Poster Number-11 - The Role of Over-the-Counter Pain Relivers for Self-Care in America’s Changing Healthcare Landscape

The COVID-19 pandemic triggered dramatic changes in daily life in the United States (US) and globally. The pandemic also exacerbated existing inequitable access to health care and accelerated changes in the delivery of health care, influencing individuals to take more responsibility for their own care (self-care).  Review of published literature confirms changes in healthcare access, delivery and seeking brought on by the pandemic.^1,2  However, a gap exists regarding patients’ perceptions of the value of over-the-counter (OTC) medicines for appropriate self-care at home.  In this context, the current study aimed to understand patients’ attitudes about OTC pain relievers, particularly acetaminophen, and its role in the at-home health care toolkit.

Methods:

APCO Insight, a stakeholder research consultancy that has particular expertise in conducting qualitative and quantitative research in the health sector, identified and refined key concepts to develop a consumer-focused questionnaire in partnership with medical experts (eg, medical doctors) and academically credentialed survey methodologists. The main survey focused on 4 distinct sets of questions to capture the current public health context and view of OTCs: demographics, health history/access, views toward OTC medicines, and the value and impact of current acetaminophen options. APCO partnered with YouGov, an internationally-recognized data collection platform and analytics group, to conduct a 400-person pilot study of the questionnaire to ensure target populations understood the survey language and questions had meaningful differentiation. Pilot study results and open-end responses from participants about the survey quality and ease of use for both Spanish and English speakers were reviewed to improve quality. APCO and YouGov then conducted a 20-minute, nationally representative online survey in both English and Spanish from January 26 – February 9, 2022 among 2,499 US adults, including oversamples for key subpopulations.  The survey monitored national demographics by gender, age, race, and geography: 48% of participants were male, 51% female, 51% under 50-years-old, 49% older than 50 and 23% older than 65.  The majority were white (64%), with 12% self-identifying as Black/African American, 15% as Hispanic/Latino and 10% as part of another group; 48% lived in suburban areas, 28% in urban, and 24% in rural areas. 

The data were examined descriptively. Oversampling was implemented for two key subpopulations (African Americans and low-income households) to ensure large enough sample sizes for statistical analysis.  Survey results were weighted to be representative of the US adult population.  The margin of error for the survey is ±2% overall; though the margin of error is higher when opinion is more divided.

Results:

51% reported using OTC medicines, 60% prescription medicines and 68% daily vitamins/nutritional supplements during the previous week. OTC medicines that ≥50% reported having in their homes included pain relievers (85%), cold/cough (75%), allergy relief (61%), antibiotic ointment (58%) and antacids (56%). Among those with a pain reliever in their home, acetaminophen (76%) and ibuprofen (77%) were reported most commonly. 

Ibuprofen and acetaminophen were most often preferred for common ailments, except cold/flu. Acetaminophen was most preferred for fever, seen as satisfactory in treating multiple common conditions and used occasionally (73% reported use ≥few times over previous 6 months). During the previous 6 months, 3 of 4 participants experienced aches and pains (85%), headache (79%), and back pain (73%); ≥3 of 10 also had cold/flu (49%), pain from injury (43%), arthritis pain (41%), or fever (31%). Ibuprofen was preferred to acetaminophen for treating aches and pains (50% and 40%, respectively), back pain (40% and 32%, respectively), and arthritis pain (24% and 20%, respectively). Acetaminophen was preferred to ibuprofen to treat fever (46% and 34%, respectively). Multiple ingredient cold treatments were most preferred for cold/flu (66%).

Acetaminophen is seen as important to have OTC; has preferred existing dosing options; is viewed as efficacious, accessible, and safe; helps people manage pain to engage in regular activities; and satisfactorily relieves common ailments. Similar percentages of respondents preferred regular strength (650 mg) and extra strength (1000 mg) acetaminophen (43% and 42%, respectively).  Among 81% who reported ability to get acetaminophen as an OTC medicine was very (53%) or somewhat (28%) important, efficacy (46%) and accessibility (38%) were the most common open-ended reasons. A majority strongly or somewhat agreed that acetaminophen was important to be available OTC because it was accessible without a prescription (88%), affordable (83%), effective (76%), tolerable (77%), non-addictive (75%), and safer than other pain relief options (60%).  Regarding how acetaminophen helped with their regular activities, 52% reported that acetaminophen aided them in getting a full night’s sleep through pain relief.  Approximately 40% said acetaminophen helped them with daily living tasks like showering and dressing (40%), spending quality time with loved ones (40%) and typical movement activities (48%). 41% reported relying on acetaminophen for pain relief so that they were able to participate in activities that required extra effort (eg, swimming, hiking). For headaches (66%), aches and pains (63%), and fever (61%) over 6 in 10 participants were satisfied with acetaminophen; < 5% were unsatisfied.

Conclusion:

This nationally representative survey of adults in the US showed strong reported use of various self-care options. Half of participants reported using OTC medicines. Pain relievers were the most commonly reported OTC medicines in participants’ homes and acetaminophen and ibuprofen were the analgesics most commonly used to manage aches and pains, back pain, arthritis pain, and fever.  Nearly 3 of 4 participants (73%) reported using acetaminophen at least a few times over the previous 6 months.  When asked to focus on acetaminophen, survey participants cited efficaciousness, availability, and affordability of acetaminophen as top reasons for it to be available as an OTC medicine.  Moreover, participants confirmed that OTC acetaminophen enabled them to be active in a variety of activities of daily living. Survey results suggest that the accessibility and effectiveness of OTC acetaminophen allows individuals to appropriately self-manage their health and quality of life.

References: 1. Nana-Sinkham et al. 2021.
2. Centers for Disease Control and Prevention. 2022..