The Acetaminophen Awareness Coalition plans to place its “Know Your Dose” educational materials on 4,600 Walmart pharmacy counters by the end of 2015, while also reaching other large chains and smaller pharmacies.

Acknowledging the potential that label instructions are not read or not followed correctly, AAC made “Double Check: Don’t Double Up!” the Know Your Dose 2015 campaign theme to encourage consumers to double check OTC medicines to ensure they do not take multiple doses of the same active ingredient.

The Consumer Healthcare Products Association, a member of the coalition involved in the national campaign, says research published earlier in 2015 “validates” the coalition’s argument that public service messaging campaigns are critical to preventing unintentional overdose.

CHPA says Walmart initiated becoming the first retailer to work with AAC, which also includes the Alliance for Aging Research, the American Association of Nurse Practitioners and the National Association of Chain Drug Stores Foundation.

“We are now looking to expand the program so that we can get more of our Know Your Dose materials into more retail pharmacy outlets throughout the country in order to educate more consumers,” said Colleen Creighton, director of CHPA’s Educational Foundation, in an interview.

Educational materials with the tagline Know Your Dose include flyers, information cards and shelf talkers that pharmacists and other health care professionals can place on counters and in waiting rooms to encourage patients in proper dosing of the drug, said CHPA.

FDA and the American Academy of Pediatrics are advisors to AAC, which was formed after an advisory committee in 2009 recommended the agency lower the daily and maximum doses of acetaminophen available OTC to reduce the risk of unintentional overdose. The maximum daily dosage for acetaminophen is 4,000mg Also see "Acetaminophen Awareness Coalition Prepares To Launch Education Campaign" - Pink Sheet, 22 November, 2010..

In a 2009 final rule, FDA required manufacturers to add information on risks of liver damage in the warnings section on labels of OTC products containing acetaminophen ([A#05150209003]).

Since then, however, researchers have questioned whether the warning is enough to prevent unintentional overdose. A 2012 study published in the Journal of General Internal Medicine found many consumers do not carefully read product labels Also see "Acetaminophen Overdose Risk Persists Despite Label Changes – Study" - Pink Sheet, 11 June, 2012..

The coalition also is expanding its collaboration with pharmacists and other health care professionals to provide the latest information on acetaminophen, which is used by 50 million US consumers weekly in more than 600 OTC and prescription drugs. Brett Snodgrass, a family nurse and practitioner and the Tennessee representative to AANP, on Nov. 10 spoke for Know Your Dose in an AAC webinar.

Research ‘Validates’ Campaign

A study published in the Journal of Public Policy & Marketing in March, conducted by researchers led by Jesse Catlin of California State University, Sacramento, highlighted that consumer overdoses of acetaminophen are a growing concern. It notes previous research found that of 3,618 acetaminophen users, 4.5% exceeded the recommended total daily dose on at least one of seven observation days.

The researchers found consumers’ risk judgments can be improved by a public service message that both “challenges their naive beliefs that OTC drugs are relatively risk free and educates them that OTC active ingredient information is diagnostic because taking two drugs concurrently with the same active ingredient poses a health risk,” according to the study.

The study included 259 consumers who responded online. They were told they would read pages from a new online magazine that “specializes in short articles written by experts that are designed to help people live better lives” and that they would be asked their opinions of the articles.

Subjects then viewed four one-page articles, with subjects addressing personal finance, food safety, traveling with pets and other subjects, as well as a one-page public service message on the third page that was randomly determined to be either the treatment or control message about OTC drugs.

The treatment message, using information adapted from existing FDA public service messages about OTC drugs, stated that taking two OTC drugs with the same active ingredient was dangerous. The control message warned about the dangers of improper storage of OTC drugs around children.

After reading the pages, participants rated the articles on quality before they were asked whether they recalled reading various subjects, including an article about OTC medicines. They were shown eight OTC drug pairs – a mix of brand names and indications and some with both products containing the same active ingredient – and asked to rate the drug pairs on similarity and the risk of concurrent use of products in each pair.

On average, the researchers found 97% of the participants correctly recalled seeing the public service message about OTC drugs.

The researchers say the findings indicated that the public service message “weakened the naive belief that OTC drugs were relatively risk-free and enhanced the perception of the active ingredient as diagnostic in assessing the risk of taking two OTC drugs concurrently.”

“Participants who saw the intervention message correctly judged that double-dosing or using two OTC drugs with the same active ingredient (vs. different active ingredients) increased risk. Participants who saw the control message judged that using two OTC drugs with the same (vs. different active ingredients) active ingredient increased risk, but to a significantly lesser degree,” the researchers say.

The public service announcements worked regardless of the subjects’ level of knowledge about OTC drugs. “Participants benefited from the public service message similarly, regardless of their subjective, self-reported OTC drug expertise,” according to the study.

‘Double Check’ Acetaminophen Message Reaches Walmart Pharmacies

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