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Official websites use. Share sensitive information only on official, secure websites. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Self-medication is a prevalent practice among university students globally and is a significant public health concern. However, previous research has been limited in scope, focusing primarily on adolescents or the general public, leaving a gap in understanding the causal relationships associated with self-medication; thus, this study aimed to investigate the factors influencing self-medication practices among university students in Bangladesh by developing a comprehensive causal model. Data from students across five public universities were collected using the simple random walk technique by a team of 10 members. The study utilized constructs of knowledge, attitude, and convenience related to self-medication as independent variables, while self-medication practice as the dependent variable. The findings revealed that students with better medication knowledge and adverse drug reactions ADRs were more likely to practice self-medication. A positive attitude towards self-medication and ADRs was also significantly associated with higher self-medication practice scores. Additionally, those who perceived self-medication as convenient and prescribed medication as inconvenient had higher self-medication practice scores. The attitude towards self-medication had the most substantial negative effect on self-medication practice, followed by the inconvenience of prescribed medication and the convenience of self-medication. University students in Bangladesh possess intermediate knowledge of medication and primary knowledge of ADRs. They exhibit a positive attitude towards self-medication and ADRs. Physical convenience favors self-medication, while the inconvenience of prescribed medication contributes to its lower preference. Policymakers should focus on evidence-based guidelines to reduce the extent of unnecessary self-medication practice and to enhance the quantity and accessibility of prescribed medications to address the issue effectively. Self-medication, defined as the practice of diagnosing and treating one's own illnesses without seeking professional medical advice, is a common practice among university students worldwide and is considered a significant public health concern 1 — 3. While self-medication is considered a convenient way to address common health issues, it poses significant health risks, such as adverse drug reactions, drug interactions, and treatment failure 4 — 6. Self-medication can also lead to antibiotic resistance, a global health challenge 7. Both developed, and developing countries commonly engage in self-medication, although the prevalence is higher in developing nations 5. The occurrence of self-medication in developing countries exhibits a wide range, spanning from South Asian countries, in particular, demonstrate higher rates of self-medication. If self-mediation is used responsibly, it can help conserve limited medical resources by addressing minor ailments, the burden on healthcare facilities, and reduce costs and time associated with seeking professional care for minor illnesses Due to that, WHO has pointed out that appropriate self-medication can be beneficial in treating acute ailments that do not require medical consultation. But it also has a flip side which can cause serious problems such as adverse drug reactions, treatment failure, antimicrobial resistance, etc. In Bangladesh, antimicrobial resistance is a significant issue, primarily attributed to unethical drug sales practices. A recent petition filed in the High Court of Bangladesh aimed to address this problem by seeking legal action against the immoral selling of drugs Although recently the healthcare system of Bangladesh has expanded its coverage and infrastructure has also improved substantially still it is considered suffering a budget shortage as only 5. Consequently, there is a lack of accessible health insurance, both at the national and private levels In addition, the prevalence of self-medication in the country is exacerbated by the presence of unethical drug sellers, inadequate regulatory measures, and the widespread availability of prescription drugs without the requirement of a prescription These factors collectively contribute to the high prevalence of self-medication practices in Bangladesh. University students, particularly in developing countries, are highly susceptible to self-medication due to influential factors such as media and internet exposure promoting this behavior. Additionally, factors such as low perception of associated risks, easy access to the internet, increased pharmaceutical advertising without regulation, availability of drugs, level of education, and social status contribute to this trend 17 , Among university students, the prevalence of self-medication is notably high However, irresponsible self-medication can lead to various negative consequences. It is crucial to identify the influences on self-medication practices among university students, considering that they are generally knowledgeable about medication yet still susceptible to engaging in high levels of