In this study, there was a medium tendency for self-treatment among diabetic patients.
Female gender, lower education and co-morbid illnesses of hypertension, cardiac disease and hyperlipidemia showed the relationship with self-treatment. If the treatment with Insulin or renal complications were considered as the indicator of severity of the diabetes, it seems that severity of the diabetes is not significantly related to self-treatment, but the symptoms that patient experience might determine his or her self-treatment behavior. Patients prefer to seek formal treatments in severe symptoms. The inpatient and outpatient situations were not related to self-treatment behaviors. This might represent the fact that self-treatment is a basic health-related behavior that is not affected by temporary situations.
Different factors could influence self-treatment behaviors. Giovannini found that self-treatment is the most common first therapeutic choice in the patients [13]. However, we should consider that self-treatment is a broad concept, and a process which can be divided into three-stages of self-diagnosis, self-treatment and self-monitoring [14]. The patients' treatment behaviors can be ranged from seeking care from doctors as outpatients, waiting to see the progress of symptoms, resting or consulting books, using home remedies to self-treatments [15].
In our study, patients showed different self-treatment behaviors. Self-medication is the most prevalent self-treatment behavior. 27% of patients reported self medication. In Tabriz 81.64% of individuals embarked on self-treatment using chemical drugs [16]. This is much higher compared to our study. It seems that self-treatment is more common in general population than in patients with diabetes mellitus.
The next aim of this study was to identify the background factors of self-treatment in diabetes. The seven factors were extracted from the data. In a study, the most common factors' underlying self-drug consumption was negligence of the disease (30%) and inability to afford the visit fees of the physicians (14.7%) [4]. In a different study in Iran, it was found that costly treatments (32.4%) and lack of time (23.7%) were the reasons why patients refused to visit the physicians [17]. Another study showed that symptomatic therapy by physician, insignificance of diseases from the patients' viewpoints, and cost of the treatments were the main reasons for practicing self-medication [18]. The comparable factors can be seen in our study. Like us, Jirojwong also found that compared to men, women tend more to use home remedies and show more self-treatment behaviors [15]. The women had significantly lower education compared to men, which can explain the difference. But studies show that there are basic differences between men and women in treatment-seeking behaviors and self-treatment [15, 12, 19, 5].
It is possible that the medium tendency of self-treatment in patients to be related to their tendency of not choosing the extreme options in the questionnaire. Convenience sampling was used for this research, and it should be noted that the participants of this study were patients with diabetes seeking care at the ambulatory clinic or admitted to the hospital due to diabetes complications, which might be a potential source of bias and limits the generalization of the findings.