Keywords

Consumer Purchase Behaviour, Consumers' Attitude, Behavioural Control.

Introduction

Globally the use of non-prescription medicines is the most customary form of medical care (Covington, 2002), and it has seen tremendous growth in sales than that of prescription medicines since 2008 Tisman (2010). There may be some reasons for its growth. Firstly, the tendency for self-medication is increasing and to treat minor and ordinary health problems OTC medicines are convenient and inexpensive. Secondly, prescription only-to-OTC switching is not likely to decrease, making more medications available without a prescription. Thirdly, health literacy is likely to increase, as the source of self-medication information is widely available through the internet or social media (George, 2006).

As per, Battistoni et al. (2014) OTC medicine market has four very specific characteristics. At first consumers purchase products in response to their specific health needs. Secondly, the market is not strictly monitored in the same way that the prescription market is, which permits the pharmaceutical companies to choose their pricing and communication strategies. Many drugs that can be dispensed as OTC medicine if it is used appropriately may irradiate nearly 60- 80% of health-related problems, as a lower-cost alternative to prescription medicine. In the OTC medicine segment, consumers cannot be forced by physicians to buy any specific drug, so the consumer may choose the one they prefer by themselves.

As per the FMoH & WHO (2003), the pharmaceutical industry internationally is highly competitive. Therefore, speculating the reasons for growth and based on the characteristics of the OTC medicine market, manufacturers and marketers will have to develop strategies that will influence consumers’ purchase decision-making process in line with customers’ actions. Particularly knowing what makes customers prefer prescription and OTC medicines will make the marketer adapt strategies based on the influential factors (Kotler and Armstrong, 2012). There are many social studies regarding consumer buying behaviour and the factors that influence consumers’ buying intentions in general Pandey & Srivastava (2016). However, consumers’ buying behaviour toward OTC medicines has some unique characteristics Ayub & Mustafa (2017) and few studies of the pharmaceutical market in the Indian context have discussed this issue Kohli & Buller (2013). To the researchers’ knowledge is a concern, the factors affecting people’s intentions of buying OTC allopathic analgesic medicines have not been studied empirically within the Indian context before. Consequently, this research aims to fill this gap in the literature by developing a conceptual framework by identifying the factors affecting the intention to buy OTC medicine.

This research aims to answer the following questions:

RQ1. What are the main patterns that motivate the originator factor which affects the buying intention of the consumer for non-prescription “OTC allopathic” medicines in the Indian market?

RQ2. Among these factors which influence the consumer decision-making process for purchasing OTC allopathic medicines are most dominant?

Conceptual Framework and Research Hypotheses

Purchase behaviour is the combination of diverse actions like how people buy, what they buy, when they buy and why they buy (Kotler, 2003). It has been defined as "a process, through which inputs and their output are managed which leads to actions and satisfaction of needs and wants" (Enis, 1974, p.228). According to Blackwell et al (2006), consumer purchasing behaviour is itself a complex subject and drive-by intention.

Buying intention is a preliminary step for making the buying decision; it reflects the willingness to buy (Dodds et al., 1991). While the intention is a predictor of actual behaviour (Ajzen & Fishbein, 2005). Consumer theories like the theory of reasoned action (the TRA), and the theory of planned behaviour (TPB) manage individual social expectations dependent on customary perspective, and these theories have been successfully utilized to link various issues. The reasoned action model integrates attitude components into a structure that explains and predicts intention and behaviour in a better way. The first of a breed of ‘expectancy-value models of attitude formation’ was developed by Martin Fishbein. Which was popularly known as the ‘Fishbein model' (Fishbein 1963, Fishbein 1965, Fishbein 1967, Fishbein and Bertram 1962). The Fishbein model proposed that a person‘s overall attitude toward an object is derived from his beliefs and feelings about various attributes of the object (Ahtola 1975, Loudon and Bitta 1993). TRA has been widely used and supported by researchers to predict consumer behaviour through attitudes and subjective norms. The main purpose of the Theory of Reasoned Action is to explain the relationship between attitudes and behaviours within human action. It is used to predict how individuals will behave based on their pre-existing attitudes and behavioural intentions. An individual's decision to engage in a particular behaviour is based on the outcomes the individual expects will come as a result of performing the behaviour in question Bhowmick (2020). The theory of reasoned action was developed on basis of the assumption that the behaviour being studied is under full volitional control. Many behaviours cannot simply be performed at the will of the consumer; they require skills, opportunities, resources, or cooperation for their successful execution Sutton (2001). The extension of TRA as proposed by Ajzen, overtly incorporates perceived behavioural control as an antecedent to behavioural intention ( Madden and Ajzen, 1992). The theory of planned behaviour extends the boundary condition of pure volitional control specified by the theory of reasoned action which is accomplished by including the belief regarding the procession of requisite resources and opportunities for performing the behaviour Bhowmick (2020). According to the TPB, three major and important components influence human behaviour to behave. The components are attitude, subjective norm and perceived behavioural control mediated by purchase intention. These components provide a guideline to predict human social behaviour. Conceptualization of TPB presented by Ajzen (1991) implies a causal relationship between these four things, namely: beliefs, attitudes, intentions and behaviour JINNAH et al. (2020).

