A National Survey of Self-Prescription of Beta-Blockers and Their Relation to Undiscovered Anxiety Among Medical and Pharmacological Students in Saudi Arabia

Figures & data

Table 1 Baseline Characteristics for the Whole Cohort

Baseline Characteristics (N = 3326)
Mean age (years)	21.9±1.7
Male (%)	33.0
Medical students (%)	79.6
Pharmacy students (%)	20.4
Government university (%)	94.1
Junior student (%)	41.5
Senior student (%)	56.4
Intern (%)	1.1
Graduated (%)	1.0
Location of the college
Western region of Saudi (%)	25.8
Eastern region of Saudi (%)	16.4
Northern region of Saudi (%)	11.9
Southern region of Saudi (%)	23.6
Central region of Saudi (%)	22.4
Lifestyle habits
Cigarette smokers %	8.6
Shisha/Argela smokers %	9.9
No energy drinking consumption %	57.9
Daily energy drinking consumption %	4.6
Weekly energy drinking consumption %	9.7
Rarely energy drinking consumption %	27.8
Comorbid conditions
Chronic medical diseases (%)	8.8
Existed psychiatric disorders %	7.4
Hands tremor (%)	20.6
Chronic medical disease diagnosis
Asthma and allergy (%)	2.7
Existed Psychiatric diagnosis
Anxiety (%)	1.8
Schizophrenia (%)	0.3
Depression (%)	2.2
Obsessive compulsive disorders (%)	0.7
Existed other psychiatric disorders
Panic disorders (%)	1.5
Social phobia (%)	2.0
Post-traumatic stress disorder (%)	0.1
Diagnosis was made before college enrolment (%)	74.1
Screening with Generalized Anxiety Disorders 7-items (GAD-7)
Mean GAD-7 score (SD)	5.3±5.1
Normal (%)	51.2
Mild anxiety (%)	29.8
Moderate anxiety (%)	12.2
Sever anxiety (%)	6.8

Table 2 Prevalence and Characteristics of Beta-Blockers Usage

Baseline Characteristics
Overall Beta blocker usage (%)	6.4
Beta blocker usage before all the exams (%)	1.0
Beta blocker usage before most of the exams (%)	1.4
Beta blocker usage before some of the exams (%)	4.0
Beta blocker usage before theory exam (%)	3.5
Beta blocker usage before clinical exam (%)	4.7
Beta blocker usage before seminar presentation (%)	4.3
Beta blockers prescribed by a health care providers (%)	29.9
Self-prescribed medications other than Beta blockers (%)	15.1
Reason of Beta blockers usage
I did not study well for the exam (%)	15.0
I studied well, but feels anxious on the exam day (%)	53.5
I feel more confident/will do better on the exam if I take it (%)	31.5
Exam fields where Beta blockers was used for
Internal medicine (%)	22.6
General surgery (%)	12.3
Obstetrics/Gynecology (%)	14.2
Pediatrics (%)	0.1
Biology (%)	0.1
Biochemistry (%)	7.5
Pharmacology (%)	2.3
Therapeutic (%)	37.7
Others (%)	3.2
Final scores for the topics after Beta blockers usage
GPA improved after Beta-blockers use (%)	32.3
GPA unchanged after Beta-blockers use (%)	60.0
GPA worsen after Beta-blockers use (%)	7.0
A+ or A (%)	18.1
B+ or B (%)	51.6
C+ or C (%)	22.6
D+ or D (%)	7.7
Did you ever failed an exam after using beta-blocker pills? (%)	17.5
Beta blockers harms
Experienced side effects related to Beta blockers usage (%)	24.0
Do you think non-prescribed Beta blockers usage is harmful? (%)	63.9
Study participants whom were able to identify correctly two common side effects (%)	2.7
Study participants whom were able to identify correctly two serious side effects (%)	5.2
Specialty of the health care providers for those who prescribed Beta blockers
General practitioner (%)	23.3
Family physician (%)	23.3
Internal medicine doctor (%)	26.7
Psychiatric doctor (%)	25.6
Beta blockers users’ source of advice/information
Study materials in college (%)	37.4
Same level college student (%)	32.5
Senior college colleagues (%)	25.2
Junior college colleagues (%)	4.9
Did you review any evidence for Beta blockers usage before the exam?	23.9
Types of the medication that is self-prescribed other than Beta blockers
Antibiotic (%)	13.8
Antihistamine (%)	10.7
Analgesic (%)	29.8
Others (%)	26

