Use Of Non-prescription Analgesics Research Articles

Analgesic use in Germany : Survey of the years 2008 to 2019

There are previously published data on the percapita use of analgesics in Germany, but only to 2005. In the present analysis, data for the years 2008-2019 were evaluated. The use of prescription and nonprescription analgesics was investigated and possible influencing factors were discussed. The percapita use of prescription and nonprescription analgesics was determined based on data on prescriptions and cash purchases in pharmacies (IMS Pharmascope®, Wiener Neudorf, Austria). Moreover, an evaluation according to active substances was performed for nonprescription drugs. In addition, pharmaceutical manufacturers' advertising expenditures and changes in distribution channels were analyzed as possible influencing factors. During the observation period 2008-2019, the use of prescription analgesics in Germany increased, while the use of nonprescription analgesics decreased. Single-agent drugs constitute the majority of sales of nonprescription analgesics. The share of combination drugs has decreased in recent years. The use of nonprescription analgesics in Germany decreased between 2008 and 2019. The trend as of 1995, which was observed in aprevious investigation, is therefore continuing. External factors, such as the increase in advertising expenses or easier access via mail-order pharmacies, do not appear to influence use.

Prospective Cross-Sectional Study of the Uses of Non-prescription Analgesics among Hail Residents

<p>The aim of this paper was to describe the general status of the use of non-prescription analgesics (NPA) among the residents of Hail city to ensure the safe use of non-prescription analgesics. Â One hundred participants with different diseases were studied consecutively from January to March 2020. Data were collected with an online, semi-structured questionnaire; the obtained data were converted into statistical data using Microsoft Excel 2013. Most participants were taking a single, non-prescription analgesic (87.5%), while combination analgesic products were used by only 12.5% of participants. Using over-the-counter analgesics is common among residents of Hail, and most of those studied use these products in moderation and do not exceed the recommended dose. Acetaminophen is the most widely used product, but people also use NSAIDs and amphetamine-like products. The use of over-the-counter analgesics is common among residents of Hail, and most of the participants in this study use these products in moderation and do not exceed the recommended dose; therefore, exposure of patients to an increased risk of adverse effects of these products is out of the question, and this indicates that a large group of people in this region knows the risk of analgesics overuse. New studies are needed to help improve the approaches to the use of NPA drugs</p>

It hurts inside: a qualitative study investigating social exclusion and bullying among adolescents reporting frequent pain and high use of non-prescription analgesics

BackgroundBeing bullied and socially excluded interferes with the fundamental need for humans to belong to a social group, which is necessary for well-being. This might underpin pain and the use of non-prescription analgesics.AimThe aim of the study was to gain insight into how social exclusion and bullying affect well-being in adolescents reporting frequent pain and high use of non-prescription analgesics.MethodsA phenomenological hermeneutical method based on in-depth interviews was used. Nineteen teenagers, 14–16 years of age voluntarily participated in the study. Those included had frequent pain and used non-prescription analgesics daily or several times a week.ResultsBullying and social exclusion affects thoughts, feelings and attitudes and thereby the quality of life of the adolescents we interviewed. They described feelings such as sadness, loneliness and depression, and a sense of being an outsider among peers was common. It also appears that bullying has significant potential to spread in a school environment.ConclusionThe adolescents were self-aware and well-articulated. They conceptualised their experiences of being socially excluded and bullied. They described being socially excluded and bullied by peers as painful and they used non-prescription analgesics to alleviate pain. Teachers and health professionals should be aware of frequent pain and high use of non-prescribed analgesic medication as signs of psychosocial stress caused by social exclusion and bullying. Social exclusion and bullying should be systematically mapped, and targeted interventions implemented.

