Arthritis patients could be mismanaging paracetamol intake

Many Australians with arthritis may be putting their health ‘at risk’ by inadvertently mismanaging the amount of paracetamol medications they consume.

This is a finding of a UOW School of Medicine study of 254 adult patients with arthritis published in The Journal of Pharmacy Practice and Research.

If taken appropriately, prescription and over-the-counter pain medications, containing paracetamol, are relatively safe. However, if mismanaged through over consumption, such medications can cause health problems including liver disease.

Those most at risk, according to the study, included patients with low functional health literacy who were not always able to recognise paracetamol to be an active ingredient in several prescription or over-the-counter pharmaceutical products. Study participants who were at even greater risk, included those who had shared or borrowed their prescription and over-the-counter pain medications.

Research team leader Dr Judy Mullan (Senior Lecturer in Population Health for UOW’s School of Medicine) said that the data collection was conducted as part of Dr Janette Ellis’s PhD study.

Eligible study participants, diagnosed with arthritis, were invited to complete an anonymous survey which included questions about their prescription and over-the-counter pain medications; their medication borrowing and sharing behaviours; their functional health literacy; and their knowledge about preparations containing paracetamol as an active ingredient.

Most of the 254 participants used analgesic agents containing paracetamol, as combination tablets (paracetamol 500 mg and codeine 30 mg) or paracetamol-only tablets (paracetamol 665 mg) to self-manage their pain.

Dr Mullan said respondents with low functional health literacy scores were significantly less likely to identify paracetamol as an active ingredient in both combination and paracetamol-only pharmaceutical products.

“And they were more likely to guess or did not know how to identify that paracetamol was an active ingredient in these products,” she said.

Almost 30 per cent of the respondents indicated that they had, and/or intended to borrow/share, their over-the-counter pain medications whereas fewer than 10 per cent suggested that they had, and/or intended, to borrow/share their prescription pain medication.

Dr Mullan said that the study findings highlight the need for health professionals, especially pharmacists and pharmacy staff, to help educate consumers about how to identify the active ingredients, the maximum dosage and the potential for side effects associated with taking pharmaceutical products containing paracetamol.

The research team consisted of the late Dr Janette Ellis (Dr Ellis died in 2013), Dr Judy Mullan, Professor Anthony Worsley, Professor Nagesh Pai, Dr Kathryn Weston, Dr Warren Rich and Dr Alistair Lethbridge. All the researchers are from UOW’s School of Medicine and the Illawarra Health and Medical Research Institute, except for Professor Worsley who was formerly from the University of Wollongong but is currently at Melbourne’s Deakin University.

(Source: University of Wollongong, The Journal of Pharmacy Practice and Research)