Prevalence and Factors Associated with Self-Medication with Antihypertensive Drugs among Pharmacy Clients in Brazzaville, Republic of Congo: A Cross-Sectional Study
Background: Self-medication with antihypertensive drugs is a common practice in sub-Saharan Africa that may contribute to poor blood pressure control and cardiovascular complications. However, quantitative data on this practice remain scarce in Central Africa, particularly in the Republic of Congo. Objective: To determine the prevalence of self-medication with antihypertensive drugs among pharmacy clients in Brazzaville and to identify associated factors and pharmacy dispensing practices. Methods: A cross-sectional descriptive study was conducted from March to November 2021 in five community pharmacies in Brazzaville. Hypertensive patients purchasing antihypertensive drugs without valid prescriptions were interviewed using structured questionnaires. Pharmacy staff were also surveyed regarding their dispensing practices and knowledge about self-medication risks. Results: Among 367 pharmacy clients screened, 100 (27.2%; 95% CI: 22.4% - 32.5%) practiced self-medication. The mean age was 53.8 ± 14.5 years with male predominance (59%). Most participants had secondary (39%) or higher education (37%), worked in the informal sector (32%) or were retired (29%). The main reason for self-medication was lack of money (72%), followed by lack of time (15%). Diuretics (52%), ACE inhibitors (39%), and calcium channel blockers (32%) were the most commonly self-medicated drugs. Only 20% of participants knew about health risks of self-medication. In case of treatment failure, 73% reported they would consult a physician. Among 25 pharmacy staff surveyed, 52% had dispensed antihypertensive drugs without prescriptions, and 12% believed medical consultation was not essential before starting antihypertensive treatment. Conclusion: Self-medication with antihypertensive drugs is highly prevalent among pharmacy clients in Brazzaville, driven primarily by economic constraints and facilitated by inadequate enforcement of prescription requirements. Urgent interventions targeting patient education, pharmacy practice regulation, and economic barriers to healthcare access are needed to improve hypertension management in Congo. However, conclusions regarding pharmacy practices should be interpreted with caution, given the limited number of pharmacy staff included in the study.
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