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.

Notre étude évalue par un autoquestionnaire le bon usage (indication, schéma posologique) et la connaissance du paracétamol (risques, identification de spécialités) chez des adultes en situation d’automédication dans des pharmacies de zone urbaine de la région lorraine. Sur les 302 patients interrogés, la plupart (86,4 %) s’avéraient de « bon usagers » et les facteurs indépendants de bon usage en analyse multivariée étaient une bonne connaissance du paracétamol (OR=5,3 ; p<0,0001) et plus curieusement le fait de ne pas avoir d’enfant (parentalité : OR=0,1 ; p=0,006). On note, en revanche, qu’un patient sur dix s’exposait à une dose suprathérapeutique, qu’un patient sur sept témoignait d’un mauvais usage, qu’un patient sur cinq se plaçait potentiellement en situation de surdosage involontaire et qu’un patient sur trois connaissait le risque de toxicité hépatique. Bon usage et bonne connaissance étaient significativement associés à une information provenant d’une source validée (pharmacien, médecin ou notice du médicament).