self-medication. Mohamed Elkalmi et al. This sentiment was echoed by Raut et al. Conversely, Parihar et al. Moreover, Parihar et al. Convenience and the hope of prompt relief were cited as additional motivators for self-medication. Contrarily, Beyene et al. However, Parihar et al. In terms of students' understanding of medication, Raut et al. This underscores the importance of education and awareness campaigns regarding responsible medication use among students. Johny et al. Conversely, Mohamed Elkalmi et al. However, Beyene et al. In terms of common health issues prompting self-medication, findings vary among studies. Raut et al. Parihar et al. Furthermore, Johny et al. Regarding the frequency of self-medication, Raut et al. Previous research has identified several factors contributing to self-medication practices, such as knowledge and literacy 24 , 26 , attitude 28 , 30 , and the convenience of self-medication 32 , 34 were identified as the most significant contributor to self-medication practices. However, how these variables specifically affect university students nationwide remains uncertain. Additionally, the inconvenience of prescribed medication e. Previous studies in Bangladesh have primarily focused on self-medication among medical or medical-related students 9 , 35 , 36 or the general public 13 , 37 lacking a comprehensive understanding of the causal relationships among self-medication practices and other factors. Addressing this research gap, this study aims to investigate the factors knowledge, attitudes, and convenience influencing self-medication practices among university students in Bangladesh by developing a causal model. Factors such as knowledge and literacy 24 , 26 , attitude 28 , 30 , and the convenience of self-medication 32 , 34 have a significant impact on self-medication practices. Self-medication has been a widely acknowledged phenomenon, with numerous attempts made to identify the factors influencing this practice. The Knowledge, Attitude, and Practice KAP model is commonly employed in this context, positing that existing knowledge shapes a favorable attitude toward self-medication, which in turn enhances the practice 38 — Studies such as those by Alves et al. Shitindi et al. Conversely, research by Abebe et al. Alkhawaldeh et al. A critical aspect identified in various studies is the knowledge about adverse drug reactions ADR and the attitudes towards them, which significantly influence self-medication 42 , Studies by Gedam and Kuchya 45 and Sivadasan et al. Consequently, understanding ADR knowledge and attitudes becomes imperative for comprehensive research on self-medication. Beyond the KAP model, the convenience of self-medication, juxtaposed with the inconvenience of obtaining prescribed medication, emerges as another influential dimension. James and French 47 highlights that individual perceive self-medication as time-saving, economical, and providing quick relief. Afzal et al. In countries like Bangladesh, there is a high prevalence of over-the-counter drug selling 49 , enhancing the convenience of self-medication. Conversely, obtaining prescribed medication in Bangladesh can be challenging, requiring considerable time and money, particularly for university students 50 , This inconvenience may significantly impact the actual practice of self-medication among university students, emphasizing the need to consider convenience as a crucial dimension in understanding predictors of self-medication. Therefore, this study proposes following hypothesis Fig. H1: Students with higher knowledge of self-medication are more likely to practice it compared to those with less knowledge. H2: Students with higher knowledge of Adverse Drug Reactions ADR are more likely to practice self-medication compared to those with less knowledge. H3: Students with a positive attitude towards self-medication are more likely to practice it than their counterparts. H5: Students who find self-medication more convenient are more likely to practice self-medication than others. H6: Students who find prescribed medication more inconvenient are more likely to practice self-medication than others. This cross-sectional descriptive study utilized primary data, collected from March 21 to April 29, using a structured questionnaire. This research incorporates quantitative method to analyse data using various statistical modelling techniques such as, descriptive statistics, one-way ANOVA, confirmatory factor analysis CFA and structural equation modelling SEM. The data was obtained through face-to-face interview techniques. Study area and population. This study includes students from five public universities in Bangladesh. These universities are located in different regions of Bangladesh, and their students come from diverse backgrounds and cultures. Those universities have approximately 78, students in undergraduate and graduation program Supplementary Table 1. This study includes both undergraduate and graduate students. The inclusion criteria are that the person needs to be 1 an enrolled student from one of the selected universities, 2 currently continuing their study. Any student who is physically incapable of providing the required information is excluded from this study. Researchers