Annual global spending on medicines was estimated to reach nearly 1.2 trillion United States Dollars by 2016, with the top 20 therapy areas accounting for 42% of the total, where cancer, diabetes and asthma/chronic obstructive pulmonary disease (COPD) take the lead [1]. Despite this, globally, one-third of the population lacks regular access to essential medicines. This reaches up to 50% in the poorest nations of Africa and Asia. About 50% of the medicines available are prescribed, dispensed and sold inappropriately, while half of patients do not take their medicines appropriately [2].

Different factors can be said to determine the use of medicines in the community. These include knowledge about use, the cost of medicines, regulatory systems, cultural factors, community beliefs and communication with prescribers among others [3]. These factors play out at different levels including household and community. The way medicines are used is also influenced by individual beliefs about them, which may have been shaped by members of the immediate family and those in extended family networks at household level. The community is the immediate context in which individuals and families deal with their health problems. People talk to each other about therapies, creating and reinforcing existing medicine use cultures, and they rely on local sources of medicines. In order to address the problem of irrational use of medicines, health planners and administrators require specific information on the types, extent and the reasons of irrational use of medicines [4].

Several studies on medicine utilization have been conducted globally as well as in Ethiopia, focusing mainly on health institutions [5–9]. A number of studies regarding utilization of medicines in the community have also been conducted in different countries [10–16].

In Ethiopia, medicine utilization studies among households are very scarce, restricted to self-medication and currently available medicines at home [17–20]. To the best of literature search done, no study documenting overall medicine use among households in Gondar town, was found. The aim of this study was to generate information on the pattern medicine use and related factors among households; and identify areas of improvement for enhanced rational use of medicines in Gondar town, northwestern Ethiopia.

This study assessed the extent and predictors of medicine use among households in Gondar town. It showed that nearly half of the households reported medicine use in the past one month. Leaving medicines unfinished was reported as a very common practice by the households. In addition, a considerable level of sharing medicines was found with more than one in six households reportedly engaged in it. As to predictors of medicine use, secondary school education, presence of a person with chronic illness and a health professional were all found to increase likelihood of reporting medicine use in the households.

Looking at the details of the findings, more than a fifth were found to have at least one member with chronic illness. This was consistent with past studies in Ethiopia which reported considerably high prevalence of non-communicable and chronic illnesses [24, 25]. However, the finding in the current study was lower than that of another from Oman; where nearly half of the surveyed households had members with chronic illnesses. Despite this, the specific chronic illnesses reported in the two studies, were comparable. This was evident in that hypertension and diabetes mellitus were reported in high proportions in both studies [13].

The study found that medicine use was high in the area, with nearly half of the households reporting taking medicine during the one month prior to the study. This could be associated with the considerable proportion of households with individuals having chronic illnesses. Another explanation could be the access to various sources of medicines in the town. There are many medicine retail outlets, in addition to the dispensaries in the public and private health institutions. A study done in Porto Alegre (Brazil), with a recall period of 15 days, reported a level of medicine use (54.5%) comparable to the present study [26].

Sharing of medicines was another notable problem identified in the study; it was reportedly practiced in more than one-sixth of the households. This was consistent with a finding in Greece in relation to sharing medicines with relatives, friends and neighbors. However, the Greece study reported a much higher level of sharing within family. The large difference could partly be attributed to the small sample size in the Greece study [27]. The finding on sharing medicines was also lower compared to a finding in Malaysia among female students in a university where more than half reported sharing medicines with friends and families. This could be associated with the difference in the living arrangement where the students lived in a university campus unlike the subjects of the present study [28].

Another study in Ethiopia reported a higher proportion of households engaged in medicine sharing than in this study. The cited study also showed urban areas were less likely to engage in sharing compared to rural areas. The higher figure in the compared study could be attributed partly to the inclusion of rural areas; this might have increased sharing due to lower access to medicine and health services [18]. The habit of leaving medicines unfinished, which was reported by almost all of the households, could indicate an important problem associated with adherence. This could lead to suboptimal therapy and resistance in the case of antibiotics.

The study also found that nearly half of the households had at least one medicine at the time of data collection. This was higher compared to a study done in Tigray region of Ethiopia, and another one from Uganda [29, 30]. However, the finding in this study was fairly comparable to a study done in Nekemte, in the south west of Ethiopia [18]. In contrast, the finding was much lower than results of studies in a number of countries in the Middle East; including United Arab Emirates, Iraq, Iran as well as Oman. According to these findings, medicines were stored in almost all the households studied [11, 13, 31, 32].

In more than half of the households, which reported discarding unused medicines, putting in garbage was the major means of disposal. Discarding in toilets and burning were also reported by a considerable proportion of the households. Similar methods were reported by other studies including in the United Kingdom, Qatar and United Arab Emirates. They reported dumping in garbage of unused medicines as the principal means of disposing, accounting for how two-thirds or more of medicines were disposed [30, 33, 34].

Secondary education, presence of a family member with chronic illness and a health professional in a household were found to predict medicine use during the previous 1 month. In this respect studies which are comparable to the present study were not found. Higher educational level as well as a health professional in a household may have had increased medicine use due to their higher chance of knowing more about medicines and recommending them for various conditions. Chronic illnesses oftentimes require patients to take medicines for a long time. Hence, this could increase the likelihood of medicines use in the households where people with such illnesses reside.

A high level of medicine use among households in the town was found in this study. Medicine use problems such as sharing and a very common habit of leaving medicines unfinished were identified. Secondary education, presence of health professionals as well as members with chronic illness were found to predict medicine use among the households in the study. On the basis of these findings, it is recommended that interventions involving medicine use counseling and education at various levels of the health system are needed. This can be done at hospitals, health centers, clinics and medicine retail outlets; as these are common sources of medicines for households.