Prevalence and patterns of self-medication in Pakistan: a systematic review and meta-analysis

Self-medication is widespread in many developing countries and may lead to serious consequences such as antimicrobial resistance and delays in receiving appropriate healthcare. This systematic review and meta-analysis aimed to estimate the pooled prevalence of self-medication in Pakistan and explore possible sources of variation across different populations and regions. Although the search covered studies published between 2000 and 2025, all eligible studies included in the analysis were published between 2008 and 2025.

A systematic search was conducted across Ovid MEDLINE, Embase, CINAHL, Scopus, Web of Science, and PakMediNet to identify studies published between 2000 and August 2025. The final database search was performed in August 2025. The review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251117353). Observational studies reporting the prevalence of self-medication were included. A random-effects meta-analysis, subgroup analyses, sensitivity analysis, and meta-regression were performed.

A total of 65 studies involving 35,960 participants were included. The overall pooled prevalence of self-medication was estimated at 64% (95% CI: 57-71). However, a very high level of heterogeneity was observed across studies (I² = 99.7%), indicating substantial variation between populations and study settings. Therefore, the pooled estimate should be interpreted with caution. The highest prevalence was observed in the Sindh province (69.8%, 95% CI: 60.3% to 79.3%) and among university students (71.3%, 95% CI: 64.7-77.8), while lower rates were reported in the general population and the Punjab province. Meta-regression showed no significant association between prevalence and publication year, sample size, or study quality. Sensitivity analysis confirmed the robustness of the findings, showing that no single study substantially influenced the overall estimate.

Self-medication is highly prevalent in Pakistan. These findings highlight the urgent need for regulatory policies to control over-the-counter drug use and public health interventions to raise awareness about the risks associated with self-medication.