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

Journal article


Hoban, B., Larance, B., Gisev, N., Nielsen, S., Cohen, M., Bruno, R., Shand, F., Lintzeris, N., Hall, W., Farrell, M. and 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), pp. 1366-1376. https://doi.org/10.1111/ijcp.12716
AuthorsHoban, B., Larance, B., Gisev, N., Nielsen, S., Cohen, M., Bruno, R., Shand, F., Lintzeris, N., Hall, W., Farrell, M. and Degenhardt, L.
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.

Year2015
JournalInternational Journal of Clinical Practice
Journal citation69 (11), pp. 1366-1376
PublisherBlackwell Publishing Ltd
ISSN1368-5031
Digital Object Identifier (DOI)https://doi.org/10.1111/ijcp.12716
Scopus EID2-s2.0-84946499587
Research or scholarlyResearch
Page range1366-1376
FunderNational Health and Medical Research Council
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online13 Aug 2015
Publication process dates
Accepted22 Jul 2015
Deposited09 Sep 2021
Grant IDNHMRC/1022522
NHMRC/1041472
NHMRC/1073858
NHMRC/1013803
NHMRC/569738
NHMRC/1091878
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