More than 100 studies and articles have been examined over the past 20 years to understand the antecedents of consumer buying behaviour and the factors that influence it. Of these factors, attitude, price, subjective norms, brand image and trust were the most frequently studied antecedents Pandey & Srivastava (2016). It is worth mentioning that the consumer buying behaviour toward medicines has some distinctive characteristics that differentiate it from the buying behaviour of any other product, as consumers can avoid buying many things, yet they cannot ignore medicine Ayub & Mustafa (2017).

Hypothesis

Behavioural intention is determined by consumer belief to be the outcome of performing the behaviour. From TRA/TPB, the most important determinant of behaviour is the intention to perform the behaviour which may be influenced by attitude toward the behaviour, subjective norms or perceived behavioural control. Without motivation, a person is unlikely to carry out a recommended behaviour (Montano and Kasprzyk 2008).

Attitude

Attitude towards the purchase of nonprescription medicines is a function of their involvement in the purchase decision-making process (Gore, 1994). Consumer attitudes are a composite of a consumer‘s beliefs, feelings and behavioural intentions toward some object within the context of marketing (Perner, 2010). However, the intention to perform a given action is high if people evaluate it positively and if they believe that how important others think they should perform the actions in question. However, the relative importance of the two factors may vary crosswise behaviours and populations Smelser & Baltes (2001).

Attitude reflects the person's salient behavioural beliefs or outcome belief concerning the possible personal consequences of the actions the individual is performing. Outcome belief is based on declarative memory which develops through personal experience, semantic memory and knowledge individual develops gradually in his mind. For example, a person who believes that performing a given behaviour will lead to mostly positive personal consequences will hold a favourable attitude towards the behaviour. Higher outcome belief leads to a higher personal attitude towards performing the behaviour Bhowmick & Jha (2021). Specifically, attitude is held to be a function of the sum of the person's salient behavioural beliefs concerning the outcome of the action each weighted by their evaluation of that outcome Smelser & Baltes (2001). Connecting outcomes to the program seems like a simple criterion for outcome evaluations, but it is often overlooked. This criterion requires that the analyzed outcomes logically be the product of the services received through the program and not an unintended effect of externalities. The outcomes should first be identified as being sensitive to change and intervention; otherwise, an intervention provided by a program would have no effect. The outcomes should then be attributed to the intervention in such a way that it is obvious that a link exists between the services provided and the outcomes observed. (Frederick M, 2005). Based on previous research it can be concluded that outcome evaluation reflects the outcome of taking the behaviour or outcome of doing that behaviour in question. Hence the researchers considered outcome belief and outcome evaluation as the components for determining the attitude of the consumer for adjudging behavioural intention towards purchasing OTC allopathic medicine. Based on this the paper poses the following hypothesis:

H₁: Consumer expectancy of favourable outcome belief for OTC allopathic medicines has a positive relationship with behavioural intention

H₂: A satisfactory outcome evaluation of OTC allopathic medicine influences the behavioural intention of the consumer.

