Self-medication, which is a common self-care practice, is widespread around the world . Self-medication products account for approximately 20% of the total international pharmaceutical market . Among various self-medication options, the use of over-the-counter (OTC) medicines is the most prevalent. In the U.K., an estimated £1,268.5 million was spent on OTC medicines in 1994, which equates to one-third of the total cost of prescribed drugs . In Germany, self-medication sales were over £5.4 billion in 2006 . The benefits of OTC medicines include convenience to consumers/patients, better self-management of minor problems, and a reduction in governmental medical costs. Thus, throughout the world, a wider range of medicines is becoming available directly to the public , and the current practice of self-medication offers consumers/patients more flexible choices in health management.
Self-care choices vary according to sex, age, and socioeconomic status (SES). For example, in Ireland, females report buying OTC medicines more often than do males, and younger adults report buying OTC medicines more often than older adults do . With regard to SES, costs can function as a barrier that reduces access to prescription medicines , but the significance of this variable depends on the healthcare system within a particular country. In the U.S., where a universal health care system is unavailable, a study found that a significantly large number of mothers without health insurance were likely to give OTC medicines to their young children . In contrast, in Denmark, a country with an established universal health care system, medical costs do not appear to function as a barrier that reduces access to prescription medicines . In Japan, the effects of a long-term recession have negatively influenced the overall economic situation of many individuals. Thus, a medical/health discrepancy between people low and high in SES is apparent. Do people at lower SES levels hesitate to see a doctor because of medical costs? This question has yet to be well researched. When people at lower SES levels are encouraged to practice self-medication, are they able to choose medicines based on valid evidence of the medicine’s safety? Advertisements for OTC medicines are legal in many countries, including Japan, and such marketing might affect perceptions among consumers/patients as to the benefits of different products . Traditionally, patients are rather passive and dependent, and they tend to follow the instructions of experts . However, taking individual responsibility for safe self-medication practices is increasingly necessary as several OTC medicines become available on the market.
When discussing self-medication issues, the topic of self-medication for children is noteworthy. Research on this topic has been accumulating within Western countries for over a decade. In the U.S., 70% of illnesses among preschoolers were treated with non-prescription medicines . However, the use of non-prescription medicines for children was often inappropriate. A U.S. study found that 71% of caregivers have inappropriately used non-prescription medicines for their children, and 10.9% reported that they only “sometimes” read labels and drug information . Similarly, parents in the U.K. were generally unaware of potential side effects of OTC medicines because they believe that “over-the-counter medicines are not strong and were unlikely to harm their child,” or they believe that “prescription medicines are strong and otherwise carry risks”  p. 27]. On the other hand, Du and Knopf  conducted a profile analysis of caregivers who use OTC medicines and found “the higher the socioeconomic status of the children’s family, or the higher the educational level of the children’s mother, the more OTC medicines the children were likely to receive” (p. 606). Because OTC medicines for children are relatively new in Japan, few studies have been conducted. Therefore, it is necessary for public health policy makers to explore how self-medication is practiced for children in order to better construct parental education regarding OTC administration. Caregivers’ demographic information, along with their attitudes, must be addressed.
In Japan, the revised Pharmaceutical Affairs Act was only recently enacted in 2009; this introduced the concept of self-medication. In 2008, a group of Japanese researchers asked approximately 1,000 adults if they knew the term “self-medication” and 60.5% did not recognize this term . However, research on self-medication issues is important given the fact that declining birthrates and a growing proportion of elderly people will have a significant impact on the Japanese pension and social welfare system in the near future.
Therefore, the goals of the present study were to examine the following: (1) how Japanese consumers/patients practice self-medication to manage their health problems, (2) how Japanese consumers/patients select particular OTC medicines, (3) how consumers/patients’ attitudes toward OTC medicines, and (4) caregiver-initiated medication behaviors for children. This study also investigated the role of sex, age, and socioeconomic status (SES) on the preceding research questions.