAEL MANRIQUE CARHUAS¹

PUBLISHED 22 Sep 2022

Author details Author details

¹ Facultad de Farmacia y Bioquímica, Universidad Norbert Wiener, Lima, Lima, 15072, Peru
² Facultad de Ciencias Empresariales, Universidad Cesar Vallejo, Lima, Lima, 13001, Peru
³ Universidad Nacional Micaela Bastidas de Apurímac, Abancay, Apurímac, 03001, Peru
⁴ Universidad Autónoma de Ica, Ica, Ica, 11701, Peru
⁵ Universidad Privada del Norte, Trujillo, La Libertad, 13001, Peru

Ambrocio Teodoro Esteves Pairazaman
Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Supervision

Daniel Ñañez del Pino
Roles: Methodology, Supervision, Writing – Review & Editing

Walter Gregorio Ibarra Fretell
Roles: Writing – Review & Editing

Oscar Arbieto Mamani
Roles: Writing – Review & Editing

Rosmery Sabina Pozo Enciso
Roles: Writing – Review & Editing

Veronica Liset Esteves Cardenas
Roles: Data Curation, Writing – Review & Editing

YSABEL VALVERDE FLORES
Roles: Writing – Review & Editing

ELISABET FIORELA ARIAS ANCHIHUAY
Roles: Investigation, Methodology, Validation, Visualization, Writing – Review & Editing

PABLO RAFAEL MANRIQUE CARHUAS
Roles: Investigation, Methodology, Validation, Visualization, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

This article is included in the Emerging Diseases and Outbreaks gateway.

Abstract

Background: Self-medication is a non-responsible act and leads to the inappropriate use of medications, causing low effectiveness and insecurity in treatments. The aim of this study is to determine the relationship between self-medication and anxiety symptoms in the context of coronavirus disease 2019 (COVID-19), in users attending a pharmacy in Los Olivos, Lima in 2021.
Methods: The research method was deductive, basic and with a quantitative approach; the design used was non-experimental, descriptive, correlational, cross-sectional, and prospective. Spearman's Rho analysis was performed to validate the hypothesis.
Results: 384 users were evaluated, finding 93.5% aged 18-59 years, of whom 53.4% were female, 42.7% had completed high school, 57.8% were single and 51.6% presented physical symptoms, predominantly muscular tension accompanied by pain, 60.7% presented behavioral symptoms, highlighting unusual sadness in the face of COVID-19 and 70.1% presented cognitive symptoms with greater frequency of concern about contracting COVID-19. In addition, the greater the symptoms of anxiety, the higher the self-medication increased from 9.0% to 21.1%. A similar case was evidenced in self-medication on their own initiative where the increase was from 7.5% to 33.3%; likewise, self-medication without medical prescription increased from 15.8% to 47.7%, and the consumption of anxiolytics or antidepressants increased from 0.8% to 26.3% caused by the symptoms of anxiety.
Conclusion: It was determined that there is a moderate relationship between self-medication and anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

Keywords

Self-medication, prescription, anxiety, depression, COVID-19.

Corresponding author: Ambrocio Teodoro Esteves Pairazaman

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2022 Esteves Pairazaman AT et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Esteves Pairazaman AT, Ñañez del Pino D, Ibarra Fretell WG et al. Self-medication for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021 [version 1; peer review: 1 approved with reservations, 1 not approved]. F1000Research 2022, 11:1084 (https://doi.org/10.12688/f1000research.123308.1) First published: 22 Sep 2022, 11:1084 (https://doi.org/10.12688/f1000research.123308.1) Latest published: 22 Sep 2022, 11:1084 (https://doi.org/10.12688/f1000research.123308.1)

Introduction

Self-medication is a worldwide problem, which when added to the physical and mental damage that coronavirus disease 2019 (COVID-19) has caused in the individual, has motivated a group of the population to self-medicate to calm their anxious state.¹ Likewise, the misinformation from the media and the promotion of the intake of drugs without scientific basis have generated a close relationship.² At the same time, anxiety, the most important psychiatric disorder in the world, has generated feelings of fear as a result of the pandemic because it has affected the economy and the daily life of the population.³

First, it is important to understand self-medication, which is defined as the selection and use of medications to treat self-recognized symptoms or ailments without consulting a physician. Globally, it is a major concern because it affects both developed and developing countries. Numerous studies indicate that self-medication is a common practice with a prevalence of 32.5% to 81.5% worldwide.¹^,²

In the context of COVID-19 it has generated a collective concern, where the misinformation of the media and the promotion by the intake of medicines without scientific basis have influenced its increase.¹

In fact, a study conducted in Spain on self-medication among pharmacy students at the University of Murcia found that 72.5% of those interviewed had a self-medication habit.⁴ On the other hand, a study conducted in Peru showed that prior to the pandemic, the average age of those who used to self-medicate was 46.5 years; this number has been reduced to 40.8 years in the context of COVID-19.⁵ Studies conducted in regions such as the coast, highlands and jungle show that factors such as residence, age and work activities are associated with self-medication by the population in these times of pandemic.⁶ Likewise, a study carried out in Junín on factors associated with self-medication showed that socioeconomic factors are even more frequent in the Peruvian population due to the availability of over-the-counter drugs.⁷

Self-medication is a health problem that affects different sectors of our population due to multiple factors such as: economic, social and cultural, and has developed a close relationship with anxiety.⁸ Due to the pandemic it has generated feelings of fear about COVID-19 and the consequences it may bring, causing a general increase in anxiety.³^,⁹

In China, more than 1000 people were evaluated in several cities, and it was shown that 16.5% presented symptoms of stress and 28.8% symptoms of anxiety.¹⁰ In the same context, Peru is no stranger to this problem since a study conducted in Chota on anxiety in times of social isolation by COVID-19, showed that 43% of participants had anxiety, of which 20.9% had mild anxiety, 13.4% had moderate anxiety and 9% had severe anxiety.¹¹

Self-medication is a non-responsible act and leads to the inappropriate use of medications, causing low effectiveness and insecurity in treatments, damage to health and patient dissatisfaction.¹² On the other hand, COVID-19 has caused unfavorable consequences for the mental health of the Peruvian people and, being one of the countries in Latin America most affected by the pandemic, it has caused anxiety problems in its population and an increase in self-medication.¹³ In conclusion, both situations have produced diverse health problems, which is why the present research study intends to show how self-medication is related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos.