used a structured five-part questionnaire where each question was considered vital for the research. Questionnaires were first translated into Bangla and then again transformed into English to maintain meaning and consistency. Researchers translated the questionnaire to ask the questions to the participants. As suggested by previous studies, the questionnaires were pre-tested within Khulna University with 30 students before finalizing them for data acquisition 52 , This study's dependent variable comprises three parts, each indicating critical aspects of self-medication practice. The first part Code: PR-1 includes a question about the problem for which the respondent takes self-medication. The problems are divided into three body sections: head, main body, and leg area, with 12 problems for each section which are more prevalent in developing nations 54 , Respondents choose the problems for which they take self-medication, and the researcher sums up all the reasons, giving a range of 0—36, with a higher number indicating a greater self-medication practice Supplementary Table 2. The second part Code: PR-2 includes a self-medication practice scale comprising 8 items from existing literatures 47 , Researchers sum up the end result within a range of 8 to 40, with a higher score indicating a higher level of self-medication practice. The third part Code: PR-3 includes questions about the drugs used for self-medication, with 10 different medicine groups most frequently used worldwide 57 , 58 Supplementary Table 4. The researcher incorporated a 5-point Likert scale to measure the practice of consuming those medicines without a prescription. The final score of this scale is also counted by summing up all the individual questions ranging from 10 to 50, with a higher score indicating a greater level of self-medication practice. The study examines the holistic model of self-medication among varsity students by considering four independent variables: knowledge, attitude, convenience of self-medication, and inconvenience of prescribed medication. Each independent variable is assessed using multiple questions presented with a 5-point Likert scale showed in the Table 1. For the Analysis of Variance, the researcher categorizes each construct into three ordinal categories based on the total score of that construct. Respondents' knowledge was assessed across two dimensions: knowledge of medication and medicine groups, and knowledge about adverse drug reactions ADR. The scale covered aspects such as dose, content, regimen, and duration. Similarly, knowledge about the eight most commonly consumed medicine groups 57 , 58 was assessed using a five-point Likert scale score ranging from 10 to Knowledge about adverse drug reactions ADR was primarily assessed using eight items extracted from previous research 60 — 62 However, only five items were found to load into a single item with a factor loading score exceeding 0. Attitudes were assessed in two domains: attitude towards self-medication and attitude towards adverse drug reactions ADR. Attitude towards self-medication was evaluated using 8 items from existing literature 2 , Among these, 6 items exhibited factor loading scores above 0. Similarly, attitude towards ADR was assessed with 4 items from previous research 7 , Convenience was examined from two perspectives: perceived convenience of self-medication and perceived inconvenience of prescribed medication. For perceived convenience of self-medication, 8 items were extracted, specifically tailored for the context of Bangladesh or similar cultural settings 13 , 63 Similarly, 6 items were identified for measuring inconvenience of prescribed medication 13 , In both cases, 5 items loaded onto a single component with loading scores exceeding 0. The cross-sectional survey was conducted from March 21 to April 29, , utilizing Taro 65 technique to determine the sample size. Eventually, after sorting all the incomplete and errors datasets, responses from respondents were collected and included for analysis. Calculation process is given below. In SEM, sample size holds particular importance. According to Hair Jr. Expanding upon this, Hair Jr. Notable, the sample size obtained in our study surpasses this threshold, indicating adequacy for model development. The data collection technique employed in this study was a random walk, which was the most suitable technique for clusters based on previous research 68 , A team of ten trained members carried out the survey. Before data collection, the group underwent a full-day training session covering the data collection procedure, ethics, and obtaining consent. The final sample consisted of participants, and it was divided proportionately among five selected universities based on their student populations. Upon approaching each university, the data collection team divided the campus into blocks and initiated data collection from the main entrance. They proceeded clockwise for one minute and approached the nearest respondent, who fulfilled all the inclusion criteria. This process was repeated until the predetermined quota was achieved. In cases where a selected respondent declined to cooperate, the team labeled it a non-response and continued with the data