Medication safety in the context of self-medication and polypharmacy: A systematic review of prevalence, risk factors, and clinical implications
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Ionela Daniela Fertu 1 * , Caterina Nela Dumitru 1 , Ancuta Iacob 1 , Mihai Tudor 2 , Claudia Simona Stefan 1 , Simona Steliana Tudor 1
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1 Centrul de Cercetare in Domeniul Medico-Farmaceutic, Facultatea de Medicina si Farmacie, Universitatea “Dunarea de Jos” Galati, Galati, ROMANIA2 Stațiunea de Cercetare Pentru Viticultură și Enologie Bujoru, Departamentul de Fizico-Chimie și Biochimie, Târgu Bujor, ROMANIA* Corresponding Author

Abstract

Self-medication and polypharmacy are major global challenges, with significant impacts on the safety of drug therapy and the rational use of medicines. The increasing access to over-the-counter (OTC) medicines and the prevalence of chronic diseases contribute to the concomitant use of multiple therapies, often without adequate medical supervision. The study aims to systematically assess the prevalence, determinants, and clinical consequences of self-medication and polypharmacy, with a focus on their impact on medication safety. A systematic literature review was conducted using major international databases (PubMed, Scopus, Web of Science, ScienceDirect, Springer, and Wiley) for the period 2020-2025. Studies were selected based on pre-established inclusion criteria, with the analysis focusing on the prevalence, risk factors, and adverse effects associated with self-medication and polypharmacy. The results highlight a high global prevalence of self-medication, ranging from approximately 53% to 74%, with higher values in Asia and Europe. Polypharmacy is prevalent among the elderly population and patients with multiple comorbidities. Both phenomena are associated with an increased risk of adverse drug reactions, drug interactions, inappropriate treatment use, and decreased therapeutic efficacy. The main determining factors include limited access to health services, socioeconomic constraints, previous experiences with medicines, and the wide availability of OTC products. Self-medication and polypharmacy significantly affect the safety of drug therapy and represent major public health problems. Strengthening regulations, patient education, and interdisciplinary collaboration are essential to reduce risks and optimize the use of medicines.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Review Article

ELECTRON J GEN MED, Volume 23, Issue 3, June 2026, Article No: em739

https://doi.org/10.29333/ejgm/18704

Publication date: 04 Jun 2026

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