The aim of the present work is to investigate the relationship between self-medication and anxiety symptoms in the context of COVID-19 in the district of Los Olivos, which is one of the 9 districts under the jurisdiction of the Directorate of Integrated Networks of Northern Lima (DIRIS Lima Norte) and one with the highest number of positive cases of COVID-19 in a recent study.¹⁴ Likewise, the work will provide knowledge that will be a contribution for the institutes, universities, and health centers and related to the subject of study and will allow the future development of a global study to identify people with anxiety disorders and medication problems as a result of the COVID-19 pandemic.

Methods

Ethics and consent

For the elaboration of the study, the norms of the research ethics code of the Norbert Wiener Private University were taken into account, which reviewed and approved the project set forth in Resolution N°134-2021-DFFB/UPNM approved on 18 December 2021, by the Faculty of Pharmacy and Biochemistry of the same university. This research followed the principles of the Declaration of Helsinki, promulgated by the World Medical Association (WMA).¹⁵^,¹⁶

Informed consent was taken from all participants in writing before they responded to the questionnaire, and participants were guaranteed both their anonymity and that the data used will be exclusively for the research, as per the ethical guidelines.

Design and participants

The type of research was basic, the method was deductive, and the approach was quantitative and cross-sectional.¹⁷^–¹⁹

The population for the case of the present study was the users of a drugstore located in Los Olivos, Lima.

This pharmacy was chosen because the district of Los Olivos was one of the districts with the highest number of positive COVID-19 cases at the beginning of the pandemic. In addition, we worked there in the pharmacy located in Los Olivos and we have witnessed how these controlled medicines were requested by users who came to the pharmacy to calm their anxious state.

The pharmacy is registered with the “Direccion General de Medicamentos Insumos y Drogas” (DIGEMID), it also has a chemist-pharmacist in the store.

The pharmacy is located in a central location where there is a large number of people.

The following inclusion and exclusion criteria were used to select the sample:

Inclusion criteria

• Users willing to participate in the research work.
• Users over 18 years of age.
• Male and female users.
• Users entering the pharmaceutical establishment.

Exclusion criteria

• Users under 18 years of age.
• Users who do not agree to participate in the survey.
• Users who do not enter the pharmaceutical establishment.

For the calculation of the sample, an infinite population was considered, where the sample size will be obtained from the following formula:

n = \frac{Z^{2} * P * Q}{e^{2}}

Where:

n: Sample size

Z: tabulated value 1.96 of the normal distribution at 95% confidence level

p: percentage of the population that has the desired attribute = 50%.

q: percentage of the population that does not have the desired attribute = 1-p

e: Precision (in the research a 5%) = 0.05

Then, replacing values in the formula, we have:

n = \frac{{(1. 96)}^{2} * 0.5 * 0.5}{{(0. 05)}^{2}} = 384

The sample consisted of a total of 384 people to be surveyed.

In order to recruit people, a systematic random sample was used, and it was determined that 740 people attended the drugstore on a weekly basis. Data collection was carried out over of 12 days, from 19 to 31 December 2021. An average of 32 people per day were surveyed and randomly selected to complete the total of 384 respondents. For the application of the survey, we waited for each person to leave the drugstore after shopping, explained the study to them and gave them the informed consent form and then the survey, both in writing, so that they could fill out their questionnaires themselves. The researchers were always available to answer any questions the respondents might have.

The researchers' contact numbers were left with each respondent in case they wished to withdraw from the study.

Instruments

As a data collection technique, the survey was used to collect information on the behavior of the individual to be studied, using a questionnaire as an instrument,¹⁷ which consists of two parts where questions related to the two study variables that were used.

Variable 1: Self-medication

Dimensions: Self-initiated, without medical prescription and medication used.

No. of items: 9

Variable 2: Anxiety symptoms in the context of COVID-19

Dimensions: Physical symptoms, behavioral symptoms, and cognitive symptoms.

No. of items: 13

Scale of measurement for both variables: Never (1), almost never (2), sometimes (3), almost always (4) and always (5).

The instrument was validated by three experts in the research field, who approved the collection tool for its subsequent application.

For the processing of the information, the statistical technique used was as follows: first the answers were tabulated in an Excel 2019 spreadsheet, and all data were exported to SPSS version 24, to be able to perform the reliability of the values by means of Cronbach's Alpha (0.866). Then a descriptive analysis of the results obtained from the indicators grouped by the dimensions was performed, a normality test was performed for both variables, with the result that the two variables are nonparametric. Spearman's Rho test was chosen to test the hypotheses proposed and finally the results were presented in tables and graphs which were interpreted for a better understanding.

Results

No respondent chose not to complete the survey at any time. Therefore, a total of 384 people participated in the research. All of them filled in their surveys correctly, so there was no loss of data.

Table 1 shows the percentages of the general data collected, where 53.4% of the users were female; with respect to age, the highest percentage was between 30-59 years of age (59.6%). 57.8% were single, 42.7% had secondary education, 24.0% had a technical level and 27.1% had higher education.

Table 1. Frequency of general data in users who go to a drugstore in Los Olivos, Lima 2021.

General information		Frequency	Percentage
Age ranges	18-29	130	33.9
	30-59	229	59.6
	60-84	25	6.5
Gender	Male	179	46.6
Gender	Female	205	53.4
Education level	Elementary	24	6.3
	Secondary	164	42.7
	Technical	92	24.0
	Superior	104	27.1
Marital status	Married	128	33.3
	Single	222	57.8
	Divorced	11	2.9
	Separated	23	6.0
Total		384	100.0

Table 2 shows the percentage of indicators of anxiety symptoms in the context of COVID-19. 50.5% indicated having problems relaxing or staying asleep during the pandemic (physical symptoms), with the percentage obtained from the sum of the levels: “sometimes”, “almost always” and “always”. Behavioral symptoms such as nervousness or increased movements totaled 40.2%, obtained from the sum between the levels from “sometimes” to “always”, and cognitive symptoms such as worry about catching COVID-19 during the pandemic totaled 70.1% between the levels from “sometimes” to “always”.