Subjective Norms

The self-medication practice is common either through self-knowledge or through reliance on suggestions received from family members and friends Kotwani et al. (2021). Self-medication, either through reliance on old prescriptions or through consulting family or friends is a major cause of OTC medicine purchases. Consumers reuse doctors’ previous prescriptions and start seeking medicines on their own, especially in the case of similar symptoms for which the prescription was given in the first place. Most of the consumers explicitly stated that initially antibiotics were prescribed by the doctor, but when they identified a repetitive pattern – saw that the same antibiotic was being prescribed by the doctor − they started advocating it to their friends and other family members for purchasing it directly from pharmacies and taking the antibiotics on their own Kotwani et al. (2016). There are many instances of research where the focus is placed on the role which experts influence purchasing behaviour, in this case, pharmacists, have during the choice and use of appropriate OTC medicine Šapi? et al. (2019). Unlike in the past, when the consumers showed an insufficient degree of trust and a kind of scepticism when choosing those products, in modern times a higher degree of credibility towards these people has been noticed, whose main role refers to the transfer of correct and precise information, which provides certainty and help with the decision-making process concerning the purchase (Villako et al., 2012). Apart from the influence of the family members, and peer groups influence, online social media and social networks have a major influence on spending and are the basis of many concepts and frameworks concerning purchase intention (Zukin and Maguire, 2004). Modern consumers consider OTC medicines not as regular consumer goods and rather view them as healthcare medicines (Taylor et al., 2008; Wazaify et al. (2005). Therefore, the consumer's own belief to evaluate products, and in turn, the subjective norm toward OTC medicines has a major role in the purchase behaviour of OTC medicines Jinnah et al. (2020). Hence the researchers considered normative belief and motivation to comply as the components for determining the attitude of the consumer for adjudging behavioural intention towards purchasing OTC allopathic medicine. Therefore, based on the above literature review, this paper hypothesized that.

H₄: Sturdier normative belief leads to a positive behavioural intention of the consumer to purchase OTC allopathic analgesic medicine.

H₅: Stronger the motivation to comply with OTC allopathic analgesic medicines, the higher will be the behavioural intention to purchase.

Perceived Behavioral Control

According to the theory of planned behaviour, volitional human behaviour is a function of the intention to perform the behaviour and perceived risk is the vulnerability a purchaser has when purchasing an item. The degree to which perceived behavioural control influences a behaviour directly (rather than indirectly through intention) is hypothesised to depend on the degree of actual control over the behaviour (Falko, 2014). Each time a consumer thinks about purchasing an item, the consumer has certain questions in mind before he made the purchase decision making process. They are: whether he has the accessibility to get the desired product or service he wants, whether he has the affordability to purchase the product or service or even if he has the affordability to purchase the product whether the desired product or service is available or not, controls the behavioural intention of the consumer. In previous research, it has been observed even if the consumer has a positive attitude and positive subjective norms the ultimate decision-making process is heavily dependent on the perceived control of the consumer Bhowmick (2020). In a study conducted by Martín et., al (2009), the results indicated that both psychological and physical risk has a positive and direct effect on perceived risk. Their results also proved that psychological risk influences the effects of performance, economic and social risk dimensions on overall risk (Suplet et al., 2009). This role of perceived risk was also found by Klerck and Sweeney (2007) in their research on consumer behaviour toward genetically modified food. Unlike most consumer goods, pharmaceuticals involve high risk and are related to the health of consumers (Pahud et., al 1997). Frequently in consumer behaviour research, the perceived risk acts as a mediator between an attitudinal outcome variable and extrinsic product signals. Based on previous research it can be said that even the direct role of perceived risk cannot be neglected (e.g., Agarwal and Teas, 2001; Semeijn, Van Riel and Ambrosini, 2004). Hence the following hypothesis has been proposed by the paper based on perceived behavioural control.

H₆: Higher perceived behavioural control leads to a noteworthy impact on behavioural intention to purchase OTC allopathic analgesic medicine.

