Determinants of Self-Medication in Immigrants: A Systematic Review.

Abstract

Immigrants intended to more rely on self-medication because of the difficulty of accessing formal healthcare in host countries. Negative consequences could occur when self-medication was inappropriate. This study aimed to systematically explore the prevalence, sources and determinants of immigrants' self-medication and the extent of their inappropriate self-medication episodes. PubMed, Scopus, SpringerLink, and ScienceDirect were used for data searching. The search date was 10th June 2023, with no beginning date to limit searching articles. Thirty-two studies were included. The prevalence of immigrants' self-medication presented from 18 studies ranged between 20.2% and 94.6%. Major sources of immigrants' self-medication were commonly obtained from their home countries, local markets or shops, and informal networks. The determinants of immigrants' self-medication were systematically collated into four themes: (1) illness and self-medication perception, (2) access to healthcare and medication, including 6 dimensions: accessibility, availability, affordability, acceptability, awareness and accommodation, (3) worry, and (4) predisposing factors of immigrants. About 46% of immigrant's self-medication episodes were inappropriate, especially antibiotic use. About 66% of the included studies described antibiotic self-medication. Prevalence rates of self-medication among different immigrantsvaried based on different time frames, context of diseases and migrated countries. Immigrants' cultural health belief, facing significant worry about job security, legal status, and cultural barriers influenced their self-medication. When immigrants have greater availability, accommodation, awareness, accessibility, acceptability, and affordability of health services in host countries, they are less likely to use self-medication. The predisposing factors like age, income, work status and immigrants' language also influenced their self-medication.