Table 2. Frequency of anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

Anxiety symptoms		Scale	Frequency	Percentage
Physical symptoms	Increased heart rate (palpitations) during the pandemic	Never	246	64.1
		Almost never	42	10.9
		Sometimes	86	22.4
		Almost always	8	2.1
		Always	2	0.5
	Muscle tension accompanied by pain in certain parts of the body during the pandemic.	Never	137	35.7
		Almost never	49	12.8
		Sometimes	172	44.8
		Almost always	16	4.2
		Always	10	2.6
	Trouble relaxing or staying asleep during the pandemic.	Never	145	37.8
		Almost never	45	11.7
		Sometimes	143	37.2
		Almost always	41	10.7
		Always	10	2.6
Behavioral symptoms	Unusual sadness in front of COVID-19.	Never	113	29.4
		Almost never	38	9.9
		Sometimes	179	46.6
		Almost always	38	9.9
		Always	16	4.2
	Nervousness or movement more than usual.	Never	167	43.5
		Almost never	63	16.4
		Sometimes	124	32.3
		Almost always	24	6.3
		Always	6	1.6
	Insecurity and awkward movements (e.g., dropping things)	Never	221	57.6
		Almost never	62	16.1
		Sometimes	88	22.9
		Almost always	8	2.1
		Always	5	1.3
Cognitive symptoms	Unpleasant thoughts or images during the pandemic.	Never	154	40.1
		Almost never	58	15.1
		Sometimes	138	35.9
		Almost always	23	6.0
		Always	11	2.9
	Difficulty staying focused (dazed or confused) during the pandemic.	Never	157	40.9
		Almost never	67	17.4
		Sometimes	140	36.5
		Almost always	12	3.1
		Always	8	2.1
	Concern about COVID-19 infection during the pandemic.	Never	81	21.1
		Almost never	34	8.9
		Sometimes	144	37.5
		Almost always	72	18.8
		Always	53	13.8
Total			384	100.0

Table 3 shows the percentages of anxiety symptoms experienced by the drugstore users, which range from never feeling symptoms to almost always showing them. It can be seen that none of the respondents always felt symptoms of anxiety. Therefore, when making a cross table we observe that as users feel symptoms of anxiety, they sometimes or almost always feel anxious; they opt for self-medication (3.6%).

Table 3. Self-medication for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

		Self-medication
		Never		Almost never		Sometimes		Almost always		Always		Total
	scale	N	%	n	%	n	%	n	%	n	%	n	%
Anxiety symptoms	Never	114	95.0%	6	5.0%	0	0.0%	0	0.0%	0	0.0%	120	100%
	Almost never	111	83.5%	22	16.5%	0	0.0%	0	0.0%	0	0.0%	133	100%
	Sometimes	61	55.0%	40	36.0%	10	9.0%	0	0.0%	0	0.0%	111	100%
	Almost always	8	42.1%	7	36.8%	4	21.1%	0	0.0%	0	0.0%	19	100%
	Always	0	0.0%	1	100.0%	0	0.0%	0	0.0%	0	0.0%	1	100%
Total		120	294	76.6	76	19.8	14	3.6	0	0.0	0	0.0	384

Table 4 shows that as anxiety symptoms increase, the percentage of surveyed users who “sometimes” self-medicate on their own initiative increases from 7.5% to 33.3% and in the levels of “almost always” the percentage increases from 3.0% to 21.1%. It is also noted that the percentage of users who “sometimes” self-medicate irresponsibly is 36.8%, 42.1% “sometimes” self-medicate on the recommendation of third parties and 26.3% “sometimes” self-medicate under the influence of the media.

Table 4. Own initiative in the face of anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

		Anxiety symptoms
		Never		Almost never		Sometimes		Almost always		Always		Total
	Scale	N	%	n	%	n	%	n	%	n	%	n	%
Irresponsible self-medication	Never	101	84.2%	83	62.4%	46	41.4%	6	31.6%	0	0.0%	236	61.5%
	Almost never	4	3.3%	27	20.3%	18	16.2%	2	10.5%	0	0.0%	51	13.3%
	Sometimes	14	11.7%	17	12.8%	33	29.7%	7	36.8%	0	0.0%	71	18.5%
	Almost always	0	0.0%	4	3.0%	9	8.1%	2	10.5%	1	100.0%	16	4.2%
	Always	1	0.8%	2	1.5%	5	4.5%	2	10.5%	0	0.0%	10	2.6%
Third-party recommendation	Never	103	85.8%	84	63.2%	50	45.0%	7	36.8%	0	0.0%	244	63.5%
	Almost never	6	5.0%	17	12.8%	19	17.1%	2	10.5%	0	0.0%	44	11.5%
	Sometimes	11	9.2%	28	21.1%	35	31.5%	8	42.1%	1	100.0%	83	21.6%
	Almost always	0	0.0%	3	2.3%	6	5.4%	2	10.5%	0	0.0%	11	2.9%
	Always	0	0.0%	1	0.8%	1	0.9%	0	0.0%	0	0.0%	2	0.5%
Influence of mass media	Never	103	85.8%	79	59.4%	59	53.2%	10	52.6%	0	0.0%	251	65.4%
	Almost never	9	7.5%	19	14.3%	19	17.1%	1	5.3%	0	0.0%	48	12.5%
	Sometimes	8	6.7%	31	23.3%	29	26.1%	5	26.3%	1	100.0%	74	19.3%
	Almost always	0	0.0%	4	3.0%	4	3.6%	1	5.3%	0	0.0%	9	2.3%
	Always	0	0.0%	0	0.0%	0	0.0%	2	10.5%	0	0.0%	2	0.5%
On its own initiative	Never	97	80.8%	60	45.1%	41	36.9%	5	26.3%	0	0.0%	203	52.9%
	Almost never	14	11.7%	44	33.1%	20	18.0%	4	21.1%	0	0.0%	82	21.4%
	Sometimes	9	7.5%	25	18.8%	37	33.3%	5	26.3%	0	0.0%	76	19.8%
	Almost always	0	0.0%	4	3.0%	12	10.8%	4	21.1%	1	100.0%	21	5.5%
	Always	0	0.0%	0	0.0%	1	0.9%	1	5.3%	0	0.0%	2	0.5%
Total		120	100.0%	133	100.0%	111	100.0%	19	100.0%	1	100.0%	384	100.0%

Table 5 shows in general terms that as anxiety symptoms increase, the percentages of surveyed users who “sometimes” self-medicate without medical prescription increase from 15.8% to 47.7% and in the levels of “almost always” the percentage increases from 2.5% to 26.3%. The percentage of users who “sometimes” self-medicated due to the time factor was 38.7%, 43.2% “sometimes” self-medicated due to economic deficiency and 29.7% “sometimes” self-medicated using previous prescriptions.

