Impact of different pack sizes of paracetamol in the United Kingdom and Ireland on intentional overdoses: a comparative study

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dc.contributor.authorHawton, Keith
dc.contributor.authorBergen, Helen
dc.contributor.authorSimkin, Sue
dc.contributor.authorArensman, Ella
dc.contributor.authorCorcoran, Paul
dc.contributor.authorCooper, Jayne
dc.contributor.authorWaters, Keith
dc.contributor.authorGunnell, David
dc.contributor.authorKapur, Navneet
dc.contributor.funderDepartment of Health, UKen
dc.contributor.funderNational Institute for Health Research, United Kingdomen
dc.contributor.funderHealth Service Executive, Irelanden
dc.date.accessioned2016-06-15T14:48:38Z
dc.date.available2016-06-15T14:48:38Z
dc.date.issued2011-06-10
dc.date.updated2014-10-24T10:40:44Z
dc.description.abstractBACKGROUND: In order to reduce fatal self-poisoning legislation was introduced in the UK in 1998 to restrict pack sizes of paracetamol sold in pharmacies (maximum 32 tablets) and non-pharmacy outlets (maximum 16 tablets), and in Ireland in 2001, but with smaller maximum pack sizes (24 and 12 tablets). Our aim was to determine whether this resulted in smaller overdoses of paracetamol in Ireland compared with the UK. METHODS: We used data on general hospital presentations for non-fatal self-harm for 2002-2007 from the Multicentre Study of Self-harm in England (six hospitals), and from the National Registry of Deliberate Self-harm in Ireland. We compared sizes of overdoses of paracetamol in the two settings. RESULTS: There were clear peaks in numbers of non-fatal overdoses, associated with maximum pack sizes of paracetamol in pharmacy and non-pharmacy outlets in both England and Ireland. Significantly more pack equivalents (based on maximum non-pharmacy pack sizes) were used in overdoses in Ireland (mean 2.63, 95% CI 2.57-2.69) compared with England (2.07, 95% CI 2.03-2.10). The overall size of overdoses did not differ significantly between England (median 22, interquartile range (IQR) 15-32) and Ireland (median 24, IQR 12-36). CONCLUSIONS: The difference in paracetamol pack size legislation between England and Ireland does not appear to have resulted in a major difference in sizes of overdoses. This is because more pack equivalents are taken in overdoses in Ireland, possibly reflecting differing enforcement of sales advice. Differences in access to clinical services may also be relevant.en
dc.description.sponsorshipDepartment of Health, UK (NHS R&D Programme (DH/DSH2008)); National Institute for Health Research, UK (NIHR Programme Grants for Applied Research scheme as part of NIHR programme of work related to suicide prevention (RP-PG-0606-1247)); Health Service Executive, Ireland (HSE National Office for Suicide Prevention)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid460
dc.identifier.citationHawton, K., Bergen, H., Simkin, S., Arensman, E., Corcoran, P., Cooper, J., Waters, K., Gunnell, D. and Kapur, N. (2011) 'Impact of different pack sizes of paracetamol in the United Kingdom and Ireland on intentional overdoses: a comparative study'. BMC Public Health, 11: 460. http://dx.doi.org/10.1186/1471-2458-11-460en
dc.identifier.doi10.1186/1471-2458-11-460
dc.identifier.endpage460 (8)en
dc.identifier.issn1471-2458
dc.identifier.journaltitleBMC Public Healthen
dc.identifier.startpage460 (1)en
dc.identifier.urihttps://hdl.handle.net/10468/2745
dc.identifier.volume11en
dc.language.isoenen
dc.publisherBiomed Centralen
dc.rights© 2011 Hawton et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/en
dc.subjectParacetamolen
dc.subjectUnited Kingdomen
dc.subjectIrelanden
dc.subjectDrug packagingen
dc.subjectPharmaciesen
dc.titleImpact of different pack sizes of paracetamol in the United Kingdom and Ireland on intentional overdoses: a comparative studyen
dc.typeArticle (peer-reviewed)en
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