collection process. The same technique was applied consistently throughout the entire data collection phase. Additionally, 8 respondents were disregarded due to missing or improper data, resulting in data sets being considered for analysis. The data were stored, coded with appropriate weights, and categorized based on knowledge, attitude, convenience, and practice segments. Descriptive analysis was performed to present the data, followed by one-way ANOVA with post-hoc Least Significant Difference LSD to identify any mean differences among groups, showing which group used more self-medication. Finally, a Structural Equation Model SEM was developed to assess the causal relationship between self-medication practice with knowledge, attitude, and convenience. SEM was chosen over linear regression due to its ability to accommodate multiple dependent variables, as in this case where three distinct constructs are involved. Additionally, SEM enables the depiction of latent variables and the examination of both direct and indirect effects, making it a powerful tool for testing theoretical models The internal consistency of the questions for each section was assessed using Composite reliability and Average variance extracted AVE. The discipline and supervisor of this study protocol was approved. All the methods are in accordance with relevant guidelines and regulations. Table 2 presents the demographic characteristics of the respondents. No significant differences were observed between males and females regarding self-medication in any dimension. The CGPA of the respondents exhibited a significant difference in the real-life practice of self-medication. However, there were no differences in drug usage or disease treatment associated with self-medication among different CGPA groups. The year of study did not have any effect on the self-medication practices of the students. Regardless of their academic year, all students demonstrated similar patterns of self-medication. The study area was found to have a significant effect on self-medication practices. Surprisingly, students studying pure science or applied science reported significantly higher self-medication levels than other groups. They treated more diseases with self-medication, used a greater variety of drugs, and had higher overall self-medication scores. Science students are assumed to have more knowledge about medication and its potential adverse effects, yet they still engage in self-medication. The convenience of self-medication over prescribed medication may play a significant role in this regard. Economic dependence did not significantly affect self-medication practices among the respondents. Table 3 presents those individuals with intermediate knowledge about medication mean DT: Post hoc LSD results show that they treat more diseases than those with higher medication knowledge mean DT: Similarly, those with intermediate medication knowledge mean RP: However, those with intermediate knowledge of medication do not use a variety of medicine groups for treating many diseases. Table 3 shows that those with the highest knowledge about medication mean 7 use a variety of medicine groups in self-medication. Post hoc LSD results reveal a positive relationship between knowledge about medication and variety of medicine intake. Knowledge about different medicine groups individuals with higher knowledge about other medicine groups mean DT: Their mean score is significantly higher than the second-highest group, indicating the impact of knowledge on self-medication effectiveness. Individuals with a positive attitude towards self-medication practice it more frequently mean RP: Those with a negative attitude or uncertainty about self-medication show no significant differences in practice scales. Individuals with a negative attitude towards adverse drug reactions have lower scores in all practice scales mean DT: Those with a positive attitude practice more self-medication and take a greater variety of medicines. Respondents who find self-medication highly convenient or prescribed medication highly inconvenient practice self-medication more frequently. Physical convenience or inconvenience plays a significant role in shaping the practice of self-medication. Those who find prescribed medication slightly inconvenient mean DT: The physical inconvenience of prescribed medication plays a more significant role in pushing people towards self-medication than the convenience of self-medication. Challenges associated with obtaining prescribed medication contribute to the prevalence of self-medication in Bangladesh. This model is well validated and fit for SEM computation because all the values are under an acceptable threshold. In this case, the composite reliability scores ranged from 0. In this study, the AVE values for all the constructs were above 0. It suggests that the items in our questionnaire are closely related and measure a single, reliable construct. A lower value suggests a better fit, and a value around 4 is generally considered acceptable whereas the Root Mean Square Error of Approximation RMSEA measures the discrepancy between the model and the observed data. A value of 0. The outcomes of the Fornell and Larcker criterion, displayed in