Knowledge, attitude and practice of self-medication of mefenamic acid in dysmenorrhea among health science students

*Corresponding author: Rajan Manandhar. Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0. Knowledge, attitude and practice of self-medication of mefenamic acid in dysmenorrhea among health science students Samjhana Tamang 1, Shirsha Upadhyaya 2, Susmita Sapkota 3, Rajan Manandhar 4, * and Jaya Bahadur Ghale 5 1 Department of Pharmacy, All Nepal College of Technical Education, Gaushala, Kathmandu. 2 Department of Pharmacy, Little Buddha Prabhidik Shikshalaya, Banneshwor, Kathmandu. 3 Department of Pharmacy, Asian College of Advance Studies, Lalitpur. 4 Department of Pharmacy, Kathmandu Model Hospital Institute of Health Sciences, Bagbazar, Kathmandu. 5 Department of Pharmacy, Kathmandu Multiple College, Gaushala, Kathmandu. World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 435-449 Publication history: Received on 16 August 2025; revised on 23 September 2025; accepted on 25 September 2025 Article DOI: https://doi.org/10.30574/wjbphs.2025.23.3.0846 Abstract Background: Self-medication(SM) is widely practiced in developed and developing countries. SM is very common nowadays because it is accessible, cheap, rapid and convenient solutions. Self-medication is an important public health issue which may affect children and adolescents. Incorrect diagnosis, improper dosage, drug interaction can be seen due to SM. Dysmenorrhea is the one of the most common public health problems which may produce negative impact on female, health, school, work activities and psychological state. The prevalence of dysmenorrhea can be found in between 48.4-84.2% of all reproductive age women in different countries like US, Japan, India. Mefenamic acid is commonly used medication in dysmenorrhea. Mefenamic acid is non-steroidal anti-inflammatory drug (NSAID) can be used for the acute treatment of pain. It is the anthranilic acid derivative class of NSAIDS. Objective: To assess the knowledge, attitude, and practice of self-medication of mefenamic acid in dysmenorrhea among health science students. Methodology: The descriptive cross-sectional study was conducted on 343 health science students who were practicing self-medication in dysmenorrhea from May to July 2023 using selfadministered questionnaire. Results and Conclusions: Out of 343 participants, 55.70% of the respondents have an adequate knowledge of selfmedication but 44.30% have an inadequate knowledge of self-medication. 76.10 % of the respondents are doing correct practice and 23.90% are doing incorrect practice. 64.4% have positive attitude towards self-medication in dysmenorrhea and 35.6% of the respondents have negative attitude towards self-medication in dysmenorrhea. The study findings highlight need to aware young females regarding self-medication to provide knowledge of benefits, adverse effects, and their impact on health due to wrong use of medication. Keywords: Selfmedication; Dysmenorrhea; Mefenamic Acid; Health science students; NSAID World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 435-449 436 1. Introduction According to the WHO, Self-medication is the selection and use of the drugs to treat self-diagnosed disorders or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. Self-medication is widely practiced in developed and developing countries. Self-Medication is very common nowadays because it is accessible, cheap, rapid and convenient solutions [1]. Self-medication is an important public health issue which may affect children and adolescents. Incorrect diagnosis, improper dosage, drug interaction can be seen due to SM. People may not be aware about the warning, precaution, storage condition, shelf life and adverse drug reactions which may lead to an increase in the risk of side effects [4]. The lower abdominal pain or pelvic pain which may be radiating to the lower back, legs and inner thighs is known as Dysmenorrhea [5]. Dysmenorrhea is the one of the most common public health problems which may produce negative impact on female, health, school, work activities and psychological state [5]. The prevalence of dysmenorrhea can be found in between 48.4-84.2% of all reproductive age women in different countries like US, Japan, India. Dysmenorrhea can be classified into two categories. Primary dysmenorrhea and Secondary dysmenorrhea. PD can be defined as painful period in women with normal pelvic anatomy begins during adolescence and lasts up to reproductive age [1]. Prevalence of dysmenorrhea was found to be more than 50% women with severe pain in 2% 29% of women studied. Worldwide, the prevalence of dysmenorrhea can be found between 48.4-84.2% among women of reproductive age [3]. It is affecting daily activities of women and quite severe in about 10%. In context of Nepal, the prevalence among medical students was reported as high as 94%. 