Hoban, B and Larance, B and Gisev, N and Nielsen, S and Cohen, M and Bruno, R and Shand, F and Lintzeris, N and Hall, W and Farrell, M and Degenhardt, L, 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. ISSN 1368-5031 (2015) [Refereed Article]
Copyright 2015 John Wiley & Sons, Ltd
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.
|Item Type:||Refereed Article|
|Keywords:||chronic non-cancer pain, opioid use|
|Research Division:||Psychology and Cognitive Sciences|
|Research Field:||Psychology not elsewhere classified|
|Objective Group:||Public Health (excl. Specific Population Health)|
|Objective Field:||Substance Abuse|
|Author:||Bruno, R (Associate Professor Raimondo Bruno)|
|Funding Support:||National Health and Medical Research Council (APP1022522)|
|Web of Science® Times Cited:||3|
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