Self-medication and pain in the European Union: Gender differences and associated factors

Pain management, including self-medication, is an increasingly critical responsibility of public health. This study examines the prevalence and associated factors of self-medication in individuals experiencing pain in the European Union. This study performs multivariable analysis utilizing data from wave three (2018–2020) of the European Health Interview Survey ( N = 149,349). Overall self-medication prevalence is 42.7%, with rates ranging from 19.0% to 85.1%.Self-medication prevalence is affected by pain severity and the association differs by sex: men are most likely to self-medicate at moderate pain levels (adjusted odds ratio [AOR] = 1.25;95%CI = 1.16,1.35), whereas women are most likely to self-medicate at severe/very severe pain levels (AOR = 1.30;95%CI = 1.20,1.40). Additionally, an association between depression and self-medication is found exclusively in men (AOR = 1.38;95%CI = 1.19,1.59). Several factors are also associated with self-medication in both sexes, notably improved education (male AOR = 2.70;95%CI = 2.11,3.45/female AOR = 4.09;95%CI = 3.44,4.87) and over-the-counter medication availability outside pharmacies (male AOR = 1.72;95%CI = 1.61,1.84/female AOR = 2.25;95%CI = 2.13,2.37). Finally, we find that economic barriers to healthcare access influence self-medication (male AOR = 1.31;95%CI = 1.11,1.55/female AOR = 1.33;95%CI = 1.18,1.49). The findings highlight sex differences and the impact of pain severity on self-medication. The results also demonstrate cross-country variation in both self-medication practices and pain, underscoring the need for better education about responsible self-medication, a review of over-the-counter medication policies, and reduced healthcare barriers. • Self-medication is more prevalent among individuals in pain than general population. • Major sex differences exist for self-medication in individuals experiencing pain. • Education is one of the strongest influences on self-medication behavior. • Over-the-counter medication availability outside of pharmacies increases their use.