64.4% practice self-medication in dysmenorrhea.14% of 499 female consume Mefenamic acid globally [4]. 26% of 641 females in India and 48%of 269 females in Nepal consume Mefenamic acid without prescription or without consulting healthcare professionals [1, 17]. Knowledge, attitude, and practice of self-medication of Mefenamic acid dysmenorrhea will be studied and their analysis will be done to give the final result. Providing awareness about self-medication of Mefenamic acid has also been a challenging issue. One of the important reasons of self-medication of Mefenamic acid is being unaware of side effects or seeking immediate relief in severe pain. This study aims to find the knowledge attitude and practice of mefenamic acid among health science students of Purbanchal University and CTEVT. Several studies have reported that SM starts with onset of adolescence and increases with age. Therefore, SM among the health science students is an important topic in scientific research. The objective of the study is to assess the knowledge, attitude, and practice of self-medication of mefenamic acid in dysmenorrhea among health science students. 1.1. Conceptual Framework Figure 1 Conceptual Framework 2. Methodology 2.1. Study Design The descriptive cross-sectional study was conducted among health science students who were practicing selfmedication in dysmenorrhea. World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 435-449 437 2.2. Study Area This study was conducted among Health Science students at Health Science Colleges affiliated to Purbanchal University and CTEVT at Kathmandu Valley. • Asian College for Advance Studies • Shankarapur Academy • Little Buddha College of Health Science • Kantipur Academy of Health Science Four colleges were selected by non-probability convenient sampling method. . Primary data were collected via semistructured questionnaire to assess knowledge, attitude and practice of health science students towards self-medication of mefenamic acid in dysmenorrhea. 2.3. Duration of Study 6 months 2.4. Study Variables 2.4.1. Independent Variables: • Age • Marital status • Faculty • Menarche Age 2.4.2 Dependent Variables • Knowledge • Practice • Attitude 2.5. Study Population 2.5.1. Inclusion Criteria • Female students of age group 18 years and above • Students with Dysmenorrhea. • Females who were practicing self-medication in dysmenorrhea. 2.5.2. Exclusion Criteria • Students who were below 18 years. • Students other than Health Science Students. • Students who were not willing to participate. 2.6. Sample Size and Sample techniques The sample size was calculated by using cross sectional formula for finite population. n =Zα2 pq/ E2 Where, n= required sample size Zα= statistics for a level of confidence (66.3% at 95% confidence interval) p = prevalence = 0.663 World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 435-449 438 q = 1-p = 1-0.663 = 0.337 E = margin of error = 5% = 0.05 At 95% confidence interval, 1-α = 0.95 α= 0.05 Zα = Z 0.05 = 1.96 (from table) Now. n = (1.96)2 (0.663*0.337) / (0.05) = 343 Hence, the sample size was 343. . 2.7. Data Collection and Analysis The tools used for data collection was self-administered questionnaire. The questionnaire was prepared by using suitable literatures as reference and it contained of 34 multiple choice questions • Data entry and data analysis was performed using SPSS. • For descriptive analysis, continuous data was expressed as Mean +Standard deviation. • Frequencies and percentage were calculated. • Correct answers and “yes’’ were scored as 1, while incorrect answers and “no” were scored as 0. Median was calculated. Knowledge below median was defined as inadequate and knowledge equal to and above median was defined as adequate knowledge. Attitude was evaluated using Likert scale. Strongly agree -5, Agree-4, Neutral-3, Disagree-2, Strongly disagree-1. 17 For practice also correct answers and “yes’’ were scored as 1, while incorrect answers and “no” were scored as 0. Median was calculated. Practice below median was defined as incorrect practice and practice equal to and above median was defined as correct practice. For inferential analysis, association between the sociodemographic characteristics like age, marital status, religion, faculty, academic year, ethnicity, age at which respondents got their first period and self-medication of mefenamic acid in dysmenorrhea was generated by using Chi-square test or Fisher exact test (if n < 5). A p value less than 0.05 was considered as level of significance. 