Self-Medication in South and Southeast Asia: A Gap-Mapping Review of Patient-Reported and System-Level Evidence

Abstract

Rationale

Self-medication is widely documented in South and Southeast Asia and is frequently discussed in relation to antimicrobial resistance, pharmacy practice, regulatory enforcement, and primary care stewardship. However, it remains unclear whether these system- and practice-level domains are empirically examined within the indexed peer-reviewed biomedical self-medication literature from which such claims are drawn.

Aim

To map how the PubMed- and Google Scholar–indexed peer-reviewed self-medication literature in South and Southeast Asia is structured, and to examine alignment between the level at which evidence is generated and the level at which interventions are proposed.

Methods

A gap-mapping review of PubMed- and Google Scholar-indexed studies (January 2000–July 2026) classified empirical evidence across six predefined analytic domains: patient-reported behaviours, patient-reported barriers, pharmacy dispensing practices, regulatory or enforcement processes, primary care consultation processes, and intervention evaluation.

Results

Thirteen empirical studies met inclusion criteria. All (13/13) examined patient-reported behaviours and barriers. Pharmacy dispensing practices were mentioned in 12/13 studies but were not directly examined (0/13). Regulatory processes (0/13), primary care consultation processes (0/13), and intervention evaluation (0/13) were not empirically examined. Nine studies proposed system-level interventions without implementation or outcome evaluation. Only one study included Myanmar participants, limited to Thai-Myanmar border migrant populations.

Conclusion

Within the indexed biomedical corpus examined, empirical attention is concentrated at the level of patient-reported behaviour, while system- and practice-level processes remain unexamined. This concentration limits the extent to which claims about pharmacy practice, regulation, and clinical care can be said to derive directly from the mapped evidence base.