Table 5. No medical prescription for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

		Anxiety symptoms
		Never		Almost never		Sometimes		Almost always		Always		Total
	Scale	n	%	n	%	n	%	n	%	n	%	n	%
Time factor	Never	74	61.7%	50	37.6%	27	24.3%	4	21.1%	0	0.0%	155	40.4%
	Almost never	13	10.8%	23	17.3%	14	12.6%	5	26.3%	1	100.0%	56	14.6%
	Sometimes	29	24.2%	47	35.3%	43	38.7%	5	26.3%	0	0.0%	124	32.3%
	Almost always	2	1.7%	8	6.0%	20	18.0%	3	15.8%	0	0.0%	33	8.6%
	Always	2	1.7%	5	3.8%	7	6.3%	2	10.5%	0	0.0%	16	4.2%
Economic deficiency	Never	78	65.0%	54	40.6%	23	20.7%	5	26.3%	0	0.0%	160	41.7%
	Almost never	11	9.2%	29	21.8%	18	16.2%	4	21.1%	0	0.0%	62	16.1%
	Sometimes	28	23.3%	38	28.6%	48	43.2%	2	10.5%	1	100.0%	117	30.5%
	Almost always	3	2.5%	10	7.5%	17	15.3%	6	31.6%	0	0.0%	36	9.4%
	Always	0	0.0%	2	1.5%	5	4.5%	2	10.5%	0	0.0%	9	2.3%
Use of previous prescription	Never	97	80.8%	83	62.4%	56	50.5%	11	57.9%	0	0.0%	247	64.3%
	Almost never	12	10.0%	18	13.5%	12	10.8%	3	15.8%	1	100.0%	46	12.0%
	Sometimes	10	8.3%	24	18.0%	33	29.7%	2	10.5%	0	0.0%	69	18.0%
	Almost always	1	0.8%	6	4.5%	8	7.2%	1	5.3%	0	0.0%	16	4.2%
	Always	0	0.0%	2	1.5%	2	1.8%	2	10.5%	0	0.0%	6	1.6%
Without medical prescription	Never	65	54.2%	39	29.3%	15	13.5%	4	21.1%	0	0.0%	123	32.0%
	Almost never	33	27.5%	36	27.1%	23	20.7%	6	31.6%	0	0.0%	98	25.5%
	Sometimes	19	15.8%	48	36.1%	53	47.7%	3	15.8%	1	100.0%	124	32.3%
	Almost always	3	2.5%	10	7.5%	20	18.0%	5	26.3%	0	0.0%	38	9.9%
	Always	0	0.0%	0	0.0%	0	0.0%	1	5.3%	0	0.0%	1	0.3%
Total		120	100.0%	133	100.0%	111	100.0%	19	100.0%	1	100.0%	384	100.0%

Table 6 shows in general that as anxiety symptoms increase, the percentages of surveyed users who “sometimes” self-medicate with anxiolytics or antidepressants increase from 0.8% to 26.3%, It also stands out that the percentage of users who “sometimes” self-medicated with anxiolytics with a long half-life such as clonazepam was 26.3% and those with an intermediate half-life such as alprazolam was 21.1%, and the highest percentage of self-medication with antidepressants (sertraline) was 15.8%.

Table 6. Medication used for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

		Anxiety symptoms
		Never		Almost never		Sometimes		Almost always		Always		Total
	Scale	n	%	n	%	n	%	n	%	n	%	n	%
Diazepam	Never	118	98.3%	121	91.0%	94	84.7%	13	68.4%	1	100.0%	347	90.4%
	Almost never	0	0.0%	7	5.3%	9	8.1%	0	0.0%	0	0.0%	16	4.2%
	Sometimes	2	1.7%	5	3.8%	7	6.3%	4	21.1%	0	0.0%	18	4.7%
	Almost always	0	0.0%	0	0.0%	0	0.0%	1	5.3%	0	0.0%	1	0.3%
	Always	0	0.0%	0	0.0%	1	0.9%	1	5.3%	0	0.0%	2	0.5%
Clonazepam	Never	114	95.0%	121	91.0%	86	77.5%	11	57.9%	1	100.0%	333	86.7%
	Almost never	1	0.8%	7	5.3%	8	7.2%	0	0.0%	0	0.0%	16	4.2%
	Sometimes	5	4.2%	5	3.8%	15	13.5%	5	26.3%	0	0.0%	30	7.8%
	Almost always	0	0.0%	0	0.0%	0	0.0%	1	5.3%	0	0.0%	1	0.3%
	Always	0	0.0%	0	0.0%	2	1.8%	2	10.5%	0	0.0%	4	1.0%
Alprazolam	Never	115	95.8%	122	91.7%	92	82.9%	15	78.9%	1	100.0%	345	89.8%
	Almost never	2	1.7%	6	4.5%	8	7.2%	0	0.0%	0	0.0%	16	4.2%
	Sometimes	3	2.5%	4	3.0%	9	8.1%	4	21.1%	0	0.0%	20	5.2%
	Almost always	0	0.0%	0	0.0%	1	0.9%	0	0.0%	0	0.0%	1	0.3%
	Always	0	0.0%	1	0.8%	1	0.9%	0	0.0%	0	0.0%	2	0.5%
Lorazepam	Never	117	97.5%	124	93.2%	101	91.0%	17	89.5%	1	100.0%	360	93.8%
	Almost never	0	0.0%	7	5.3%	7	6.3%	0	0.0%	0	0.0%	14	3.6%
	Sometimes	3	2.5%	2	1.5%	3	2.7%	2	10.5%	0	0.0%	10	2.6%
	Almost always	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%
	Always	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%
Bromazepam	Never	117	97.5%	127	95.5%	102	91.9%	18	94.7%	1	100.0%	365	95.1%
	Almost never	3	2.5%	5	3.8%	7	6.3%	0	0.0%	0	0.0%	15	3.9%
	Sometimes	0	0.0%	1	0.8%	2	1.8%	1	5.3%	0	0.0%	4	1.0%
	Almost always	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%
	Always	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%
Sertralina	Never	119	99.2%	128	96.2%	95	85.6%	14	73.7%	1	100.0%	357	93.0%
	Almost never	1	0.8%	2	1.5%	5	4.5%	1	5.3%	0	0.0%	9	2.3%
	Sometimes	0	0.0%	2	1.5%	11	9.9%	3	15.8%	0	0.0%	16	4.2%
	Almost always	0	0.0%	1	0.8%	0	0.0%	0	0.0%	0	0.0%	1	0.3%
	Always	0	0.0%	0	0.0%	0	0.0%	1	5.3%	0	0.0%	1	0.3%
Fluoxetina	Never	119	99.2%	124	93.2%	99	89.2%	15	78.9%	1	100.0%	358	93.2%
	Almost never	0	0.0%	5	3.8%	6	5.4%	1	5.3%	0	0.0%	12	3.1%
	Sometimes	1	0.8%	3	2.3%	5	4.5%	2	10.5%	0	0.0%	11	2.9%
	Almost always	0	0.0%	1	0.8%	0	0.0%	0	0.0%	0	0.0%	1	0.3%
	Always	0	0.0%	0	0.0%	1	0.9%	1	5.3%	0	0.0%	2	0.5%
Medication used	Never	118	98.3%	126	94.7%	94	84.7%	13	68.4%	1	100.0%	352	91.7%
	Almost never	2	1.7%	6	4.5%	13	11.7%	1	5.3%	0	0.0%	22	5.7%
	Sometimes	0	0.0%	1	0.8%	4	3.6%	5	26.3%	0	0.0%	10	2.6%
	Almost always	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%
	Always	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%	0	0.0%
Total		120	100.0%	133	100.0%	111	100.0%	19	100.0%	1	100.0%	384	100.0%

