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Keywords:

  • acetaminophen;
  • opioid;
  • medication use;
  • drug safety;
  • survey;
  • claims data;
  • pharmacoepidemiology

ABSTRACT

Purpose

To compare awareness, use of acetaminophen, and preferences for receiving information aimed at reducing acetaminophen overdose.

Methods

A survey of health plan enrollees identified from automated pharmacy data who were long-term and acute users of opioids with acetaminophen (n = 720 each cohort), and a general population cohort (n = 360) during the 2010–2011 cold/flu season. A 74% response rate was achieved. Differences were tested across the three cohorts, and by level of education, using age-adjusted regression models.

Results

Use of over-the-counter or prescription medicine containing acetaminophen in the prior 2 weeks was reported by 84% in the long-term opioid cohort, 76% in the acute opioid cohort, and 36% in the general population, but use of over-the-counter medicine with acetaminophen did not differ across the cohorts (30–34%). All three cohorts were unlikely to correctly identify drugs containing acetaminophen, but the opioid cohorts performed slightly better than the general population. Those with higher education performed slightly better when asked to identify acetaminophen products than those with no college education. The average usual daily acetaminophen dose (mg/day) reported was highest in the long-term opioid cohort (1185), followed by the acute opioid cohort (1010), and the general population (891)—p < 0.001. Estimated supratherapeutic exposure (>4000 mg/day) was rare but three to five times more common in the opioid cohorts than in the general population.

Conclusions

Acetaminophen use is common, and supratherapeutic exposure may be of concern in users of opioids. Knowledge of which drugs contain acetaminophen appears inadequate; better labeling and proactive education from professionals may be impactful. Copyright © 2012 John Wiley & Sons, Ltd.