Use of non-prescription analgesics and male reproductive function

We studied the association between intake of non-prescription analgesics and semen quality and male reproductive hormone levels in a cross-sectional study among 1493 men. The men provided one semen (n=1493) and blood sample (n=1056) and filled in questionnaires on use of non-prescription analgesics (paracetamol, NSAIDs and combination drugs (yes/no)). Adjusting for age, study and other covariates, we observed no association between intake of non-prescription analgesics and markers of semen quality. Adjusting for age and time of day of blood sampling, users of non-prescription analgesics had a 10.4% (95% confidence interval (CI) 4.0–17.1%) higher testosterone level than non-users. When we stratified by medication type, the association between analgesics and higher testosterone was observed between users of non-steroidal anti-inflammatory drugs (NSAIDs) and combination drugs but not paracetamol. This study suggests that use of non-prescription analgesics is associated with slightly higher serum testosterone levels than non-use.

Use of Non-Prescription Analgesics and its Associated Factors in Boralasgamuwa Medical Officer of Health Area

Use of Non-Prescription Analgesics and its Associated Factors in Boralasgamuwa Medical Officer of Health Area

The association between adolescent and parental use of non-prescription analgesics for headache and other somatic pain – A cross-sectional study

Background and purposeOver the last years, concern has been expressed about adolescents’ possible liberal attitude towards – and use of – non-prescription analgesics. A high consumption of analgesics is unfortunate as it may lead to various harmful effects and worsening of headache. In order to address this challenge, it is necessary to achieve a more extensive knowledge about adolescent consumption. The main aim of this study was to examine the association between adolescent and parental use of non-prescription analgesics, taking into account headache as well as other somatic pain. The effects of parental prescription analgesics use was a secondary aim. MethodsThe study is based on data from two cross-sectional health studies conducted in 2005 and 2012 in Norway, including 646 adolescents and an accompanying parent. By using sample weights, the final weighted sample used in the analysis was 1326. Data was collected through postal questionnaires to parents and adolescents as well as parental telephone interviews. Questionnaires included questions on different pain locations and the pain for each location was graded according to how troubling the pain was. Medication data on prescription and non-prescription analgesics was from telephone interviews and was quantified based on the pattern over the past 4 weeks. Multivariate logistic regression models and complex samples analyses were used. Results20% of adolescents were reported as using non-prescription analgesics during the previous 4 weeks. Girls were more often reported to use non-prescription analgesics than boys. Headache and all other somatic pain locations except back pain were reported more frequently among girls while boys more frequently reported back pain. There was a clear association between the use of non-prescription analgesics and headache with 34% of adolescents with headache using non-prescription analgesics versus 19% of adolescents with other somatic pain and 14% of adolescents not reporting pain. Among adolescents reporting headache, 9% were reported to use non-prescription analgesics daily or almost daily versus 3% and 2% among those reporting other somatic pain and reporting no pain respectively. In addition, parental use of non-prescription analgesics was a strong independent predictor of adolescent use (adjusted OR 1.69 for boys, 1.54 for girls). This relationship increased when the adolescents were less bothered by headache themselves. ConclusionHeadache is the dominant medication-driving pain for non-prescription analgesics among adolescents but parental medication use of non-prescription analgesics also strongly influences adolescent use. ImplicationsThere is a need for health services to improve information to parents and adolescents about risks associated with use of analgesics and also to work on prophylactic strategies focusing on adolescents. Parents should be made aware that their medicine use strongly influences that of their children.

Prevalence of use of non-prescription analgesics in the Norwegian HUNT3 population: Impact of gender, age, exercise and prescription of opioids.

