Using suitability profiles to better inform consumers' choice of commonly used over-the-counter analgesics

Abstract

Objective To quantify the impact of labelled contraindications, precautions and warnings for use on the population that may take commonly used over‐the‐counter (OTC) analgesics. Setting Primary care: data were collected from a general practitioner database in Australia. Methods Patient data were audited retrospectively (n = 107553) to determine the number of patients with contraindications, warnings or precautions to the use of OTC paracetamol and the non‐steroidal anti‐inflammatory drugs aspirin and ibuprofen. The primary outcome measure was the suitability rate (i.e. the proportion of patients with no contraindications, warnings or precautions) of these commonly used analgesics. Key findings In this Australian dataset, the proportions of patients who had no contraindications, warnings or precautions to the use of paracetamol or ibuprofen were 98.1 and 76.9%, respectively (P = 0.0001); 83.4% of patients had no contraindications, warnings or precautions to the use of aspirin (P = 0.005 compared with paracetamol). Conclusion Of the three OTC analgesics examined, paracetamol is suitable for use by a larger proportion of the general population without the need to seek medical advice.

Responsible self-medication: perceived risks and benefits of over-the-counter analgesic use

“…The quality use of medicines, in particular OTC NSAIDs, is becoming increasingly reliant on product labelling and the ability of consumers to understand and self‐assess risk. Our suitability‐rate data are consistent with previous patient data research conducted among Australian general practitioners [7] …”

“…The age‐interactions‐medications (AIM) protocol is a simple screening tool designed to ensure appropriate use of OTC analgesics [7] . Applying the first of the principles set out in this tool (age) to our consumer data it is noteworthy that, despite the rise in OTC NSAID use, the proportion of elderly patients (aged 65 years or more) currently using these compounds is minimal (2.0%) and that paracetamol use has increased among the elderly.…”

“…These outcome measures provided an indirect means of assessing patterns of analgesic usage and potential for misuse of analgesics. Prior research has shown that paracetamol is more suitable for use in a larger proportion of the general population than is ibuprofen [7] . Using a similar methodology, a suitability rate was calculated for regular OTC analgesic users (the proportion of regular OTC analgesic users with no current contraindications, warnings or precautions or potential drug–drug interactions to the analgesic that they had used).…”

Analgesic Use in Older Adults with Back Pain: The BACE Study

“…This is remarkable, because older patients are more prone to adverse drug reactions, especially in the case of comedication or of comorbidities such as liver or kidney failure. An Australian study found that for over-the-counter medication, 1.9% of paracetamol users and 23.1% of ibuprofen users had contraindications for these analgesics [36]. In another open population, it was shown that 10% of older patients with low back pain used NSAIDs while they were also using a diuretic and an angiotensin-converting enzyme inhibitor or angiotensin II receptor antagonist [35]; such patients are at increased risk of acute renal failure [37].…”