supplementary table 6 , reveal that the square root of the AVE for each construct is higher than its correlation with other constructs. This signifies that discriminant validity has been established for all the constructs. All the HTMT ratios were below 0. Discriminant validity ensures that the measures used to assess different constructs are distinct and not measuring the same underlying concept. The correlation with KN-2 is 0. Discriminant validity is supported if the correlations with other constructs off-diagonal elements are smaller than 0. The correlation with PR is 0. The researcher initially developed a hypothesized structural model to investigate self-medication practice. However, upon evaluating the modification indices and parameter estimates, some paths in the model were identified as non-significant. As a result, the researcher removed those non-significant paths and added several covariance paths, as suggested by the modification indices. The final model showed a better fit compared to the hypothesized model. In the paper, six hypotheses were presented regarding self-medication practice, all supported by the presented Structural Equation Model Fig. These findings suggest that the model is reliable and valid for investigating self-medication practices. Those with a negative attitude towards self-medication were found to practice self-medication less. The study's findings indicate a moderate to a high level of self-medication practice among university students in Bangladesh, consistent with previous studies 35 , 36 , 38 , 72 , Several factors contribute to this practice, including limited access to healthcare services, cost-effectiveness, cultural beliefs, and the convenience of purchasing medications without a prescription from pharmacies and drug stores The researcher focused on two types of knowledge among university students in Bangladesh: knowledge about medication and knowledge about adverse drug reactions ADRs. Knowledge about medication was assessed based on medication doses, content, and related aspects, as well as knowledge of different medicine groups. The findings revealed that most students possessed intermediate knowledge about medication, with a relatively higher level of knowledge about medicine groups, consistent with previous studies conducted in different cities This observation could be attributed to the country's heavy marketing efforts of pharmaceutical companies. Surprisingly, most students exhibited only basic knowledge of ADRs. Previous research indicated that students often hold misconceptions, believing that non-severe illnesses cannot lead to serious consequences This knowledge gap regarding the risks associated with self-medication might be one of the reasons for the high prevalence of self-medication among university students in Bangladesh. The limited awareness about ADRs among students could be attributed to the insufficient emphasis on pharmacovigilance in the country. The structural equation model SEM presented in Fig. Previous research 75 — 77 supports this by indicating that individuals who engage in self-medication within the last 12 months tend to have a higher level of knowledge about self-medication. Furthermore, the SEM suggests that knowledge about medication indirectly affects self-medication by influencing knowledge about ADRs. Thus, those with greater knowledge about self-medication are likely to possess more knowledge about ADRs and higher self-medication practice. Additionally, in Bangladesh, the easy availability of over-the-counter medicine and the convenience of storing it 78 , 79 make self-medication a preferred choice. Conversely, obtaining prescribed medication is more difficult and inconvenient 78 , as observed in this study. Consequently, knowledgeable individuals may opt for the convenient, easily accessible, and quick relief self-medication provides. Contrasting findings were presented by a study conducted in Portugal 41 found no positive connection between knowledge and the practice of self-medication. Similarly, a study in Nepal 80 revealed that individuals with higher knowledge about medication safety were less likely to engage in self-medication. Additionally, a study in Nigeria 75 showed a negative correlation between knowledge about ADRs and self-medication practices among university students. These findings highlight the complex nature of the relationship between knowledge and self-medication, suggesting that various factors influence it. While university students in Bangladesh continue to engage in self-medication despite understanding the associated risks, others may avoid it due to their awareness of potential consequences. The results of this study indicate that most university students in the country have a positive attitude towards self-medication and adverse drug reactions ADRs. Previous studies on general university and medical students have also shown that most of them hold a positive attitude toward self-medication 17 , 29 , 32 , 73 , 79 , However, some studies suggest that students generally have a negative attitude toward self-medication 27 , 81 , 82 and are cautious about recommending self-medication to friends and family members These studies further suggest that students may