BackgroundThere are concerns about potential increasing use of over-the-counter (OTC) analgesics. The aims of this study were to examine 1) the prevalence of self-reported use of OTC analgesics; 2) the prevalence of combining prescription analgesics drugs with OTC analgesics and 3) whether lifestyle factors such as physical activity were associated with prevalence of daily OTC analgesic use.MethodsQuestionnaire data from the Nord–Trøndelag health study (HUNT3, 2006–08), which includes data from 40,000 adult respondents. The questionnaire included questions on use of OTC analgesics, socioeconomic conditions, health related behaviour, symptoms and diseases. Data were linked to individual data from the Norwegian Prescription Database. A logistic regression was used to investigate the association between different factors and daily use of paracetamol and/or non-steroid anti-inflammatory drugs (NSAIDs) in patients with and without chronic pain.ResultsThe prevalence of using OTC analgesics at least once per week in the last month was 47%. Prevalence of paracetamol use was almost 40%, compared to 19% and 8% for NSAIDs and acetylsalicylic acid (ASA), respectively. While the use of NSAIDs decreased and the use of ASA increased with age, paracetamol consumption was unaffected by age. Overall more women used OTC analgesics. About 3-5% of subjects using OTC analgesics appeared to combine these with the same analgesic on prescription. Among subjects reporting chronic pain the prevalence of OTC analgesic use was almost twice as high as among subjects without chronic pain. Subjects with little physical activity had 1.5-4 times greater risk of daily use of OTC compared to physically active subjects.ConclusionsUse of OTC analgesics is prevalent, related to chronic pain, female gender and physical inactivity.

Analgesic Use and Frailty among Community-Dwelling Older People

Frail older people have a decreased ability to respond to stressors and may therefore be more susceptible to adverse events related to inadequately treated pain. Conversely, aging- and frailty-related changes in pharmacokinetics and pharmacodynamics may predispose frail older people to adverse events of analgesics. The aim of this study was to explore whether analgesic use is associated with frailty status and whether there are differences in the types of analgesics used between frailty groups among community-dwelling older people. The study population consisted of 605 community-dwelling people aged >75 years. Demographic, diagnostic and drug use data were collected during standardized nurse interviews. Participants were classified as frail, pre-frail or robust using the Cardiovascular Health Study frailty criteria (weight loss, weakness, exhaustion, slowness and low physical activity). Overall, 11.4 % (n = 69) of the study participants were frail and 49.4 % (n = 299) were pre-frail. The prevalence of prescription and non-prescription analgesic use was higher among frail (68.1 %) than among pre-frail (54.5 %) and robust (40.5 %) older people (p < 0.001). In multivariate analyses, frailty was positively associated with analgesic use (odds ratio 2.96; 95 % CI 1.38-6.36). However, frail analgesic users (46.7 %) were more likely to want their physicians to pay greater attention to pain management than robust (23.2 %) analgesic users. The most prevalent analgesic was acetaminophen (paracetamol) among frail (78.7 %) and pre-frail (63.2 %), and NSAIDs among robust (60.4 %) analgesic users. Frail (60.3 %) and pre-frail (58.1 %) participants were more likely to report musculoskeletal pain than robust (44.7 %) participants. Of robust, pre-frail and frail older people 33.0 %, 23.1 % and 4.9 % (respectively) did not use any analgesics to treat their pain. Frailty was associated with a higher prevalence of analgesic use. As frail older people may be more susceptible to adverse events, careful selection of analgesics is warranted. Clinicians should pay more attention to pain management to ensure adequate pain relief.

Comparative risks of non-prescription analgesics: a structured topic review and research priorities

Objective: The aims of this report are to quantify and compare competing risks associated with the use of non-prescription analgesics (daily doses of acetaminophen ≤ 4000 mg, aspirin ≤ 4000 mg, ibuprofen ≤ 1200 mg, naproxen ≤ 660 mg and ketoprofen ≤ 75 mg) and identify research needs.Methods: Literature was searched and organized by medication, adverse effect and direction of effect. Causality was determined using structured consensus, using IOM and GRADE nomenclature. Magnitude of risk data were extracted from primary sources. Structured consensus were used to construct a list of research priorities.Results: The available data favor acceptance of a causal relationship between each of the five analgesics studied and at least one specific form of harm. Dosing in excess of the non-prescription limits is associated with increased risk. Existing data do not support precise estimates of population or individual patient attributable risks for most analgesic and organ system combinations, and as a result competing risks cannot be adequately assessed. The highest priority research needs included understanding ‘real world’ dosing and how co-morbidities and prodromal symptoms modify exposure.Conclusions: Although generally safe, all non-prescription analgesics are associated with some harm, particularly when recommended dosing limits are exceeded. Research to quantify the competing risks of different analgesic strategies is urgently needed.

