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Over-the-counter (OTC) painkillers are among the most commonly used self-medication products in Europe, yet misconceptions about their safety and usage remain widespread. Despite their accessibility, these medications carry real risks-including overdose, organ damage, and dangerous drug interactions-particularly when used without medical supervision. Digital platforms offer a powerful yet underutilized opportunity to educate consumers and reduce misuse. However, little is known about how different digital communication tools are perceived in terms of credibility and influence. This paper explores the effectiveness and perceived reliability of various digital health communication channels in supporting responsible OTC analgesic use. Based on a representative survey of Hungarian adults aged 18-65, the research identifies patterns of painkiller use, digital content exposure, and trust in information sources, with a particular focus on young adults. The findings reveal a strong generational divide in content preference and perceived trustworthiness, with social media dominating younger audiences, and health portals trusted most across all age groups. The results highlight the need for platform-specific, demographically tailored strategies to ensure that digital campaigns effectively promote responsible self-medication.
Abstract: Over-the-counter (OTC) painkillers are among the most commonly used self-medication products in Europe, yet misconceptions about their safety and usage remain widespread. Despite their accessibility, these medications carry real risks-including overdose, organ damage, and dangerous drug interactions-particularly when used without medical supervision. Digital platforms offer a powerful yet underutilized opportunity to educate consumers and reduce misuse. However, little is known about how different digital communication tools are perceived in terms of credibility and influence. This paper explores the effectiveness and perceived reliability of various digital health communication channels in supporting responsible OTC analgesic use. Based on a representative survey of Hungarian adults aged 18-65, the research identifies patterns of painkiller use, digital content exposure, and trust in information sources, with a particular focus on young adults. The findings reveal a strong generational divide in content preference and perceived trustworthiness, with social media dominating younger audiences, and health portals trusted most across all age groups. The results highlight the need for platform-specific, demographically tailored strategies to ensure that digital campaigns effectively promote responsible self-medication.
Keywords: digital marketing, OTC sector, responsible use of medicines, Al-based mobile health apps, age-specific digital strategies
Introduction
In recent decades, the rise of over-the-counter (OTC) medication use has significantly transformed how individuals manage everyday health concerns. Among these, painkillers-particularly non-prescription NSAIDs and paracetamol-are widely consumed due to their accessibility and perceived safety (Wazaify et al., 2005; Zafar et al., 2023). However, this perception often obscures real medical risks. Consumers may unintentionally combine multiple products containing the same active ingredient or misuse administration instructions, leading to liver or kidney damage, overdose, or harmful interactions with prescription drugs (Spanou et al., 2015; Yusuff et al., 2021).
OTC painkillers are marketed under various brand names and indications-such as headache, fever, or flu relief-which increases the risk of duplicate use without user awareness. Low health literacy and poor awareness of drug administration timing, contraindications, and dietary interactions further amplify these issues (Schulz et al., 2019; Hughes et al., 2021). Research indicates that even among healthcare students and professionals, understanding of proper OTC use is often inadequate (Aghababaci et al., 2023; Alharthy et al., 2023).
Young adults are especially frequent users of OTC analgesics and increasingly turn to digital content for health information. Social media platforms-such as Instagram, TikTok, and Facebook-play a major role in shaping perceptions, despite concerns about content credibility and misinformation (Schulz ct al., 2019; Hughes ct al., 2021). While health portals remain trusted across most age groups, trust in user-generated social media content is notably higher among those with lower education levels (Koch et al., 2022).
This duality presents a critical challenge. On the one hand, digital media can amplify unsafe practices; on the other, they offer a scalable means of disseminating health education. Yet, there is a lack of empirical data regarding how digital platforms are perceived as health communication tools and whether they meaningfully support responsible self-medication. This study addresses that gap by examining how Hungarian adults evaluate the trustworthiness and usefulness of digital content related to OTC painkiller use, with a special focus on younger populations. The findings are intended to guide public health professionals and pharmaceutical marketers in crafting targeted, platform-appropriate health education strategies.
Research objectives
This study aims to investigate how digital marketing can be leveraged to promote more responsible self-medication practices among young adults in the context of over-the-counter (OTC) analgesic use. The specific goals of the research are to:
* Evaluate how young adults perceive the credibility and educational impact of digital marketing messages related to health.
* Analyze the links between demographic attributes, patterns of analgesic use, and trust in digital health communications.
* Generate practical recommendations for designing targeted digital health education initiatives tailored to the needs of younger audiences.
Data and Methods
This research set out to explore how people in Hungary make health-related decisions, particularly how they relate to digital health solutions such as mobile applications and AI-powered tools. We also aimed to understand broader consumer health behaviors and attitudes toward innovation in this context.
The study was conducted in April 2025, using an online questionnaire as part of a cross-sectional, quantitative research design. Data collection was managed by Inspira Research Ltd., an independent market research company, through their online panel. Participants were recruited via email, and everyone was informed in advance about the study's purpose, how their data would be handled, and the voluntary nature of participation. All responses were submitted anonymously, and respondents could leave the questionnaire at any point. Full compliance with GDPR and ethical data handling protocols was ensured by the research provider. Only fully completed responses were included in the final dataset. On average, completing the questionnaire took around 20 to 25 minutes.
Sample and Sampling
A total of 1,000 adult respondents participated in the survey. To ensure representativeness, a quota sampling technique was applied based on gender, age, region, and settlement type, using national census data from the Hungarian Central Statistical Office (KSH, 2011). The sample reflects the adult Hungarian population aged 18-65. No additional inclusion or exclusion criteria were applied beyond being a resident of Hungary within this age range.