General hypothesis test:

H₀: Self-medication is not related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

H₁: Self-medication is related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

At P-value (sig. <0.05), a significance value of 0.000 was obtained, rejecting the null hypothesis and accepting the alternative hypothesis, with a Spearman's Rho coefficient of 0.537. According to the correlation test estimation scale, it is indicated that there is a moderate positive correlation, that is to say that an increase in anxiety symptoms is associated with greater self-medication. Therefore, it is concluded that self-medication is related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

Specific hypothesis test 1:

H₀: The self-initiated dimension of self-medication is not related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

H₁: The self-initiated dimension of self-medication is related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

At P-value (sig. <0.05), a significance value of 0.000 was obtained; rejecting the null hypothesis and accepting the alternative hypothesis, with a Spearman's Rho coefficient of 0.410. According to Spearman's correlation estimation scale, it is indicated that there is a moderate positive correlation, that is to say that an increase in anxiety symptoms is associated with a greater self-medication on one's own initiative; Therefore, it is concluded that the self-initiated self-medication dimension is related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021 (See Tables 7 -10).

Table 7. Spearman's Rho test between self-medication versus anxiety symptoms in users who go to a drugstore in Los Olivos, Lima in 2021.

Spearman’s Rho		Self-medication
Anxiety symptoms	Correlation coefficient	0.537
	Sig. (bilateral)	0.000
	N	384

Table 8. Spearman's Rho test for self-initiated anxiety symptoms in users who go to a drugstore in Los Olivos, Lima in 2021.

Spearman’s Rho		On its own initiative
Anxiety symptoms	Correlation coefficient	0.410
	Sig. (bilateral)	0.000
	N	384

Table 9. Spearman's Rho test without medical prescription versus anxiety symptoms, in users who go to a drugstore in Los Olivos, Lima in 2021.

Spearman’s Rho		Without medical prescription
Anxiety symptoms	Correlation coefficient	0.467
	Sig. (bilateral)	0.000
	N	384

Table 10. Spearman's Rho test between the medication used against anxiety symptoms, in users who go to a drugstore in Los Olivos, Lima in 2021.

Spearman’s Rho		Medication used
Anxiety symptoms	Correlation coefficient	0.285
	Sig. (bilateral)	0.000
	N	384

Specific hypothesis test 2:

H₀: The dimension without medical prescription of self-medication is not related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

H₁: The dimension without medical prescription of self-medication is related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

At P-value (sig. <0.05), a significance value of 0.000 was obtained; rejecting the null hypothesis and accepting the alternative hypothesis, with a Spearman's Rho coefficient of 0.467. According to Spearman's correlation estimation scale, it is indicated that there is a moderate positive correlation, that is to say that an increase in anxiety symptoms is associated with greater self-medication without medical prescription; Therefore, it is concluded that the dimension without medical prescription of self-medication is related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

Specific hypothesis test 3:

H₀: The medication dimension of self-medication is not related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

H₁: The medication dimension of self-medication is related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

At P-value (sig. <0.05), a significance value of 0.000 was obtained, rejecting the null hypothesis and accepting the alternative hypothesis, with a Spearman's Rho coefficient of 0.285. According to the Spearman's correlation estimation scale, it is indicated that there is a low positive correlation, this is lower correlation than the other factors analysed, that is to say that an increase in anxiety symptoms is associated with a greater self-medication with the medication used. Therefore, it is concluded that the medication used dimension of self-medication is related to anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

Discussion and conclusion

It should be noted that it is not possible to generalise the results obtained, due to the fact that a low percentage of respondents consider that they have signs of anxiety. It is recommended that future studies should recruit patients previously diagnosed with anxiety.

For self-medication and anxiety symptoms in the context of COVID-19, it is evident that as anxiety symptoms increase, the percentages of surveyed users who “almost never” self-medicate increase from 5.0% to 36.8%, a similar case is observed in users who “sometimes” self-medicate, where the percentage increases from 9.0% to 21.1%. These results are similar to the study by Yasif, et al.²⁰ on sleep quality and psychological states of the Bangladeshi population during the COVID-19 pandemic, which found that 39.5% of the population presented with sleep problems, while others had anxiety and severe depression, and showing that 7.14% of the respondents self-medicated with sleeping pills. Likewise, Grigsby,²¹ who conducted a study on rates of self-reported increases in the use of anxiety-related medications and sleep aids, found that symptoms of major depressive disorder, generalized anxiety disorder and somatization disorder were related to the increase in the use of medications for anxiety and sleep aids.