2.8. Ethical Consideration Ethical approval was taken from IRC of Asian College for Advance Studies. Formal permission was taken from supervisor and advisors. The collected information was used for study purpose only. The confidentiality of information was maintained unless there are no legal issues. 2.9. Operational Definition Knowledge: - means theoretical and practical understanding of the subject matter. • 3-6: - Adequate Knowledge • 7-11: - Inadequate Knowledge Attitude: - a predisposition or a tendency to respond positively or negatively towards a certain idea, object, person or situation. • 14-19: - Negative Attitude • 20-29: - Positive Attitude World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 435-449 439 Practice: - Application of knowledge or practical approach to the subject matter. • 2-6: - Incorrect Practice • 7-9: - Correct Practice 3. Results Age distribution of the study population shows that most of the (60.3%) respondents were of age group 25-27, 29.4% were of age group 21-24 and 10.2% were of age group 18-20. The mean age was found to be 24.25± 2.18 (mean± SD). Marital status distribution of respondent’s shows majority of the respondents were unmarried (95%) and minority (5%) were married. 3.1. Faculty distribution of the respondents Table 1 Faculty distribution of the respondents Faculty of Respondents Frequency (f) Percentage (%) Diploma in Pharmacy 97 28.3 Bachelor in Pharmacy 85 24.8 Bachelor in public health x 40 11.7 Nursing 69 20.1 Health Assistant 21 6.1 Others 31 9.0 3.2. Distributions of Age of First Period Table 2 Distribution of Age of First Period Menarche Age (Years) Frequency (f) Percentage (%) 10-12 110 32.1 13-16 233 67.9 3.3. Practice of Respondents Figure 2 Practice of Medication World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 435-449 440 3.4. Level of Knowledge of self-medication Figure 3 Knowledge of self-medication 3.5. Attitude of Respondents Figure 4 Attitude of Respondents 3.6. Knowledge of self-medication of Mefenamic Acid Table 3a Knowledge of self-medication of Mefenamic Acid Question Frequency (f) NO YES Do you know about self-medication 44 (12.8 %) 299 (87.2%) Do you know the correct dose 210 (61.2%) 133 (38.8%) Do you know the correct frequency and duration of drug 194(56.6 %) 149 (43.4%) Do you think self-medication is always advantageous 279 (81.3) 64 (18.70 Is mefenamic acid safe to consume 128(37.3 %) 215 (62.7%) Does long term use of mefenamic acid result in adverse effect 40 (11.7%) 303(88.3%) World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 435-449 441 Does long term use of mefenamic acid result in dependency 75(21.9%) 268 (78.1%) Mefenamic acid should be taken according to recommended dose 17(5.0 %) 326(95.0%) You can increase and decrease the dose as much as you want 320 (93.3%) 23(6.7%) You should stop taking medication as soon as you feel better 114(33.2%) 229 (66.8%) Among those respondents who think self-medication is always advantageous as per Table 3, i.e. 64, why do they find it advantageous was questioned with following results Table 3b Why to respondents think self-medication is advantageous (among total 64 respondents) Reason Frequency (f) Percentage Percentage (%) Quick relief 45 70.3 Convenient use 10 10.9 Economical 2 3.1 Time saving 7 10.9 Total 64 100.0 Table 3c Knowledge about use of mefenamic acid Use Frequency (f) Percentage (%) Dysmenorrhea (painful period) 329 95.9 Oligomenorrhea (irregular period) 6 1.7 Gastritis 7 2.0 Headache 1 0.3 3.7. Attitude towards self-medication in dysmenorrhea Table 4 Attitude towards self-medication in dysmenorrhea S.N Question Frequency (f) Strongly disagree Disagree Neutral Agree Strongly Agree 1 You should take medication for dysmenorrhea 15 4.4 % 159 46.45 74 21.6 % 79 23.0% 16 4.7% 2 Medication always cures the pain 9 2.6% 100 29.2% 54 15.7% 54 15.7% 16 4.7% 3 Taking medication without consulting healthcare professionals is right 133 38.8% 187 54.5% 6 1.7% 10 2.9% 7 2.0% 4 Consequences of self-medication may affect your health adversely 5 1.5% 16 4.7 % 16 4.7 % 202 58.9% 104 30.3% 5 Self-medication of mefenamic acid should be controlled 0 28 8.2% 37 10.8% 219 63.8 5 59 17.2% 6 Proper dose should be taken by consulting healthcare professionals 3 0.9% 4 1.2 % 5 1.5 % 152 44.3 % 179 52.2% World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 435-449 442 3.8. Practice of Self-medication Figure 5 Medicine used in dysmenorrhea Figure 6 When does respondent consume medication? Figure 7 Number of Pills per day World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 435-449 443 Figure 8 Interval of taking medication Figure 9 Time of taking medication Figure 10 Respond after taking medication