Analgesic use among community-dwelling people aged 75 years and older: A population-based interview study

Background: Pain is often underrecognized and undertreated among older people. However, older people may be particularly susceptible to adverse drug reactions linked to prescription and nonprescription analgesics. Objectives: The aims of this study were to assess the prevalence of analgesic use among a random sample of community-dwelling people aged ≥75 years, and to investigate factors associated with daily and as-needed analgesic use. Methods: A random sample of people aged ≥75 years was drawn from the population register in Kuopio, Finland, in November 2003. Data on prescription and nonprescription analgesic use were elicited during nurse interviews conducted once for each participant in 2004. Self-reported drug utilization data were verified against medical records. The interview included items pertaining to sociodemographic factors, living conditions, social contacts, health behavior, and state of health. Physical function was assessed using the Instrumental Activities of Daily Living Scale, and the 10-item Barthel Index. Self-rated mobility was assessed by asking whether respondents could walk 400 meters (yes, yes with difficulty but without help, not without help, or no). Cognitive function was assessed using the Mini-Mental State Examination. The presence of depressive symptoms was assessed using the 15-item Geriatric Depression Scale. Respondents' self-rated health was determined using a 5-point scale (very poor, poor, moderate, good, or very good). Results: Of the initial random sample of participants (N = 1000), 700 provided consent to participate and were community dwelling. Among the participants, 318 (45.4%) were users of ≥1 analgesic on a daily or as-needed basis. Only 23.3% of analgesic users took an analgesic on a daily basis. Factors associated with any analgesic use included female sex (odds ratio [OR], 1.78 [95°% CI, 1.17–2.71]), living alone (OR, 1.46 [95°% CI, 1.02–2.11]), poor self-rated health (OR, 2.6 [95% CI, 1.22–3.84]), and use of ≥10 nonanalgesic drugs (OR, 2.21 [95% CI, 1.26–3.87]). Among users of ≥1 oral analgesic, factors associated with opioid use included moderate (OR, 2.46 [95% CI, 1.175.14]) and poor (OR, 2.57 [95% CI, 1.03–6.42]) self-rated health. Opioid use (OR, 0.19 [95% CI, 0.04–0.86]) and daily analgesic use (OR, 0.16 [95% CI, 0.34-0.74]) were inversely associated with depressive symptoms. Pain in the previous month was reported by 71.4% of analgesic users and 26.4% of nonusers of analgesics. Conclusions: Analgesics were used by ~50% of community-dwelling people aged ≥75 years. However, age was not significantly associated with increased use of analgesics in multivariate analysis. The majority of analgesic drugs were used on an as-needed rather than a daily basis (76.7% vs 23.3%, respectively). Factors most significantly associated with analgesic use were female sex, living alone, poor self-rated health, and use of ≥10 nonanalgesic drugs.

Overuse of non-prescription analgesics by dental clinic patients

BackgroundMany patients present to dental clinics for treatment of painful conditions. Prior to seeking treatment, many of these patients will self-medicate with non-prescription analgesics (NPA), and some will unintentionally overdose on these products. The objective of this study is to describe the use of NPA among dental patients.MethodsAll adult patients presenting to an urban dental clinic during a two-week period in January and February of 2001 were approached to participate in this research project. Trained research assistants using a standardized questionnaire interviewed patients. Patient demographics and the NPA usage over the 3 days preceding the office visit were recorded. We defined a supra-therapeutic dose as any dose greater than the total recommended daily dose stated on package labeling.ResultsWe approached 194 patients and 127 participated. The mean age of participants was 35.5 years, 52% were male. Analgesic use preceding the visit was reported by 99 of 127 patients, and most (81/99) used a NPA exclusively. Fifty-four percent of NPA users were taking more than one NPA. NPA users reported using ibuprofen (37%), acetaminophen (27%), acetaminophen/aspirin combination product (8%), naproxen (8%), and aspirin (4%). Sixteen patients reported supra-therapeutic use of one or more NPA (some ingested multiple products): ibuprofen (14), acetaminophen (3), and naproxen (5).ConclusionNPA use was common in patients presenting to a dental clinic. A significant minority of patients reported excessive dosing of NPA. Ibuprofen was the most frequently misused product, followed by naproxen and acetaminophen. Though mostly aware of the potential toxicity of NPA, many patients used supra-therapeutic dosages.

