Severin Anne-Elise, Petitpain Nadine, Scala-Bertola Julien, Latarche Clotilde, Yelehe-Okouma Melissa, Di Patrizio Paolo, Gillet Pierre
Département de médecine générale, faculté de médecine de Nancy, 54505 Vandœuvre-lès-Nancy, France.
Laboratoire de pharmacologie clinique et toxicologie, centre régional de pharmacovigilance, CHRU de Nancy, 54000 Nancy, France.
Therapie. 2016 Jun;71(3):287-96. doi: 10.1016/j.therap.2015.09.003. Epub 2016 Feb 11.
Acetaminophen (paracetamol), the highest over-the-counter (OTC) selling drug in France, is also the first cause of acute hepatic failure. We aimed to assess the good use and the knowledge of acetaminophen in a setting of urban self-medicated patients. We conducted a prospective observational study in randomly selected community pharmacies of Metz (France) agglomeration. Patients coming to buy OTC acetaminophen for themselves or their family had to answer to an anonymous autoquestionnaire. Responses were individually and concomitantly analyzed through 3 scores: good use, knowledge and overdosage. Twenty-four community pharmacies participated and 302 patients were interviewed by mean of a dedicated questionnaire. Most of patients (84.4%) could be considered as "good users" and independent factors of good use were (i) a good knowledge of acetaminophen (OR=5.3; P<0.0001) and more surprisingly; (ii) the fact of having no children (parentality: OR=0.1; P=0.006). Responses corresponding to involuntary overdosage were mostly due to a too short interval between drug intakes (3hours). Only 30.8% of patients were aware of liver toxicity of acetaminophen and only 40.7% knew the risk of the association with alcohol. Both good use and knowledge were significantly higher in patients looking for information from their pharmacist, physician and package leaflet. Patients should definitely be better informed about acetaminophen to warrant a better safety of its consumption. Pharmacists and physicians have to remind patients the risk factors of unintentional overdose and liver toxicity. Package leaflets have also to be more informative.
对乙酰氨基酚（扑热息痛）是法国非处方药（OTC）中销量最高的药物，也是急性肝衰竭的首要病因。我们旨在评估城市自我用药患者对乙酰氨基酚的合理使用情况及相关知识。我们在法国梅斯城市群随机选取的社区药房开展了一项前瞻性观察研究。前来为自己或家人购买非处方对乙酰氨基酚的患者需回答一份匿名自填式问卷。通过三个评分标准分别对回答进行单独和综合分析：合理使用、知识掌握和过量用药情况。24家社区药房参与了研究，通过一份专门问卷对302名患者进行了访谈。大多数患者（84.4%）可被视为“合理使用者”，合理使用的独立因素为：（i）对乙酰氨基酚的良好认知（比值比[OR]=5.3；P<0.0001），更令人惊讶的是；（ii）没有孩子这一情况（生育状况：OR=0.1；P=0.006）。与非故意过量用药相关的回答大多是由于两次服药间隔时间过短（3小时）。只有30.8%的患者知晓对乙酰氨基酚的肝毒性，只有40.7%的患者知道其与酒精联用的风险。在向药剂师、医生咨询并阅读药品说明书获取信息的患者中，合理使用和知识掌握情况均显著更高。患者肯定应该更好地了解对乙酰氨基酚，以确保其用药更安全。药剂师和医生必须提醒患者注意非故意过量用药和肝毒性的风险因素。药品说明书也必须提供更多信息。
