Factors contributing to paracetamol overdoses (intentional and accidental) amongst adult and paediatric populations in the United Kingdom: a systematic review and narrative synthesis
Abstract
Abstract Background Paracetamol (acetaminophen) is a widely used analgesic, safe at recommended doses. However, paracetamol overdose accounts for around 100,000 accident and emergency visits and 50,000 hospital admissions per year in the UK. This systematic review aims to describe the factors linked to paracetamol overdose (intentional and/or accidental), identify population subgroups of the population at higher risk, and evidenced preventative interventions. Methods This review was undertaken using the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidance. Literature searches were performed with six databases: MEDLINE via PubMed, EMBASE, SCOPUS, PsycINFO, the Cochrane Library and PROSPERO register. Grey literature and social media were searched, and article reference lists reviewed. Included studies were in English with UK populations from 1998 onwards, with no patient age restriction. Title and abstract screening and full-text review was performed by two independent reviewers (with a third member to resolve disagreement). Risk of bias was assessed using the JBI and the MMAT critical appraisal checklists. A narrative synthesis of the findings was performed using thematic analysis. Results A total of 1,598 sources were identified from databases. After screening, 53 studies were selected for data extraction. The data was categorised into accidental, intentional and mixed reports of overdoses. Paracetamol utilised in overdose was obtained from…
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