title: [Good use and knowledge of paracetamol (acetaminophen) among self-medicated patients: Prospective study in community pharmacies].
abstract: Acetaminophen (paracetamol), the highest over-the-counter (OTC) selling drug in France, is also the first cause of acute hepatic failure. We aimed to assess the good use and the knowledge of acetaminophen in a setting of urban self-medicated patients. We conducted a prospective observational study in randomly selected community pharmacies of Metz (France) agglomeration. Patients coming to buy OTC acetaminophen for themselves or their family had to answer to an anonymous autoquestionnaire. Responses were individually and concomitantly analyzed through 3 scores: good use, knowledge and overdosage. Twenty-four community pharmacies participated and 302 patients were interviewed by mean of a dedicated questionnaire. Most of patients (84.4%) could be considered as "good users" and independent factors of good use were (i) a good knowledge of acetaminophen (OR=5.3; P<0.0001) and more surprisingly; (ii) the fact of having no children (parentality: OR=0.1; P=0.006). Responses corresponding to involuntary overdosage were mostly due to a too short interval between drug intakes (3hours). Only 30.8% of patients were aware of liver toxicity of acetaminophen and only 40.7% knew the risk of the association with alcohol. Both good use and knowledge were significantly higher in patients looking for information from their pharmacist, physician and package leaflet. Patients should definitely be better informed about acetaminophen to warrant a better safety of its consumption. Pharmacists and physicians have to remind patients the risk factors of unintentional overdose and liver toxicity. Package leaflets have also to be more informative.
authors.affiliation: Département de médecine générale, faculté de médecine de Nancy, 54505 Vandœuvre-lès-Nancy, France.
authors.forename: Anne-Elise
authors.initials: AE
authors.lastname: Severin
authors.affiliation: Laboratoire de pharmacologie clinique et toxicologie, centre régional de pharmacovigilance, CHRU de Nancy, 54000 Nancy, France.
authors.forename: Nadine
authors.initials: N
authors.lastname: Petitpain
authors.affiliation: Laboratoire de pharmacologie clinique et toxicologie, centre régional de pharmacovigilance, CHRU de Nancy, 54000 Nancy, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Scala-Bertola
authors.affiliation: Qualité et gestion des risques, CHRU de Nancy, 54000 Nancy, France.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Latarche
authors.affiliation: Laboratoire de pharmacologie clinique et toxicologie, centre régional de pharmacovigilance, CHRU de Nancy, 54000 Nancy, France.
authors.forename: Melissa
authors.initials: M
authors.lastname: Yelehe-Okouma
authors.affiliation: Département de médecine générale, faculté de médecine de Nancy, 54505 Vandœuvre-lès-Nancy, France.
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Patrizio
authors.affiliation: Laboratoire de pharmacologie clinique et toxicologie, centre régional de pharmacovigilance, CHRU de Nancy, 54000 Nancy, France. Electronic address: Pierre.Gillet@univ-lorraine.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Gillet
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001835:Body Weight; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D062787:Drug Overdose / Q000209:etiology; D005191:Family Characteristics; D005260:Female; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010594:Pharmacies / Q000706:statistics & numerical data; D011446:Prospective Studies; D012651:Self Medication / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D018712:Analgesics, Non-Narcotic; D004366:Nonprescription Drugs; D000082:Acetaminophen
keywords: Acetaminophen; Automédication; Bon usage; Good practice; Liver toxicity; OTC; Paracétamol; Surdosage; Toxicité hépatique