For self-medication on their own initiative and anxiety symptoms in the context of COVID-19, it is evident that as anxiety symptoms increase the percentages of surveyed users who “sometimes” self-medicate on their own initiative increase from 7.5% to 33.3%, and in the levels of “almost always” the percentage increases from 3.0% to 21.1%. It is also noted that the percentage of users who “sometimes” self-medicate irresponsibly is 36.8%, 42.1% who “sometimes” self-medicate on the recommendation of third parties and 26.3% who “sometimes” self-medicate due to the influence of the media. The results are similar to the study by Huaman and Tamayo²² on self-medication of anxiolytics and antidepressants in adult women during the COVID-19 pandemic. They found that the surveyed population self-medicated on the influence of social networks (31.1%); internet (31.6%); family members (31.1%); friends (30.1%); television (9.7%); and newspaper and/or magazines (12.2%). In addition, Taquia and Aguilar²³ conducted a study on the incidence of self-medication with anxiolytics in the population of the district of Huancayo and found that 93% self-medicated due to the influence of the virtual media. Likewise, Cabanillas,²⁴ in a study on self-medication with benzodiazepines and the risk of abuse, found that 23.57% consumed benzodiazepines without a prescription.

For self-medication without medical prescription in the context of COVID-19. it is evident that as anxiety symptoms increase, the percentage of surveyed users who “sometimes” self-medicate without medical prescription increases from 15.8% to 47.7% and in the levels of “almost always” the percentage increases from 2.5% to 26.3%. It also stands out that the percentage of users who “sometimes” self-medicate due to the time factor was 38.7%, 43.2% “sometimes” self-medicate due to economic deficiency and 29.7% “sometimes” self-medicate using previous prescriptions. Results are similar to the study by Marion, et al.²⁵ on the prevalence and characteristics of self-medication behaviors, which found that 51.7% used drugs from a previous prescription, mostly analgesics, antibiotics and anxiolytics (prescription drugs). Likewise, Huaman and Tamayo²² conducted a study on self-medication of anxiolytics and antidepressants in adult women during the COVID-19 pandemic and found that 23.5% went to a health center or hospital; 11.7% to a doctor's office or clinic; and 38.8% to a pharmacy and/or drugstore. In addition, Taquia and Aguilar²³ conducted a study on the incidence of self-medication with anxiolytics in the population of the District of Huancayo and found that 68% self-medicated because they did not have time to go to a health center.

For self-medication by the medication used for anxiety symptoms in the context of COVID-19, it is evident that as anxiety symptoms increase, the percentage of surveyed users who “sometimes” self-medicate with anxiolytics or antidepressants increases from 0.8% to 26.3%. The percentage of users who “sometimes” self-medicated with anxiolytics with a long half-life such as clonazepam was 26.3% and those with an intermediate half-life such as alprazolam was 21.1%. The highest percentage of self-medication with antidepressants (sertraline) was 15.8%. The results are similar to those from a study by Tripković, Šantrić and Odalović²⁶ on self-medication with tranquilizers and sleeping pills in a Serbian population. They found that the percentage of self-medication with tranquilizers and sleeping pills was 5.6% in women compared to 2.2% of men. Likewise, Yasif et al.²⁰ found in a study on sleep quality and psychological states of the Bangladeshi population during the COVID-19 pandemic that 7.14% of the respondents self-medicated with sleeping pills. In addition, Gras, et al.²⁷ in a study on adverse reactions linked to self-medication, found that 19.1% of the adverse reactions due to self-medication were due to psycholeptics. Likewise, Huaman and Tamayo’s²² study on self-medication of anxiolytics and antidepressants in adult women during the COVID-19 pandemic found that 40.3% consumed anxiolytics/benzodiazepines, 20.8% non-benzodiazepines and 16.7% sertraline, fluoxetine and citalopram. In addition, Rodríguez, et al.²⁸ found in a study on self-medication of anxiolytics in users who go to drugstores and pharmacies that the drugs that stand out are: bentazepam 24.1%, bromazepam 16.7% and alprazolam 19.8%.

In conclusion, it was determined that there was a moderate relationship between self-medication and anxiety symptoms in the context of COVID-19, in users who went to a pharmacy in Los Olivos.

Data availability

Underlying data

Zenodo: Self-medication for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima-2021, https://doi.org/10.5281/zenodo.6678270.²⁹

This project contains the following underlying data:

- SPSS DATA 1 ENGLISH VERSION.sav (data file 1 in English)
- SPSS DATA 2 ENGLISH VERSION.sav (data file 2 in English)
- DATA 1. csv (data file 1 in Spanish)
- DATA 2. csv (data file 2 in Spanish)

Extended data

Zenodo: Self-medication for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima-2021, https://doi.org/10.5281/zenodo.6678270.²⁹

This project contains the following extended data:

- ANEXXS – ENGLISH Q.docx (questionnaire)

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

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Author details Author details

¹ Facultad de Farmacia y Bioquímica, Universidad Norbert Wiener, Lima, Lima, 15072, Peru
² Facultad de Ciencias Empresariales, Universidad Cesar Vallejo, Lima, Lima, 13001, Peru
³ Universidad Nacional Micaela Bastidas de Apurímac, Abancay, Apurímac, 03001, Peru
⁴ Universidad Autónoma de Ica, Ica, Ica, 11701, Peru
⁵ Universidad Privada del Norte, Trujillo, La Libertad, 13001, Peru

Ambrocio Teodoro Esteves Pairazaman
Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Supervision

Daniel Ñañez del Pino
Roles: Methodology, Supervision, Writing – Review & Editing

Walter Gregorio Ibarra Fretell
Roles: Writing – Review & Editing

Oscar Arbieto Mamani
Roles: Writing – Review & Editing

Rosmery Sabina Pozo Enciso
Roles: Writing – Review & Editing

Veronica Liset Esteves Cardenas
Roles: Data Curation, Writing – Review & Editing

YSABEL VALVERDE FLORES
Roles: Writing – Review & Editing

ELISABET FIORELA ARIAS ANCHIHUAY
Roles: Investigation, Methodology, Validation, Visualization, Writing – Review & Editing

PABLO RAFAEL MANRIQUE CARHUAS
Roles: Investigation, Methodology, Validation, Visualization, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

The author(s) declared that no grants were involved in supporting this work.

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Esteves Pairazaman AT, Ñañez del Pino D, Ibarra Fretell WG et al. Self-medication for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021 [version 1; peer review: 1 approved with reservations, 1 not approved] F1000Research 2022, 11:1084 (https://doi.org/10.12688/f1000research.123308.1)

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Reviewer Report 19 Jun 2023

Mainak Bardhan, ICMR-National Institute of Cholera and Enteric Diseases (NICED), Kolkata, India

Not Approved

https://doi.org/10.5256/f1000research.135403.r175673

The authors tried to look at the two independent behavioural attributes in context to covid19 pandemic. But the draft is very poorly written and difficult to follow. I have major comments to make

The manuscript isn't

The authors tried to look at the two independent behavioural attributes in context to covid19 pandemic. But the draft is very poorly written and difficult to follow. I have major comments to make

The manuscript isn't properly drafted. Please carefully draft the methodology section, results, and Discussion section. It more likely looks like directly taken from a thesis or research proposal instead of well-crafted scientific article writing.