Attitude is the consequence of an individual outcome belief and outcome evaluation which subsequently gives rise to a sense of willingness to perform a given behaviour (Cheah and Phau, 2011). Attitude provides the means to favourably or unfavourably evaluate the purchase decision-making process based on individuals' cognitive thoughts, beliefs in terms of values as well as emotions that they have toward the given object (Ambad and Damit, 2016). It is among the factors which play an important role in predicting the intentions of consumers' purchase decision-making process (Haque et al., 2019). But when an individual’s belief regarding whether the execution of a respective behaviour will be acknowledged or disapproved by others living in the same society, then subjective norms play a vital role in the purchase decision- making process (Ajzen and Fishbein, 2005). Thus, individuals' intentions are substantially shaped through subjective norms whereby, there is a higher likelihood of performing the behaviour in question when it is believed that the performance of that behaviour will be approved by others in the society (Yeon and Chung, 2011).

Several researchers have proved that self-confidence in the ability to purchase a product, perceived affordances and consumer's acquisition and use to assess products explained a positive relationship with purchase intention (Baker and Hubona, 2007; Taylor and Todd, 1995) Li et al. (2002). A study by Chan and Tran revealed that perceived behaviour has more control over making the purchase decision of OTC medicine. Pujari et al. (2016) also discovered that 16% of the consumer purchase conventional items, while 5% of individuals settle on the choice of the expense of meds and 7% on simple accessibility.

Based on the above-related literature reviews the following conceptual framework was developed from TRA and TPB.

Based on the above-related literature reviews the following conceptual framework was developed from TRA and TPB Figure 1.

Participants and Procedures

The study was conducted among the individuals of Hooghly district in the state of West Bengal who are above the age of 18 years with educational qualifications of 12^th standard and above. The reason for this segmentation was to categorize and segregate the participants in decision- making process who could use their knowledge and has a clear understanding of OTC allopathic medicine. The educated population of Hooghly district was 4557081 (Sensus 2011).As per the outcome of the confidence interval approach method with (a 95% confidence level) the determined sample size is 376. As consumption of OTC medicine is considered sensitive information for which sample size has been considered as 500 that even if there were response error also it will not go less than 376 Bhowmick (2020).

A structured questionnaire was developed by the researcher and was used as a sole instrument to collect primary data from the respondents. The questionnaire was developed both in English and Bengali for a better understanding of the respondents. The survey questionnaires comprised of a seven-point Likert type answer scale going from 1 (strongly disagree) to 7 (strongly agree) in printed copies. The questionnaire was personally administered to the respondents to collect the data. Before handover the questionnaire, researchers have explained to the respondent about OTC allopathic medicine to clear any ambiguity in the mind of the respondent regarding the difference between general prescription medicine and OTC allopathic medicine.

The data collection process was undertaken over three months from November to January 2021. Primary data were collected from urban and rural areas of the Hooghly district. Researchers have to use a convenience sampling method. As Hooghly district is comprised of the rural and urban population, 176 respondents were finally considered from rural areas and 265 respondents were considered from urban areas.

Results

Among the 500 samples collected, 448 were found to be the valid responses of which 78.1% of the respondents were male and 21.9% female. 76.3% were in the age group between 18-25 years, 15% between 26-35 years and 8.7% were more than 36 years of age. 48.4 % and 15 % of the respondents were graduates and at the post-graduation level. 68.8% were students with 2 to 4 members in their family (65%). Concerning the frequency of purchase of OTC medicines, 60.4% purchase OTC medicines monthly, 14.1% bi-monthly, 10.9% quarterly, 14.3% yearly and 0.2% never purchased OTC medicines. This signifies almost all the respondents have used OTC allopathic medicines in the last year and they have a clear idea about OTC allopathic medicine Li et al. (2009) Table 1 and Table 2.

Table 1  Demographic Profile Of Respondents
		Count	Column N %
Age	18-25	342	76.3%
	26- 35	67	15.0%
	36-50	21	4.7%
	More than 50 Years	18	4.0%
Gender	Male	98	21.9%
	Female	350	78.1%
Qualification	High School	119	26.6%
	Graduate	217	48.4%
	Post Graduate	67	15.0%
	Others	36	8.0%
	High School	9	2.0%
Occupation	Student	308	68.8%
	Business	15	3.3%
	Service	110	24.6%
	House Wife	5	1.1%
	Retired Employee	10	2.2%
Members	<2	32	7.1%
	2 to 4	291	65.0%
	> 5	125	27.9%
Frequency of purchase	≤ Monthly	144	60.4%
	Bi Monthly	63	14.1%
	Quarterly	49	10.9%
	Yearly	64	14.3%
	Never	1	0.2%

