Behavioral Surveillance of Acetaminophen Users: Knowledge, Attitudes, and Dosing Behavior

Acetaminophen is one of the most commonly used analgesic/antipyretic compounds worldwide, and is contained in hundreds of over-the-counter and prescription products in the U.S.  While generally safe when taken as directed, concerns have been raised about over-use of acetaminophen and its potential effect on health consequences, especially liver failure.  A particular concern is inadvertent overdose due to taking multiple acetaminophen-containing products.  We are conducting a program of behavioral surveillance of U.S. adults, beginning with a baseline assessment of consumer knowledge, attitudes, and self-dosing in 2010 followed by continuous surveillance since early 2011. Participants are recruited from Lightspeed, an internet panel with 1.5 million members.  The survey design uses web-based daily diaries to collect detailed data on the use of acetaminophen-containing products (both Rx and OTC), dose, and timing.  Information on respondents’ knowledge about acetaminophen-containing products, attitudes toward the use of medicines, relevant medical history, and other characteristics is obtained in an exit survey.

The behavioral surveillance program is designed to ascertain the characteristics of acetaminophen users, with a focus on those who exceed the maximum recommended daily dose.  The data will suggest areas for potential consumer interventions and allow for the monitoring of user attitudes, knowledge, and dosing behavior over time as interventions are undertaken.  A separate diary study of a low education population recruited by mall intercept in 23 sites throughout the U.S., in which similar data were obtained, was conducted in late 2011.


David W. Kaufman, Sc.D. (Slone Epidemiology Center), Co-Principal Investigator
Saul Shiffman, Ph.D. (Pinney Associates), Co-Principal Investigator

Mary K. Malone, M.B.A. (Appleseed Consumer Insight), Co-Investigator
Rachel Weinstein, Ph.D. (Janssen Research and Development), Co-Investigator

Study Staff:

Judith P. Kelly, M.S. (Slone Epidemiology Center), Epidemiologist
Mark Sembower, Ph.D. (Pinney Associates), Statistician
Deena Batista, Ph.D. (Pinney Associates), Statistician

Source of Funding:

McNeil Consumer HealthCare

Study Period:

July 2010 to present

Current Data File:

Surveillance 9,463 acetaminophen users
Low Education Study 756 acetaminophen users

Kaufman DW, Kelly JP, Rohay JM, Malone MK, Weinstein RB, Shiffman S. Prevalence and correlates of exceeding the labeled maximum dose of acetaminophen among adults in a U.S.-based internet survey. Pharmacoepidemiol Drug Saf 2012;21:1280-88. doi: 10.1002/pds.3350.

David W. Kaufman, Sc.D., at 617-734-6006 or