Self-medication is a behavioral determinant which can be because of various reasons. What authors tried to establish was to link it to anxiety due to covid19. But they failed to make it clear throughout the draft. More upon reading it feels like self-medication due to anxiety which may be because of many other reasons. There is a lack of clarity in objectivity in the question asked in the beginning of the research work. The users' visit to drug store may not be driven by Covid19 caused anxiety. And if authors have tried to link it, they should first establish that the anxiety is solely due to Covid19.

The method section contains too many unwanted details which is not at all required. We don't need to write about sample size calculation explicitly showing the formulae and steps of calculation. Inclusion exclusion criteria writing in bullet points isn't a way how we write our methodology. It should've well versed following up a story line. Similarly the instrument section. It should not appear as if taken directly from another source. What ever mentioned in the result section regarding hypothesis testing are actually what can be explained in the method heading.
The research method should be better if includes a qualitative aspect. Mixed methods are best for addressing such complex behavioral determinants

As discussed earlier there is lack of objectivity in addressing the asked question of anxiety driven self medication due to covid 19. A through interview to understand the the users point of view would have been a great way along with additional quantitative approach
The result section contains too many tables which are not necessary to report the results. The result section isn't a place where one should just mentions the tables legends. It should be well drafted to churn out the meaning of the findings after the analysis mentioned in the method section that have been undertaken. The authors have mixed both the section
The discussion is not well written and isn't that much supportive of the findings. Due to ill-designed study it's not follow a story to be established. There is a need to extensive revision, copywriting, editing language check needed to properly bring the story going.

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Partly
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

Yes
Are all the source data underlying the results available to ensure full reproducibility?

Partly
Are the conclusions drawn adequately supported by the results?

Partly

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Clinical Research, Genetics, Neurology,Internal Medicine,Epidemiology,Public Health,

I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above.

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Reviewer Report 17 Feb 2023

Samar Thiab, Applied Science Private University, Amman, Jordan

Muna Barakat, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan

Approved with Reservations

https://doi.org/10.5256/f1000research.135403.r162339

Summery:
This study focuses on finding a correlation between self-medication for anxiety and COVID-19, and it was found there is a moderate relationship.

Citing current literature:
There is a systematic review about the prevalence and correlation of self-medication ... Continue reading

Summery:
This study focuses on finding a correlation between self-medication for anxiety and COVID-19, and it was found there is a moderate relationship.

Citing current literature:
There is a systematic review about the prevalence and correlation of self-medication practices for prevention and treatment of COVID-19 that was not mentioned at all as it emphasizes the fact that there was an increase in self-medication during COVID-19 for various reasons¹. There is also a related study conducted in India entitled "Prevalence of self-reported anxiety and self-medication among upper and middle socioeconomic strata amidst COVID-19 pandemic" that can also be cited².

Introduction:
Can the authors please clarify if any medications that should be dispensed with a prescription are allowed to be sold in Peru without having one (like antidepressants for example?) If not, and the authors are referring to OTC drugs, then why would that be a problem? Can they give examples of health related side effects or drug interactions that were reported due to the use of common OTC drugs in Peru?

Methods:
The used statistical analysis is too simple; the authors can conduct inferential analysis.
They need to add the cut-off point for the statistical significance level (P-value. <0.05) in the statistical analysis section.

Results:
Too many tables! the authors need to summarize them comprehensively, or convert some to figures.

Discussion and conclusion
The authors mentioned "It is also noted that the percentage of users who “sometimes” self-medicate irresponsibly is 36.8%, 42.1% “sometimes” self-medicate on the recommendation of third parties and 26.3% “sometimes” self-medicate under the influence of the media." Can the authors clarify if the participants got counselled by the pharmacists about the medication they choose to purchase to self-medicate, as this can minimize the problem of drug-drug, drug/herb or natural product interaction as will as the appearance of some side effects?

"Results are similar to the study by Marion, et al. on the prevalence and characteristics of self-medication behaviors, which found that 51.7% used drugs from a previous prescription, mostly analgesics, antibiotics and anxiolytics (prescription drugs)." Please clarify if it is allowed to re-dispense a drug based on a previous-old- prescription in Peru, to help us paint the whole picture and the extent of the problem?

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Partly
Are sufficient details of methods and analysis provided to allow replication by others?

Yes
If applicable, is the statistical analysis and its interpretation appropriate?

Partly
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Yes

References

1. Ayosanmi OS, Alli BY, Akingbule OA, Alaga AH, et al.: Prevalence and Correlates of Self-Medication Practices for Prevention and Treatment of COVID-19: A Systematic Review.Antibiotics (Basel). 2022; 11 (6). PubMed Abstract | Publisher Full Text
2. Chopra D, Bhandari B, Sidhu JK, Jakhar K, et al.: Prevalence of self-reported anxiety and self-medication among upper and middle socioeconomic strata amidst COVID-19 pandemic.J Educ Health Promot. 2021; 10: 73 PubMed Abstract | Publisher Full Text

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Pharmaceutical Analysis

We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above.

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VERSION 1 PUBLISHED 22 Sep 2022

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Version 1 22 Sep 22	read	read

Samar Thiab, Applied Science Private University, Amman, Jordan

Muna Barakat, Applied Science Private University, Amman, Jordan
Mainak Bardhan, ICMR-National Institute of Cholera and Enteric Diseases (NICED), Kolkata, India

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Reviewer Report

4 Views

19 Jun 2023 | for Version 1

Mainak Bardhan, ICMR-National Institute of Cholera and Enteric Diseases (NICED), Kolkata, India

4 Views Cite this report Responses(0)

Not Approved

The authors tried to look at the two independent behavioural attributes in context to covid19 pandemic. But the draft is very poorly written and difficult to follow. I have major comments to make

The manuscript isn't properly drafted. Please carefully draft the methodology section, results, and Discussion section. It more likely looks like directly taken from a thesis or research proposal instead of well-crafted scientific article writing.