Table 3 Group Characteristics Based on the College of the Participants

Baseline Characteristics	Medicine	Pharmacy	P value
Number of participants (%)	79.6	20.4	n/a
Mean age (years)	21.8±1.7	21.9±1.6	0.172
Male (%)	34.8	25.1	<0.001
Government university (%)	93.4	97.1	<0.001
Junior student (%)	42.0	38.8	<0.001
Senior student (%)	57.2	54.2
Intern (%)	0.4	3.8
Graduated (%)	0.4	3.2
Lifestyle habits
Cigarette smokers %	9.0	6.9	0.078
Shisha/Argila smokers %	10.0	9.6	0.763
No energy drinking consumption %	58.9	54.5	0.400
Daily energy drinking consumption %	4.4	5.2
Weekly energy drinking consumption %	8.2	15.1
Rarely energy drinking consumption %	28.5	25.2
Comorbid conditions
Chronic medical diseases (%)	9.3	6.9	0.046
Existed psychiatric disorders %	7.9	5.1	0.012
Hands tremor (%)	20.4	21.6	0.484
Existed Psychiatric diagnosis
Anxiety (%)	2.0	1.2	0.184
Schizophrenia (%)	0.3	0.3	0.893
Depression (%)	2.5	1.2	0.043
Obsessive compulsive disorders (%)	0.8	0.5	0.379
Existed other psychiatric disorders
Panic disorders (%)	1.6	0.1	0.283
Social phobia (%)	2.1	1.5	0.283
Post-traumatic stress disorder (%)	0.1	0.1	0.737
Screening with Generalized Anxiety Disorders 7-items (GAD-7)
Mean GAD-7 score (SD)	5.4±5.1	5.1±5.4	0.266
Normal (%)	50.9	53.3	0.968
Mild anxiety (%)	30.2	28.2
Moderate anxiety (%)	12.2	11.8
Sever anxiety (%)	6.7	6.7
Beta blockers related data
Overall Beta blocker usage (%)	6.5	6.2	0.285
Beta blocker usage before all the exams (%)	0.1	1.6	0.285
Beta blocker usage before most of the exams (%)	1.2	2.2
Beta blocker usage before some of the exams (%)	4.4	2.4
Beta blocker usage before theory exam (%)	3.2	4.7	0.061
Beta blocker usage before clinical exam (%)	5.2	2.7	0.007
Beta blocker usage before seminar presentation (%)	4.1	5.1	0.276
Beta blockers prescribed by health care providers (%)	29.7	30.6	0.262
Self-prescribed medications other than Beta blockers (%)	13.4	21.3	<0.001
Feels better during the exam that students took Beta blockers for (%)	57.9	53.3	0.858
Reason of Beta blockers usage
I did not study well for the exam (%)	16.7	7.1	0.034
I studied well, but feels anxious on the exam day (%)	56.5	42.9
I feel more confident/will do better on the exam if I take it (%)	26.8	50.0
Final scores for the topics after Beta blockers usage
GPA improved after Beta-blockers use (%)	30.2	40.5	0.625
GPA worsen after Beta-blockers use (%)	6.9	7.1
A+ or A (%)	14.8	28.6	0.268
B+ or B (%)	53.4	45.2
C+ or C (%)	24.4	16.7
D+ or D (%)	7.4	9.5
Did you ever failed an exam after using beta-blocker pills? (%)	16.7	21.7	0.724
Beta blockers harms
Experienced side effects related to Beta blockers usage (%)	24.6	21.7	0.915
Do you think non-prescribed Beta blockers usage is harmful? (%)	63.6	65.0	0.040
Study participants whom were able to identify correctly two common side effects (%)	2.9	2.4	0.297
Study participants whom were able to identify correctly two serious side effects (%)	5.5	4.0	0.071
Beta blockers users’ source of advice/information
Study materials in college (%)	34.2	48.6	0.233
Same level college student (%)	34.7	23.1
Senior college colleagues (%)	25.0	28.3
Junior college colleagues (%)	6.1	0.0
Did you review any evidence for Beta blockers usage before the exam?	20.2	38.0	<0.001
Types of the medication that is self-prescribed other than Beta blockers
Antibiotic (%)	12.6	16.2	0.062
Antihistamine (%)	12.6	7.1
Analgesic (%)	27.9	33.3
Others (%)	24.2	29.3

Figure 1 Beta blockers usage based on gender (%). P value < 0.001.

Figure 2 Beta blockers usage based on GAD-7 screening. P value 0.009.