Has the rescheduling of modified‐release paracetamol in Australia affected the frequency of overdoses?,Emergency Medicine Australasia

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Has the rescheduling of modified‐release paracetamol in Australia affected the frequency of overdoses?
Emergency Medicine Australasia ( IF 1.7 ) Pub Date : 2024-03-26 , DOI: 10.1111/1742-6723.14403
Michaela J Ryan ₁ , Andis Graudins _{1,

2} , Nicole O'Shea ₃ , Firouzeh Noghrehchi ₄ , Anselm Wong _{1,

5}

Affiliation

ObjectivesIn June 2020, modified‐release paracetamol (paracetamol‐MR) preparations were up‐scheduled from schedule‐2 (available in pharmacy) to schedule‐3 (available by request to a pharmacist only). The present study aims to ascertain whether up‐scheduling affected the frequency of paracetamol‐MR overdoses.MethodsThis is a retrospective cohort study of two data sets from 1 June 2017 to 31 May 2022. Monash Health data were extracted using the diagnosis of paracetamol overdose coding and electronic medical records data. Calls regarding paracetamol‐MR overdoses to Victorian Poisons Information Centre (VPIC) were extracted from the Poisons centre call database. We used a quasi‐experimental research design with interrupted time series analysis to evaluate the immediate impact and change in trend of poisoning‐related calls and ED presentations before and after June 2020. The change in proportion of paracetamol‐MR cases in both databases was analysed using the Χ2 test.ResultsThe proportion of paracetamol‐MR cases in both data sets did not change. From Monash Health, there was no level change in monthly paracetamol‐MR overdose‐related presentations following re‐scheduling (rate ratio [RR] = 1.08, 95% confidence interval [CI] = 0.57–2.01). There was no change in monthly paracetamol‐MR overdose‐related calls to VPIC following re‐scheduling (RR = 1.05, 95% CI = 0.96–1.14).ConclusionThe proportion of paracetamol‐MR overdoses did not decrease after the up‐scheduling to S3. Similarly, the frequency of overdoses by month remained similar. Further limitations on access to paracetamol products may need to be considered.

中文翻译：

澳大利亚改良释放扑热息痛的重新安排是否影响了过量服用的频率？

目标 2020 年 6 月，缓释对乙酰氨基酚（扑热息痛-MR）制剂从附表 2（可在药房购买）上调至附表 3（仅可向药剂师索取）。本研究旨在确定提前安排是否会影响扑热息痛-MR过量用药的频率。方法这是对2017年6月1日至2022年5月31日两个数据集的回顾性队列研究。Monash Health数据是使用扑热息痛过量编码诊断提取的和电子病历数据。维多利亚州毒物信息中心 (VPIC) 有关扑热息痛-MR 过量用药的呼叫是从毒物中心呼叫数据库中提取的。我们采用准实验研究设计和中断时间序列分析来评估 2020 年 6 月前后中毒相关呼叫和急诊就诊的直接影响和趋势变化。分析了两个数据库中扑热息痛-MR 病例比例的变化使用Χ 2测试结果两个数据集中扑热息痛-MR病例的比例没有变化。根据 Monash Health 的数据，重新安排后每月与扑热息痛-MR 过量相关的表现没有水平变化（比率 [RR] = 1.08，95% 置信区间 [CI] = 0.57-2.01）。重新安排后，每月与扑热息痛-MR 过量相关的 VPIC 呼叫没有变化（RR = 1.05，95% CI = 0.96–1.14）。结论在升级至 S3 后，扑热息痛-MR 过量用药比例并未减少。同样，每月用药过量的频率也保持相似。可能需要考虑对扑热息痛产品的进一步限制。

更新日期：2024-03-26

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