Self-medication is a prevalent practice among university students globally and is a significant public health concern. However, previous research has been limited in scope, focusing primarily on adolescents or the general public, leaving a gap in understanding the causal relationships associated with self-medication; thus, this study aimed to investigate the factors influencing self-medication practices among university students in Bangladesh by developing a comprehensive causal model. Data from 417 students across five public universities were collected using the simple random walk technique by a team of 10 members. The study utilized constructs of knowledge, attitude, and convenience related to self-medication as independent variables, while self-medication practice as the dependent variable. One-way ANOVA and structural equation modeling (SEM) were employed to develop a causal model of self-medication practice among university students in Bangladesh. The findings revealed that students with better medication knowledge and adverse drug reactions (ADRs) were more likely to practice self-medication. A positive attitude towards self-medication and ADRs was also significantly associated with higher self-medication practice scores. Additionally, those who perceived self-medication as convenient and prescribed medication as inconvenient had higher self-medication practice scores. The attitude towards self-medication had the most substantial negative effect on self-medication practice, followed by the inconvenience of prescribed medication and the convenience of self-medication. The model explained 87% of the variance in self-medication practice, indicating a good fit for the data. University students in Bangladesh possess intermediate knowledge of medication and primary knowledge of ADRs. They exhibit a positive attitude towards self-medication and ADRs. Physical convenience favors self-medication, while the inconvenience of prescribed medication contributes to its lower preference. Policymakers should focus on evidence-based guidelines to reduce the extent of unnecessary self-medication practice and to enhance the quantity and accessibility of prescribed medications to address the issue effectively.

自我药疗是全球大学生中的一种普遍做法，也是一个重大的公共卫生问题。然而，之前的研究范围有限，主要关注青少年或普通公众，在理解与自我药疗相关的因果关系方面存在差距；因此，本研究旨在通过开发综合因果模型来调查影响孟加拉国大学生自我药疗实践的因素。由 10 名成员组成的团队使用简单的随机游走技术收集了五所公立大学 417 名学生的数据。该研究利用与自我药疗相关的知识、态度和便利性作为自变量，而自我药疗实践作为因变量。采用单向方差分析和结构方程模型 (SEM) 开发了孟加拉国大学生自我药疗实践的因果模型。研究结果显示，具有更好的药物知识和药物不良反应（ADR）的学生更有可能进行自我药疗。对自我药疗和不良反应的积极态度也与较高的自我药疗实践得分显着相关。此外，那些认为自我药疗方便而处方药不方便的人的自我药疗实践得分较高。对自我药疗的态度对自我药疗实践的负面影响最大，其次是处方药的不便性和自我药疗的便利性。该模型解释了自我药疗实践中 87% 的差异，表明与数据拟合良好。孟加拉国的大学生拥有中级药物知识和初级 ADR 知识。他们对自我药疗和 ADR 表现出积极的态度。身体的便利性有利于自我用药，而处方药的不便则导致其较低的偏好。政策制定者应重点关注循证指南，以减少不必要的自我药疗实践，并提高处方药物的数量和可及性，以有效解决这一问题。