Appropriate Use of Nonprescription Analgesics in Pediatric Patients

Appropriate Use of Nonprescription Analgesics in Pediatric Patients

Appropriate Use of Nonprescription Analgesics in Pediatric Patients

Acetaminophen and ibuprofen are among the most commonly used nonprescription medications in the United States. Use of these medications is particularly widespread for the treatment of mild pain or fever in children. (The use of aspirin in children and adolescents has declined steadily since the late 1970s, when aspirin was linked to Reye syndrome.)

Physical therapists’ knowledge, attitudes, and professional use of nonprescription analgesics

Since nonprescription analgesics remain the cornerstone of the treatment of many musculoskeletal disorders, it is important to determine whether physical therapists (PTs) are using these agents in their practice. Many state physical therapy practice acts do not address the issue of drug therapy

How and why are non-prescription analgesics used in Scotland?

UK Government policy increasingly encourages self-care of minor illnesses, including self-medication. Analgesics constitute a quarter of UK over-the-counter medicines sales, but concerns have been expressed about their potential for inappropriate use. To estimate the prevalence of recent use of non-prescription analgesics in Scotland, to describe by whom they are used, and to estimate inappropriate use. A cross-sectional postal survey consisting of a self-completed questionnaire that collected data on respondents' use of non-prescription and prescription medicines, as well as demographic and lifestyle data. The sample comprised 2708 subjects of 18 years and over, randomly selected from the Scottish electoral roll. The response rate was 55% (n=1501). Some 37% (555/1501) of respondents had used a non-prescription analgesic in the previous two weeks. Analgesics accounted for 59% (636/1081) of all non-prescription medicines used in that period. After controlling for all other variables, age, sex, level of education, self-reported health status, prescription exemption status, and use of prescription analgesics, remained significant predictors of non-prescription analgesic use. There was evidence of possible inappropriate use of non-prescription analgesics including use of multiple analgesics (n=67), use by individuals self-reporting conditions associated with cautious use of certain analgesics (n=51), and potential drug-drug interactions (n=15). A few respondents appeared to be using non-prescription analgesics to supplement medical treatment of chronic conditions (n=4). Our findings have demonstrated a high level of use of non-prescription analgesics amongst the general public, with significant potential for inappropriate use. As we move towards a culture of increased self-management of minor illness, this demonstrated need for improved pharmacovigilance of non-prescribed medicines must be addressed.

Prescription and non-prescription analgesic use among the US adult population: results from the third National Health and Nutrition Examination Survey (NHANES III).

To estimate prescription and non-prescription analgesic use in a nationally representative sample of US adults. Data collected during the third National Health and Nutrition Examination Survey (1988-1994), for persons 17 years and older were analyzed (n = 20,050). During the household interview, respondents reported use, in the last month, of prescription and non-prescription analgesics. An estimated 147 million adults reported monthly analgesic use, Prescription analgesic use was 9% while non-prescription use was 76%. Females were more likely than males to use prescription (11 vs. 7%, p < 0.001) and non-prescription (81 vs. 71%, p < 0.001) analgesics. Across race-ethnicity groups, males (approximately 8%) and females (11-13%) had similar age-adjusted prescription analgesic use. Non-prescription analgesic use was higher among non-Hispanic whites than non-Hispanic blacks and Mexican-Americans for males (76 vs. 53% (p < 0.001) and 59% (p < 0.001), respectively) and females (85 vs. 68% (p < 0.001) and 71% (p < 0.001), respectively). With increasing age, prescription analgesic use increased whereas non-prescription use decreased. Approximately 30% of adults used multiple analgesics during a 1-month period. This was more common among females (35%) than males (25%, p < 0.001) and among younger (17-44 years, 33%) rather than older age groups (45+ years, 26%, p < 0.001). Analgesic use among US adults is extremely high, specifically of non-prescription analgesics. Given this, health care providers and consumers should be aware of potential adverse effects and monitor use closely.