develop this mindset due to increased awareness about medications and ADRs during their time in university 28 , Moonajilin et al. This shortage could be a prominent reason for the positive attitude towards self-medication and ADRs. Additionally, cultural and traditional beliefs have been identified as influential factors in shaping attitudes towards self-medication 74 , 84 , and the cultural and traditional beliefs in Bangladesh may have played a significant role in this context. Moreover, the present study has shown that students have limited knowledge about ADRs and their potential risks, which could contribute to these unique findings. This study reinforces the consistent finding from previous studies 28 , 41 , 73 that individuals with a positive attitude towards self-medication and adverse drug reactions ADRs tend to engage in self-medication more frequently. In contrast, those with a negative attitude are less inclined to do so. Among university students, except for some instances presented by James 28 , a positive attitude towards self-medication is a common factor 78 , The SEM Fig. Furthermore, the study reveals that the attitude toward self-medication indirectly impacts the practice by influencing the attitude toward adverse drug reactions ADRs. This suggests that individuals who perceive self-medication as acceptable also subconsciously acknowledge the potential negative consequences, despite recognizing its effectiveness. It can be attributed to self-medication as a convenient and cost-effective option to get quick relief from minor health issues 41 , Additionally, from a psychological perspective, one can argue that university students, being mature and knowledgeable individuals, possess optimism while accepting the reality of self-medication. This acknowledgment demonstrates their understanding that their choices can have both positive and negative outcomes, and they are willing to accept the responsibility that comes with it. This study highlights the widespread perception among students that self-medication is highly convenient. They report that buying and storing medicine in Bangladesh is easy, consistent with previous studies 48 , 29 , 63 conducted in Bangladesh and other countries 83 , 86 , Those over-the-counter OTC medications are commonly used for self-medication. Students also emphasize that self-medication saves time and offers quick relief, which has consistently emerged as primary motivation for self-medication in previous studies 7 , 88 , Additionally, the convenience of self-medication in Bangladesh is attributed to the knowledge gained from previous prescriptions and the online availability of medical information. These factors have also been reported as key drivers of self-medication 78 , 81 , As the convenience of self-medication increases, so does its prevalence. This finding is consistent with earlier studies 28 , 32 , 34 , 38 , 39 , 71 , 72 highlighting the positive influence of easy access to self-medication on its practice. One possible explanation for the convenience of self-medication is the proliferation of health-related resources on the internet. This enables individuals to independently research symptoms, diagnoses, and potential treatments, leading to a sense of autonomy and confidence in making health decisions without consulting a healthcare professional. Additionally, easy access to medical information allows students to become more knowledgeable about common ailments, symptoms, and treatments, thereby reinforcing the practice of self-medication 78 , 81 , This study highlights the significant inconvenience half of the students face when accessing prescribed medicine in Bangladesh, shedding light on the challenges associated with healthcare services in the country. The reasons identified by the study, including distance to government healthcare centers, unavailability of pharmacies, high cost of private medical care, and inadequate health call centers, are all significant barriers to accessing healthcare services. Previous studies conducted in Bangladesh 90 , 91 have also reported difficulties obtaining advice from healthcare professionals, further exacerbating the problem. This situation can be directly attributed to the low healthcare budget in Bangladesh, which is one of the lowest in South Asia, accounting for only 5. Consequently, the practice of self-medication among university students increases with the growing inconvenience of accessing prescribed medication. These findings align with previous research 74 , 78 , 79 , 83 , 84 that has identified difficulties in obtaining proper treatment as a significant contributing factor to the practice of self-medication. Earlier, this study stated that students with a higher level of medication knowledge resort to self-medication may be due to the significant inconvenience associated with obtaining prescribed medication. This inconvenience can also be attributed to the accepting attitude of students towards the potential negative consequences that may arise due to self-medication. Students in Bangladesh may prefer to avoid the hassle of seeking health professionals' suggestions, which contributes to this phenomenon. The strengths and weaknesses of this study have been accredited. The