Misunderstanding and Potential Unintended Misuse of Acetaminophen Among Adolescents and Young Adults

Abstract

Purpose Acetaminophen is highly accessible yet potentially dangerous when used incorrectly. In attempts to address concerns about acetaminophen, The U.S. Food and Drug Administration (FDA) has identified gaps in evidence about unintentional misuse among adolescents. Therefore, our objectives were to assess: adolescents’: 1) health literacy; 2) knowledge about acetaminophen; 3) recent use of over-the-counter (OTC) medicines; 4) and use of medication dosing instructions to understand the medicine and how to use it (‘acetaminophen skills’). Methods Subjects and Setting: We conducted a cross-sectional survey of adolescents and young adults (ages 16–23 years) recruited from education settings and health care sites in Monroe County, New York, from 11/08–9/09. Measures: Using structured in-person interviews, we assessed acetaminophen knowledge and recent use of over-the-counter (OTC) medicines. We assessed participants’ ability to identify acetaminophen in OTC products and answer questions about instructions for acetaminophen use through role-plays of everyday health scenarios. We measured health literacy with the Rapid Estimate of Adult Literacy in Medicine (REALM) for participants >18, and the REALM-Teen for those <18. Results Confusion about acetaminophen and its use was common. Limited health literacy was an independent risk factor for poor knowledge, misunderstanding, and potential unsafe use of acetaminophen-containing medicines, however, most participants at all health literacy levels erred dangerously in ‘unsafe’ understanding of acetaminophen use from label instructions. Conclusions Individuals with limited health literacy may face disproportionate risk of unsafe use of acetaminophen due to confusion and misunderstanding of label information. Better labeling, public health programs, and educational efforts could facilitate safer use of acetaminophen.

Development of the Health Literacy Assessment Scale for Adolescents (HAS-A)

“…Given that our multiple measurements imply that health literacy skills are low for many adolescents, it is important to advance the field. There have been a few adolescent health literacy studies to date exploring the relationship between health literacy and health behaviors or outcomes, 10,13,15,20,21,23 and further research is needed to evaluate how health literacy impacts youth. Inclusion of the HAS-A on youth surveys will allow for more comprehensive data to be collected, and can also be used for the evaluation of interventions to enhance health literacy skills for adolescents.…”

“…10 Health literacy tools used with adolescents include the Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen), 11–13 the Test of Functional Health Literacy in Adults (TOFHLA), 14–21 and the Newest Vital Sign (NVS). 22–26 However, these instruments assess very specific skills that are one part of health literacy, such as reading ability, reading comprehension, and numeracy.…”

Analgesic prescription pattern in the management of dental pain among dentists in Istanbul

“…Inappropriate information given to patients about use of these drugs may cause serious results (i.e. increase in adverse reaction risk and drug interactions) (22)(23)(24).…”

A rule-engine-based approach to a personalized OTC drug safety framework

“…It has been shown that patients, especially those with low health literacy or low socio-economic status, may have difficulty understanding drug warning information [4], [5]. It has been argued that the language used in drug warning labels is at a reading level beyond that of the general public [6].…”