Purpose
Acetaminophen is highly accessible yet potentially dangerous when
used incorrectly. In attempts to address concerns about acetaminophen, The
U.S. Food and Drug Administration (FDA) has identified gaps in evidence
about unintentional misuse among adolescents. Therefore, our objectives were
to assess: adolescents’: 1) health literacy; 2) knowledge about
acetaminophen; 3) recent use of over-the-counter (OTC) medicines; 4) and use
of medication dosing instructions to understand the medicine and how to use
it (‘acetaminophen skills’).
Methods
Subjects and Setting: We conducted a cross-sectional
survey of adolescents and young adults (ages 16–23 years) recruited
from education settings and health care sites in Monroe County, New York,
from 11/08–9/09. Measures: Using structured
in-person interviews, we assessed acetaminophen knowledge and recent use of
over-the-counter (OTC) medicines. We assessed participants’ ability
to identify acetaminophen in OTC products and answer questions about
instructions for acetaminophen use through role-plays of everyday health
scenarios. We measured health literacy with the Rapid Estimate of Adult
Literacy in Medicine (REALM) for participants >18, and the REALM-Teen for
those <18.
Results
Confusion about acetaminophen and its use was common. Limited health
literacy was an independent risk factor for poor knowledge,
misunderstanding, and potential unsafe use of acetaminophen-containing
medicines, however, most participants at all health literacy levels erred
dangerously in ‘unsafe’ understanding of acetaminophen use
from label instructions.
Conclusions
Individuals with limited health literacy may face disproportionate
risk of unsafe use of acetaminophen due to confusion and misunderstanding of
label information. Better labeling, public health programs, and educational
efforts could facilitate safer use of acetaminophen.