strength that lies in this study is the greater generalizability of the findings since it covered greater participants and universities. Along with appropriate statistical methods and casual modelling are the main strengths of this study. SEM allows researchers to model and test complex relationships among multiple variables simultaneously. This is particularly beneficial when investigating intricate structures or pathways in cross-sectional data. SEM incorporates measurement models, which can help account for measurement errors in observed variables. By doing so, it provides a more accurate estimation of the relationships between latent constructs. While the limitations are its cross-sectional nature limits the casual inference since outcomes and predictors variables have been collected same time frame. Therefore, SEM allows for the testing of causal relationships, establishing true causality in cross-sectional studies can be difficult. The observed relationships may be influenced by unobserved variables or bidirectional causation. While the ability to model complex relationships is a strength, it can also be a limitation. Overly complex models with too many parameters can lead to overfitting and poor generalization to new data. Despite existing regulations and healthcare facilities, effective and evidence-based guidelines are needed to improve self-medication practices. While self-medication can be beneficial if appropriately directed, but specific actions are needed. To strengthen prescribed medication practices, standardized guidelines should be developed, covering dosage recommendations, regimen instructions, and considerations for potential adverse effects. Healthcare providers should undergo continuous education on evidence-based medicine and patient safety, with mechanisms in place to monitor and evaluate adherence to guidelines. Enhancing the quantity and accessibility of prescribed medication requires collaboration between governments, healthcare providers, and pharmaceutical companies. Measures include ensuring an adequate supply of medications, reducing costs through bulk purchasing agreements and promoting generics, and improving accessibility through pharmacy networks, home delivery, and telemedicine. Improving government medical services entails increased funding for infrastructure, equipment, and staff capacity. Reducing waiting times and implementing electronic health record systems can enhance patient satisfaction and care coordination. Educating the public is vital. Public awareness campaigns should highlight self-medication risks, while collaboration with educational institutions and healthcare providers can deliver targeted programs on proper medication usage. Leveraging communication channels is essential to disseminate accurate information and discourage self-medication. Strengthening regulation and enforcement involves monitoring and controlling the availability and sales of over-the-counter medications, deterring unauthorized prescription sales, and raising awareness of legal and health consequences. There might be potential differences across different groups of university students in terms of practicing self-medications therefore further detailed study is recommended to explore these differences across different study level. In conclusion, university students in Bangladesh possess intermediate medication knowledge and primary knowledge of Adverse Drug Reactions ADRs. They exhibit a positive attitude towards both self-medication and ADRs. Students with advanced medication knowledge and positive attitudes toward self-medication are more likely to engage in it. This research is crucial for self-medicating students and policymakers seeking to improve control measures. Further research should explore age-specific factors such as individual beliefs, cultural influences, and socio-economic factors that drive self-medication preferences. MMT carried out the statistical analyses. MAR supervised the whole study. All authors contributed to the article and approved the submitted version. MMT is responsible for the overall analysis. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Sci Rep. Knowledge attitude and convenience on self-medication practices among university students in Bangladesh exploration using structural equation modeling approach Mortuja Mahamud Tohan Mortuja Mahamud Tohan 1 Development Studies Discipline, Social Science School, Khulna University, Khulna, Bangladesh. Find articles by Mortuja Mahamud Tohan. Find articles by Faysal Ahmed. Find articles by Israt Jahan Juie. Find articles by Anamul Kabir. Find articles by Md Hasan Howlader. Find articles by Md Ashfikur Rahman. Received Sep 5; Accepted Apr 29; Collection date Open in a new tab. Mean Sig. Sex of the respondents Male 64 Mean SD Sig. Knowledge about medication Primary Supplementary Tables. Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Primary 6 — 14 , Moderate 15—22 , Advanced 23— Knowledge about the difference between Side Effects and Adverse Events related to drugs. Knowledge about buying and consuming medicines without a prescription. Knowledge about ADR due to not completing or missing the timing of medicine dose.

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