Table 2 Descriptive Statistics And Correlation (N=448)
	M	S.D.	1	2	3	4	5	6	7
1.Behavioural Intention	2.64	0.945	(0.79)
2.Outcome Belief	4.46	1.313	0.156**	(0.72)
3.Outcome Evaluation	3.79	0.789	0.224**	0.420**	(0.74)
4.Normative Belief	4.23	1.341	0.080*	0.681*	0.462**	(0.80)
5.Motivation to Comply	2.55	0.671	0.462**	* -0.106*	-	-	(0.85)
6.       Perceived           Behavioural	3.86	0.725	-	0.165**	0.177** 0.366**	0.252** 0.218*	-	(0.78)
Control			0.254**			*	0.359**

In order to evaluate the statistical evidence for a linear relationship between pairs of continuous variable, Bivariate Pearson Correlation was conducted among the factors namely Outcome belief (M= 4.46; S.D =1.313), Outcome Evaluation (M= 3.79; S.D =0.789), Normative Belief Holmström et al. (2014) (M= 4.23; S.D =1.341), Motivation to Comply (M= 2.55; S.D =0.671), Perceived Behavioral Sniehotta et al. (2014) Control (M= 3.86; S.D =0.725), with Behavioral Intention (M= 2.64; S.D =0.945) towards purchase of OTC medicines. The Cronbach alpha reliability for each of the construct is mentioned across the diagonal in parentheses. The reliability values were ranging between 0.72 and 0.85 which is well above the threshold values of 0.7 as suggested by Nunnally (1975) . Outcome Belief r (448) = .156; p < .05, Outcome Evaluation r (448) = .224; p < .05, Normative Belief r (448) = .080; p < .05, Motivation to Comply r (448) = .462; p < .05 had significant positive relationship with Behavioral Intention at 5% level of significance.

Perceived Behavioral Control r (448) = -.254; p < .05, and Motivational factor r (448) = -.360; p < .05 had negative significant relationship with Behavioral Intention at 5 % level. It shows that the said predictor variable has the level of impact on the criterion variable but in a negative direction. This means higher the perceived behavioural control lower will be the intention to purchase OTC allopathic medicines.

Regression analysis was made further to test the influence of the factors on the Behavioral Intention Zoellner et al. (2017) Table 3.

Table 3 Regression Analysis
Coefficientsa
	Unstandardized		Standardized	t	Sig.	Collinearity Statistics
	B	S.E	Beta			Tolerance	VIF
(Constant)	1.610	0.411		3.920	0.000
Outcome Belief	0.085	0.040	0.118	2.143	0.033	0.517	1.936
Outcome Evaluation	0.123	0.057	0.103	2.140	0.033	0.683	1.464
Normative Belief	0.088	0.041	0.125	2.166	0.031	0.473	2.113
Motivation to Comply	0.535	0.068	0.379	7.889	0.000	0.679	1.474
Perceived Behavioural Control	-0.162	0.060	-0.124	-2.684	0.008	0.738	1.356
R2 = .308 Adj R2 = .298 F-Value = 32.648*** a. Dependent Variable: Behavioural Intention

Multiple Linear Regression analysis was conducted to predict the influence of the independent variables such as Outcome Belief, Outcome Evaluation, Normative Belief, Motivation to Comply, Perceived Behavioral Control, and Motivational factor on Behavioral Intention. A significant regression equation was found with an R2 of 0.308 and an adjusted R2 of .298. All the independent variables had a significant influence on the Behavioral Intention of which Perceived Behavioral Control had a significant negative influence at a 5 % level of significance. A Unit increase in Outcome belief, Outcome Evaluation, Normative Belief, and Motivation to Comply leads to 0.85, .123, .088 and .535 increase in behavioural intention. This signifies that consumer expectation of favourable outcome belief, outcome evaluation, normative belief, motivation to comply, and perceived behavioural control for OTC allopathic medicine has a positive relationship with behavioural intention. Similarly, a unit increase in Perceived Behavioral Control leads to -.162 and a decrease in the behavioural intention of customers in buying OTC medicines which means that there is a significant positive relationship between PBC and behavioural intention but in a negative way. This means higher will be PBC lower will be the intention to purchase OTC allopathic medicine. Based on the above statistical results all hypotheses are accepted.