Self-medication is a behavioral determinant which can be because of various reasons. What authors tried to establish was to link it to anxiety due to covid19. But they failed to make it clear throughout the draft. More upon reading it feels like self-medication due to anxiety which may be because of many other reasons. There is a lack of clarity in objectivity in the question asked in the beginning of the research work. The users' visit to drug store may not be driven by Covid19 caused anxiety. And if authors have tried to link it, they should first establish that the anxiety is solely due to Covid19.

The method section contains too many unwanted details which is not at all required. We don't need to write about sample size calculation explicitly showing the formulae and steps of calculation. Inclusion exclusion criteria writing in bullet points isn't a way how we write our methodology. It should've well versed following up a story line. Similarly the instrument section. It should not appear as if taken directly from another source. What ever mentioned in the result section regarding hypothesis testing are actually what can be explained in the method heading.
The research method should be better if includes a qualitative aspect. Mixed methods are best for addressing such complex behavioral determinants

As discussed earlier there is lack of objectivity in addressing the asked question of anxiety driven self medication due to covid 19. A through interview to understand the the users point of view would have been a great way along with additional quantitative approach
The result section contains too many tables which are not necessary to report the results. The result section isn't a place where one should just mentions the tables legends. It should be well drafted to churn out the meaning of the findings after the analysis mentioned in the method section that have been undertaken. The authors have mixed both the section
The discussion is not well written and isn't that much supportive of the findings. Due to ill-designed study it's not follow a story to be established. There is a need to extensive revision, copywriting, editing language check needed to properly bring the story going.

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Partly
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

Yes
Are all the source data underlying the results available to ensure full reproducibility?

Partly
Are the conclusions drawn adequately supported by the results?

Partly

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Clinical Research, Genetics, Neurology,Internal Medicine,Epidemiology,Public Health,

I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above.

Respond to this report

Responses (0)

Back to all reports

Reviewer Report

5 Views

17 Feb 2023 | for Version 1

Samar Thiab, Applied Science Private University, Amman, Jordan

Muna Barakat, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan

5 Views Cite this report Responses(0)

Approved With Reservations

Summery:
This study focuses on finding a correlation between self-medication for anxiety and COVID-19, and it was found there is a moderate relationship.

Citing current literature:
There is a systematic review about the prevalence and correlation of self-medication practices for prevention and treatment of COVID-19 that was not mentioned at all as it emphasizes the fact that there was an increase in self-medication during COVID-19 for various reasons¹. There is also a related study conducted in India entitled "Prevalence of self-reported anxiety and self-medication among upper and middle socioeconomic strata amidst COVID-19 pandemic" that can also be cited².

Introduction:
Can the authors please clarify if any medications that should be dispensed with a prescription are allowed to be sold in Peru without having one (like antidepressants for example?) If not, and the authors are referring to OTC drugs, then why would that be a problem? Can they give examples of health related side effects or drug interactions that were reported due to the use of common OTC drugs in Peru?

Methods:
The used statistical analysis is too simple; the authors can conduct inferential analysis.
They need to add the cut-off point for the statistical significance level (P-value. <0.05) in the statistical analysis section.

Results:
Too many tables! the authors need to summarize them comprehensively, or convert some to figures.

Discussion and conclusion
The authors mentioned "It is also noted that the percentage of users who “sometimes” self-medicate irresponsibly is 36.8%, 42.1% “sometimes” self-medicate on the recommendation of third parties and 26.3% “sometimes” self-medicate under the influence of the media." Can the authors clarify if the participants got counselled by the pharmacists about the medication they choose to purchase to self-medicate, as this can minimize the problem of drug-drug, drug/herb or natural product interaction as will as the appearance of some side effects?

"Results are similar to the study by Marion, et al. on the prevalence and characteristics of self-medication behaviors, which found that 51.7% used drugs from a previous prescription, mostly analgesics, antibiotics and anxiolytics (prescription drugs)." Please clarify if it is allowed to re-dispense a drug based on a previous-old- prescription in Peru, to help us paint the whole picture and the extent of the problem?

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Partly
Are sufficient details of methods and analysis provided to allow replication by others?

Yes
If applicable, is the statistical analysis and its interpretation appropriate?

Partly
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Yes

References

1. Ayosanmi OS, Alli BY, Akingbule OA, Alaga AH, et al.: Prevalence and Correlates of Self-Medication Practices for Prevention and Treatment of COVID-19: A Systematic Review.Antibiotics (Basel). 2022; 11 (6). PubMed Abstract | Publisher Full Text
2. Chopra D, Bhandari B, Sidhu JK, Jakhar K, et al.: Prevalence of self-reported anxiety and self-medication among upper and middle socioeconomic strata amidst COVID-19 pandemic.J Educ Health Promot. 2021; 10: 73 PubMed Abstract | Publisher Full Text

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Pharmaceutical Analysis

We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above.

Respond to this report

Responses (0)

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[20] 20. Yasif K, Anjum J, Binte N, et al.:Evaluation of sleep quality, psychological states and subsequent self-medication practice among the Bangladeshi population during Covid-19 pandemic. Clinical Epidemiology and Global Health. Elsevier B.V.; 2021; Vol. 12. : p. 100836. [Retrieved October 18, 2021]. Publisher Full Text

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[29] 29. Pairazaman E, Ambrocio ÑDP, Daniel IF, et al.: Self-medication for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima-2021 [Data set]. Zenodo.2022. Publisher Full Text

Self-medication for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021

Abstract

Keywords

Introduction

Methods

Ethics and consent

Design and participants

Instruments

Results

Table 1. Frequency of general data in users who go to a drugstore in Los Olivos, Lima 2021.

Table 2. Frequency of anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

Table 3. Self-medication for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

Table 4. Own initiative in the face of anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

Table 5. No medical prescription for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

Table 6. Medication used for anxiety symptoms in the context of COVID-19, in users who go to a drugstore in Los Olivos, Lima in 2021.

Table 7. Spearman's Rho test between self-medication versus anxiety symptoms in users who go to a drugstore in Los Olivos, Lima in 2021.

Table 8. Spearman's Rho test for self-initiated anxiety symptoms in users who go to a drugstore in Los Olivos, Lima in 2021.

Table 9. Spearman's Rho test without medical prescription versus anxiety symptoms, in users who go to a drugstore in Los Olivos, Lima in 2021.

Table 10. Spearman's Rho test between the medication used against anxiety symptoms, in users who go to a drugstore in Los Olivos, Lima in 2021.

Discussion and conclusion

Data availability

Underlying data

Extended data

References

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