Patients’ Knowledge About Analgesic-Antipyretic Medications Purchased in Community Pharmacies: A Descriptive Study

<div><p>ABSTRACT</p><p>The objective of this study was to describe the level of knowledge about paracetamol (acetaminophen), ibuprofen, and aspirin of subjects who purchased nonprescription medications containing one of these drugs. We conducted this cross-sectional descriptive study in 42 community pharmacies located in southwestern France between July and November 2013. A six-item self-administered questionnaire was used. Participants were asked to identify the active ingredient contained in 14 brand-name analgesic-antipyretics, to state the maximum daily dose of paracetamol, ibuprofen, and aspirin, the recommended first-line analgesic, and precautions of use or contraindications for paracetamol, ibuprofen, and aspirin. Among 576 participants, the identification of paracetamol ranged from 58% (for Dafalgan or Efferalgan) to 90% (for Doliprane), the identification of ibuprofen from 34% (for Nureflex) to 63% (for Nurofen), and the identification of aspirin was 70% (for Aspegic). The maximum recommended daily dose of paracetamol, ibuprofen, and aspirin was known by 58.3%, 17.7%, and 19.3% of participants, respectively, whereas 6.8%, 17.2%, and 13.2% stated supratherapeutic daily doses. Paracetamol was correctly stated as the first-line analgesic-antipyretic by 76.2% of participants. Knowledge on major precautions of use or contraindications was poor (45.8% and 53.6% for ibuprofen and aspirin use during pregnancy, and 14.1% for concurrent use of anticoagulants and ibuprofen). Purchasers of nonprescription analgesic-antipyretics had poor knowledge on the medication they purchased.</p></div

Serum creatinine and potassium monitoring after start of NSAID according to NSAID prescriber.

<p>NSAIDs, non steroidal anti-inflammatory drugs.</p

Factors associated with serum creatinine and potassium after start of NSAID.

*<p>Adjusted for age, gender, exposure to potassium supplements, glucose lowering drugs and NSAIDs prescriber.</p>†<p>according to ATC classification.</p>‡<p>Risk level of renal failure/hyperkalemia caused by Drug-Drug Interactions (DDIs) between NSAIDs and antihypertensives (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0034187#pone-0034187-t001" target="_blank">table 1</a>).</p>§<p>in the 6 months before inclusion.</p>¶<p>Compared to other prescribers.</p

Serum creatinine and potassium monitoring before^* and after start of NSAID.^†

<p>NSAIDs, non steroidal anti-inflammatory drugs.</p>*<p>in the year previous first NSAID dispensing.</p>†<p>in the 3 weeks after start of NSAID.</p>‡<p>At risk of renal failure/hyperkalemia caused by Drug-Drug Interactions (DDIs) between NSAIDs and antihypertensives (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0034187#pone-0034187-t001" target="_blank">table 1</a>).</p

Characteristics of the first dispensing of NSAID.

<p>n, number; m, mean; sd, standard deviation; d, days; med, median; IQR, interquartile range; DDI Drug-Drug interaction.</p><p>NSAIDs, non steroidal anti-inflammatory drugs; DDD, defined Daily Dose;</p><p>Acetylsalicylic Acid: excluding anti-platelet dose.</p>‡<p>At risk of renal failure/hyperkalemia caused by Drug-Drug Interactions (DDIs) between NSAIDs and antihypertensives (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0034187#pone-0034187-t001" target="_blank">table 1</a>).</p

Selection of the 3,500 antihypertensive-treated patients with a first dispensing of NSAIDS.

<p>Selection of the 3,500 antihypertensive-treated patients with a first dispensing of NSAIDS.</p

Proportion of primary care physicians delivering the twelve recommended measures of preventive care, stratified by gender and age group.

<p>Proportion of primary care physicians delivering the twelve recommended measures of preventive care, stratified by gender and age group.</p