Findings from this research are also been supported by the study conducted by Shohel, et al. (2013) and Haramiova et al. (2017) which concluded that It was important for pharmaceutical companies that their product is the first product choice that the consumer makes in that specific product category which is explained by; Shohel, et al. (2013), Yousif (2016), Boström (2011), (Cîrstea, et al., 2017), and Talab? and Andreia (2010) as nearly all consumers say that they usually buy the same OTC medicine again and again. The most common reason for this purchasing pattern is that they know the product does work and through the previous experience they have learnt about the product and that it is a solution to their problem or need. Some customers do not have the time or energy to explore other options and buy the same product again. Unlike this literature, previous experience has a positive but insignificant effect on consumers’ purchase decisions of OTC medicines.

Many teenagers described how they felt they had inherited their basic view of drug use from their parents. Other teenagers, however, argued that they took a contradictory stance to that of their parents. Some teenagers thought it would be a good idea to educate and inform parents about OTC drugs since the parents’ behaviour could also have been inherited Talaba & Andrei (2010).

Some researchers indicate that the subjective norm construct is usually shown to be a weak predictor of behaviour because it seems impossible that most people's behaviours are influenced by social pressures and interpersonal factors (Armitage & Conner 2001).

This is supported by the finding of Kevrekidis et al. (2018), which was conducted in Greece and has a mean value 4.31. In addition, the finding is supported by Haramiova et al. (2017), Talab? and Andreia (2010), Cîrstea, et al. (2017), and Boström (2011). The finding shows that consumers have a deep trust in the knowledge and competency of the pharmaceutical staff and that they are easily influenced by them. For this consumer segment, the pharmaceutical staffs are influencers who shape the consumers’ views on different products and affect their final purchase decision. The pharmaceutical staff can influence the range of products that the consumer evaluates as an alternative. If we now consider that many consumers take into consideration and also place their product choice based on the opinion or recommendation from the pharmaceutical staff, the pharmaceutical staff is likely to have a great influence on consumers’ purchase decision of products.

Sub Norms: Several studies; Shohel, et al. (2013), Haramiova et al. (2017), Yousif (2016), Boström (2011), (Cîrstea, et al., 2017), and Talab? and Andreia (2010) explain that recommendation of family and friends is considered as one of the more important factors that help the consumer choose an OTC medicine. However, this study shows there is a positive relationship between families’ and friends’ recommendations and purchase decisions of OTC medicines even if the relationship is statistically insignificant. This is in contrary to the previously studied related literature. Social factors. These reflect the direct or indirect effect of society and reference groups on one’s behaviour (Kotler and Keller, 2016, p. 181). The effect of family, friends and reference groups on someone’s behaviour has been discussed thoroughly and can be understood through the theory of reasoned action (Ha, 1998). The term, “subjective norms” is proposed to measure the perceived social influences on an individual’s behaviour and the resulting beliefs that develop. Social factors include professional advice and the recommendations of family and friends Lodorfos et al. (2006). Professional advice is described by Schaafsma et al. (2005) as, “advice from a person who was considered to be an expert on the subject and who would also be consulted in the normal course of daily routine.” Physicians and pharmacists are the healthcare professionals who are the most knowledgeable about medicines and their uses, contraindications, precautions and side effects (Villako et al., 2012; Lodorfos et al. (2006). Family and friends are considered the primary reference group with whom the person deals and interacts in a continuous and informal pattern (Kotler and Keller, 2016, p. 181; Lodorfos et al. (2006).

Teenagers described how they could be influenced by the drug use of their friends. Sometimes, if a friend took an OTC drug they would also take one, without actually needing it. . Sources of knowledge and information The greatest source of information and knowledge about OTC drugs and which could affect possible use came from the parents. According to the teenagers, parents should provide information about drugs and how to use them. They described how they gained general knowledge about OTC drugs from turning to their parents or other family members with questions about drug use, or from overhearing conversations about drug use, either at home or at pharmacies. If I’m in pain and don’t know what to take I can always go to my grandmother with my questions. (male FG 10) It did happen that girls asked each other for advice about effective relief of menstrual pain (Holmstro¨m et al, 2014).