Prescription and nonprescription analgesic use in Sweden.

To analyze patterns of prescription and nonprescription analgesic use in the general Swedish population, in association with predisposing factors, enabling factors, need, and health behavior. Cross-sectional interview survey. The Swedish Surveys of Living Conditions for the 2-year period 1988-1989. A probability sample of all inhabitants of Sweden aged 18-84 years (n = 11996). Prescription and nonprescription analgesic use during a 2-week period. Women reported use of analgesics both with and without prescriptions to a greater extent than did men. Among women, 12.2% reported prescription analgesic use and 30.4% reported nonprescription analgesic use. The corresponding proportions among men were 7.2% and 20.0%, respectively. In the descriptive analyses, prescription analgesic use was most common among persons aged 45 years and older, while use of nonprescription analgesics was most common in people aged 18-44 years. The polychotomous logistic regression analyses showed that headache and musculoskeletal pain were strongly associated with prescription analgesic use to a similar extent among men and women. Headache was associated with nonprescription analgesic use among men and women, but a gender difference was found in the association between musculoskeletal pain and nonprescription analgesic use. Women with musculoskeletal pain used nonprescription analgesics to a greater extent than did men with musculoskeletal pain. Poor health--measured as self-perceived health status and physical function--and high use of health care were related only to prescription analgesic use. Smoking and being overweight were associated with prescription analgesic use among men and with nonprescription analgesic use among women; alcohol consumption was associated with both types of analgesic use only among women. This study shows that men and women differ in their choice between prescription and nonprescription analgesics and that the choice between prescription and nonprescription analgesics is influenced by an individual's pain, self-perceived health, and lifestyle.

Generalized use of over-the-counter analgesics: relationship to premenstrual symptoms.

This study tested the hypothesis that use of nonprescription analgesics among women scoring high on premenstrual distress may generalize to time periods beyond the premenstrual phase. Fifty three female undergraduates completed Form C of the Moos Menstrual Distress Questionnaire and described their typical use of analgesics during the "average week." Results showed that symptoms of premenstrual distress were significantly related to both the frequency of analgesic use and the quantity consumed per occasion. These findings support the generalization hypothesis proposed by Blechman and her colleagues.

Generalized use of over‐the‐counter analgesics: Relationship to premenstrual symptoms

This study tested the hypothesis that use of nonprescription analgesics among women scoring high on premenstrual distress may generalize to time periods beyond the premenstrual phase. Fifty three female undergraduates completed Form C of the Moos Menstrual Distress Questionnaire and described their typical use of analgesics during the “average week.” Results showed that symptoms of premenstrual distress were significantly related to both the frequency of analgesic use and the quantity consumed per occasion. These findings support the generalization hypothesis proposed by Blechman and her colleagues. © 1997 John Wiley & Sons, Inc.

The use of non-prescription analgesics in an older population.

Older patients are frequent users of aspirin and acetaminophen, either recommended by physicians or self-prescribed, for the aches and pains that accompany aging. These mild analgesics provide effective pain relief when used appropriately. Aspirin and acetaminophen are equianalgesic on a milligram-for-milligram basis for most indications. Both are safe for most patients. Aspirin use may be associated with salicylate intoxication or salicylate interactions with other agents. There have been reports of an association of hepatotoxicity with acute massive overdosages of acetaminophen.