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The use of paracetamol (acetaminophen) among a community sample of people with chronic non‐cancer pain prescribed opioids

Journal Article


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Abstract


  • Background

    The regular use of simple analgesics in addition to opioids such as paracetamol (or acetaminophen) is recommended for persistent pain to enhance analgesia. Few studies have examined the frequency and doses of paracetamol among people with chronic non‐cancer pain including use above the recommended maximum daily dose.

    Aims

    To assess (i) the prevalence of paracetamol use among people with chronic non‐cancer pain prescribed opioids, (ii) assess the prevalence of paracetamol use above the recommended maximum daily dose and (iii) assess correlates of people who used paracetamol above the recommended maximum daily dose including: age, gender, income, education, pain severity and interference, use of paracetamol/opioid combination analgesics, total opioid dose, depression, anxiety, pain self‐efficacy or comorbid substance use, among people prescribed opioids for chronic non‐cancer pain.

    Methods

    This study draws on baseline data collected for the Pain and Opioids IN Treatment (POINT) study and utilises data from 962 interviews and medication diaries. The POINT study is national prospective cohort of people with chronic non‐cancer pain prescribed opioids. Participants were recruited from randomly selected pharmacies across Australia.

    Results

    Sixty‐three per cent of the participants had used paracetamol in the past week (95% CI = 59.7–65.8). Among the paracetamol users 22% (95% CI = 19.3–24.6) had used paracetamol/opioid combination analgesics and 4.8% (95% CI = 3.6–6.3) had used paracetamol above the recommended maximum daily dose (i.e. > 4000 mg/day). Following binomial logistic regression (χ2 = 25.98, df = 10, p = 0.004), people who had taken above the recommended maximum daily dose were less likely to have low income (AOR = 0.52, 95% CI = 0.27–0.99), more likely to use paracetamol/opioid combination analgesics (AOR = 2.01, 95% CI = 1.02–3.98) and more likely to take a higher opioid dose (AOR = 1.00, 95% CI = 1.00–1.01).

    Conclusion

    The majority of people with chronic non‐cancer pain prescribed opioids report using paracetamol appropriately. High income, use of paracetamol/opioid combination analgesics and higher opioid dose were independently associated with paracetamol use above the recommended maximum daily dose.

Authors


  •   Hoban, Bianca (external author)
  •   Larance, Briony
  •   Gisev, Natasa (external author)
  •   Nielsen, Suzanne (external author)
  •   Cohen, Milton (external author)
  •   Bruno, Raimondo (external author)
  •   Shand, Fiona (external author)
  •   Lintzeris, Nicholas (external author)
  •   Hall, Wayne (external author)
  •   Farrell, Michael P. (external author)
  •   Degenhardt, Louisa (external author)

Publication Date


  • 2015

Citation


  • Hoban, B., Larance, B., Gisev, N., Nielsen, S., Cohen, M., Bruno, R., Shand, F., Lintzeris, N., Hall, W., Farrell, M. & Degenhardt, L. (2015). The use of paracetamol (acetaminophen) among a community sample of people with chronic non‐cancer pain prescribed opioids. International Journal of Clinical Practice, 69 (11), 1366-1376.

Ro Full-text Url


  • https://ro.uow.edu.au/cgi/viewcontent.cgi?article=5205&context=sspapers

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/4180

Number Of Pages


  • 10

Start Page


  • 1366

End Page


  • 1376

Volume


  • 69

Issue


  • 11

Place Of Publication


  • United Kingdom

Abstract


  • Background

    The regular use of simple analgesics in addition to opioids such as paracetamol (or acetaminophen) is recommended for persistent pain to enhance analgesia. Few studies have examined the frequency and doses of paracetamol among people with chronic non‐cancer pain including use above the recommended maximum daily dose.

    Aims

    To assess (i) the prevalence of paracetamol use among people with chronic non‐cancer pain prescribed opioids, (ii) assess the prevalence of paracetamol use above the recommended maximum daily dose and (iii) assess correlates of people who used paracetamol above the recommended maximum daily dose including: age, gender, income, education, pain severity and interference, use of paracetamol/opioid combination analgesics, total opioid dose, depression, anxiety, pain self‐efficacy or comorbid substance use, among people prescribed opioids for chronic non‐cancer pain.

    Methods

    This study draws on baseline data collected for the Pain and Opioids IN Treatment (POINT) study and utilises data from 962 interviews and medication diaries. The POINT study is national prospective cohort of people with chronic non‐cancer pain prescribed opioids. Participants were recruited from randomly selected pharmacies across Australia.

    Results

    Sixty‐three per cent of the participants had used paracetamol in the past week (95% CI = 59.7–65.8). Among the paracetamol users 22% (95% CI = 19.3–24.6) had used paracetamol/opioid combination analgesics and 4.8% (95% CI = 3.6–6.3) had used paracetamol above the recommended maximum daily dose (i.e. > 4000 mg/day). Following binomial logistic regression (χ2 = 25.98, df = 10, p = 0.004), people who had taken above the recommended maximum daily dose were less likely to have low income (AOR = 0.52, 95% CI = 0.27–0.99), more likely to use paracetamol/opioid combination analgesics (AOR = 2.01, 95% CI = 1.02–3.98) and more likely to take a higher opioid dose (AOR = 1.00, 95% CI = 1.00–1.01).

    Conclusion

    The majority of people with chronic non‐cancer pain prescribed opioids report using paracetamol appropriately. High income, use of paracetamol/opioid combination analgesics and higher opioid dose were independently associated with paracetamol use above the recommended maximum daily dose.

Authors


  •   Hoban, Bianca (external author)
  •   Larance, Briony
  •   Gisev, Natasa (external author)
  •   Nielsen, Suzanne (external author)
  •   Cohen, Milton (external author)
  •   Bruno, Raimondo (external author)
  •   Shand, Fiona (external author)
  •   Lintzeris, Nicholas (external author)
  •   Hall, Wayne (external author)
  •   Farrell, Michael P. (external author)
  •   Degenhardt, Louisa (external author)

Publication Date


  • 2015

Citation


  • Hoban, B., Larance, B., Gisev, N., Nielsen, S., Cohen, M., Bruno, R., Shand, F., Lintzeris, N., Hall, W., Farrell, M. & Degenhardt, L. (2015). The use of paracetamol (acetaminophen) among a community sample of people with chronic non‐cancer pain prescribed opioids. International Journal of Clinical Practice, 69 (11), 1366-1376.

Ro Full-text Url


  • https://ro.uow.edu.au/cgi/viewcontent.cgi?article=5205&context=sspapers

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/4180

Number Of Pages


  • 10

Start Page


  • 1366

End Page


  • 1376

Volume


  • 69

Issue


  • 11

Place Of Publication


  • United Kingdom