Views on OTC drug accessibility

Getting access to OTC drugs was experienced as easy. OTC drugs were always available at home. Teenagers could also ask a friend or ask the school nurse. They reflected that the increased accessibility was both good and bad. Buying OTC drugs was nowadays almost the same as shopping for food. Yet only a few teenagers said they bought OTC drugs themselves, and if they did, pharmacies were the first choice (Holmstro¨m et al, 2014).

An interesting finding in this study was that OTC drugs and their use were nothing to reflect upon, and accordingly not regular topics of discussion among teenagers. OTC drugs were, in fact, a ‘non-issue’. Even though the teenagers in this study did not often purchase OTC drugs themselves, these drugs were a part of their daily life, always available at home, always accessible for example in a local gas station, and often advertised on TV. This raised the possibility of ‘hidden’ or ‘unnoticed’ misuse of OTC drugs, intentional or non-intentional, among teenagers (Holmstro¨m et al, 2014)

Implications

Though the health care facilities in India have evolved in the last few decades still the awareness among the general population regarding disease and its’ medication is not satisfactory (United Nations Office on Drug and Crime Report, 2011). Under this scenario marketers engaged in OTC allopathic medicine business should encourage consumer awareness programmes about the usage of the drugs and indication of the therapeutic areas along with their adverse effects (if exist). This will enhance the informational belief as well as descriptive belief to develop a positive attitude of the consumer towards OTC allopathic medicine. With this, the health care organizations can be benefited by developing programs to promote greater consumer involvement in OTC allopathic medicine purchase decisions.

Limitations and Scope for Future Research

The present research is not without its limitations. In the review of previous studies, it has been observed that the intentions to buy OTC medicine are still under-researched. Several studies have focused on the importance of each factor affecting consumer behaviour individually, rather than collectively. Furthermore, this study produced mixed findings regarding the importance of the factors under attitude, subjective and perceived behavioural control influencing the intention to buy OTC medicines, which is contradicted with few research findings in other segments who have tried to use the TPB model to understand consumer behaviour. While some other studies show that experience with the product has a superior effect over other factors (Abraham et al., 2015; Al-Motassem et al., 2008; Kevrekidis et al. (2018), other studies indicate it is secondary to other factors Lodorfos et al. (2006).

Our study opens other avenues for future inquiry. Both qualitative and quantitative studies can be used to explore areas which were just touched upon during the research. The agenda like how consumers perceived and understand OTC drug use? Are subjective norms like parents/ guardians are aware that they are role models for their children’s use of OTC drugs? Similarly, socioeconomics factors might disclose more knowledge of consumer behaviour inside the population which is required to be studied. These are important areas for future research.

Conclusion

Our study identified the significance of consumers' attitudes, subjective norms, and perceived behavioural control on purchasing OTC allopathic medicines based on the model of TPB. As healthcare is an integrative piece of national instructive frameworks and priorities, the outcome from the study helps the government and health care providers to think and prioritise their policies to provide maximum health care through the usage of OTC allopathic medicine. Healthcare literacy additionally reflects self-assurance Jinnah et al. (2020) which will create a positive attitude of the consumer to purchase OTC allopathic medicine under several socio- economic situations, emergencies and behavioural factors. Similarly, the subjective knowledge that consumers gain from parents, family, friends, chemists etc. can reproduce persuasive and fearless behavioural intention to purchase OTC allopathic medicines. The outcome that is identified in this research gave a foundation to understand consumers' imprint of using OTC medications and their overall wellbeing.

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Received: 26-Aug-2022, Manuscript No. AMSJ-22-12492; Editor assigned: 29-Aug-2022, PreQC No. AMSJ-22-12492(PQ); Reviewed: 12-Sep-2022, QC No. AMSJ-22-12492; Revised: 20-Sep-2022, Manuscript No. AMSJ-22-12492(R); Published: 12-Oct-2022