Abstract
Analgesics are commonly used over-the-counter (OTC) medicines readily available for purchase, sometimes without advice of a health professional. However, analgesics can cause harm even when taken according to dosing recommendations. Young adults may be more vulnerable to harm if they perceive low risk with OTC analgesic use, or struggle to interpret dosing instructions. This study aimed to explore factors affecting how young adults use OTC analgesics and associated perceptions of safety. An online survey was distributed to school-leavers and university students (17 to 25 years), in South-East Queensland, Australia, in the period November–December 2019. Most of the 302 respondents (school-leavers n = 147, university students n = 155) did not use analgesics frequently. School-leavers deferred to parents for analgesic information, while university students preferred the internet. The majority of respondents appeared safety conscious and did not take outside indicated use or instructions. However, a small proportion reported taking analgesics for an inappropriate indication. The difference in preferred source of analgesic information may reflect experience with analgesic use, increasing autonomy or decreased parental influence. Whilst it is encouraging that the majority of young adults appeared safety conscious, greater insight is needed into factors influencing decision making on OTC use, e.g., medicines knowledge, and changes with increasing age.
Highlights
Self-administration of over-the-counter (OTC) medications is common; in 2018, Australians spent an estimated $5.4 billion dollars on OTC medications [1], with most adults using at least one medication per month, most commonly analgesics [2]
Larger quantities or analgesics deemed to require health advice with purchase are restricted to pharmacy sale (Pharmacy Medicines), and analgesics associated with a higher risk of harm or misuse are supplied by the pharmacist (Pharmacist-Only Medicines) [3,4]
Young adults appear to be at high risk of paracetamol-related harm; in Australia in 2017, there were 4577 cases of paracetamol toxicity recorded with the National Hospital Morbidity Database involving young adults aged 15–24 [12]
Summary
Self-administration of over-the-counter (OTC) medications is common; in 2018, Australians spent an estimated $5.4 billion dollars on OTC medications [1], with most adults using at least one medication per month, most commonly analgesics [2]. The analgesics aspirin, paracetamol and ibuprofen can be purchased from supermarkets or petrol stations in small quantities without health professional advice as unscheduled (general sales list) medications. Larger quantities or analgesics deemed to require health advice with purchase are restricted to pharmacy sale (Pharmacy Medicines), and analgesics associated with a higher risk of harm or misuse are supplied by the pharmacist (Pharmacist-Only Medicines) [3,4]. Paracetamol toxicity is the most prevalent cause of acute liver failure in the Western world when taken inappropriately or in excess [9,10,11,12]. In Australia, paracetamol is the medication most frequently used in overdoses, and was associated with a 108% increase in paracetamol-related acute liver toxicity between 2007 and 2017 [12]. Young adults appear to be at high risk of paracetamol-related harm; in Australia in 2017, there were 4577 cases of paracetamol toxicity recorded with the National Hospital Morbidity Database involving young adults aged 15–24 [12]
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