Questionnaire Structure
The structured questionnaire consisted of six thematic blocks. This paper primarily focuses on the fifth block, which looked at how digital marketing influences consumer behavior related to over-the-counter (OTC) pain relief products-particularly in a health education context. However, insights from the other five modules were also incorporated into the interpretation.
These modules included:
* Screening and demographic information (e.g., residence, age, gender, education, family and income status)
* Familiarity with and user experiences related to the Semmelweis Help symptom checker app
* General attitudes toward sustainability and innovation in various sectors
* Innovation readiness, interest in technology, and willingness to pay more for innovative solutions
* Digital marketing's impact on OTC painkiller choices and decision-making
* Broader health-related consumer expectations, purchasing habits, and price sensitivity in healthcare spendings (medicines and private healthcare services)
The survey featured a mix of closed (single and multiple choice), scaled (Likert-type), and a few open-ended questions, enabling both quantitative and limited qualitative insights.
Statistical Analysis
Data were processed using both descriptive and inferential statistical methods. Participants were grouped based on socio-demographic variables, self-reported health status (e.g., chronic conditions), and their role in health-related decision-making. Cross-tabulation was applied to examine subgroup differences, with significance testing conducted via chi-square analysis. Fisher's exact test was used where cell counts were low (n<5). ANO YA was used to identify statistically significant differences between group means.
A particular focus was placed on identifying how different demographic groups perceive the credibility, relevance, and trustworthiness of various digital health information sources (e.g., health portals, social media, online ads). Differences in awareness and usage of digital health apps were also assessed by subgroup. Data analysis was performed using SPSS, and only valid, complete responses were included in each variable-level analysis.
Results
The findings reveal widespread pain experience and diverse analgesic use patterns across the Hungarian adult population. In the past six months, 92% of individuals aged 18-65 reported experiencing at least one type of physical pain. Notably, women were significantly more likely to report such experiences than men. On average, respondents experienced 3.14 different types of pain, with younger adults (18-29) reporting the highest average (3.43 types), primarily headaches, migraines, and menstrual pain. In contrast, respondents over 60 reported fewer pain types (2.65 on average), dominated by musculoskeletal complaints such as back and joint pain.
Table 1 illustrates the average number of pain types reported by respondents in each age group, along with the most commonly mentioned pain categories. The data confirms that younger adults tend to report more diverse pain experiences than older respondents.
The majority of respondents (79%) reported using some form of analgesic during this period. Over-the-counter (OTC) medications were the most commonly used, especially among younger cohorts: 62% of 18-29-year-olds used OTC tablets or capsules, while 12-24% opted for granules. Interestingly, 31% of those using OTC drugs also used prescription analgesics, highlighting a substantial degree of cross-use. Women were significantly more likely to use prescription options, while men were underrepresented in this category.
To better understand gender-specific patterns in pain management, Table 2 summarizes the reported use of OTC and prescription analgesics by male and female respondents.
The data confirms that women are more likely to use both OTC and prescription drugs, and are overrepresented in combined usage patterns, as also reflected in international studies.
Regarding health information behavior, only one-third of respondents could not recall encountering pain-related digital content. Among those who did, the most frequently mentioned platforms were Facebook (ads, feed posts, and reels), health portals, and blogs. Table 3 summarizes the most commonly recalled sources of online content related to OTC pain relievers. The responses reflect a strong presence of social media in health-related messaging, particularly on Facebook.
Notably, Facebook and thematic health portals dominate, while platforms like Instagram and TikTok were more frequently mentioned by younger respondents and in urban regions. Regionally, Budapest residents and 18-24-year-old respondents were more likely to recall content from Instagram and TikTok. These results suggest strong generational and geographic segmentation in digital health content exposure.
Crucially, individuals with lower educational attainment showed greater trust in social media-based health advice-including Facebook, TikTok, and blogs, forums-whereas thematic health portals were deemed the most reliable across the broader population.
Table 4 provides a quantitative breakdown of these trust dynamics across different education levels, reinforcing the need for education-sensitive health communication strategies.
This divide underscores the importance of audience-specific digital strategies. These findings align with international literature on public misperceptions of OTC drug safety and digital health misinformation (Weiler et al., 2021; Wazaify et ah, 2005; Zafar et al., 2023).
Discussion
The present results confirm that pain is a near-universal experience and that self-medication with OTC analgesics is a widely adopted behavior in Hungary. These findings are consistent with international data showing increasing global reliance on OTC medications, often accompanied by limited knowledge about their proper use (Yusuff et al., 2021; Alkhatatbeh et al., 2016). Young adults, in particular, report high levels of pain and frequent use of OTC drugs but show greater reliance on social media platforms for health-related information, a trend observed in multiple global studies (Hughes et al., 2021; Mullan et al., 2019).
A notable risk highlighted in the survey is the unintentional consumption of duplicate active ingredients under different brand names. This finding parallels research in other countries where paracetamol-related toxicity is rising due to a lack of awareness about ingredient duplication (Spanou et al., 2015; Hensrud et ak, 2023). This indicates a need for clearer drug labeling and improved public education.
The data also reflect a troubling knowledge gap regarding administration timing, potential interactions with prescription drugs, and contraindications-especially among individuals with chronic conditions. These issues are amplified by the fact that many individuals turn to less reliable sources for health advice. As highlighted in the literature, reliance on user-generated content without medical oversight may lead to misinformed and potentially harmful practices (Schulz et al., 2019).
However, the high exposure to health-related content on platforms like Facebook, Instagram, and TikTok-especially among younger adults-suggests an untapped opportunity. When appropriately designed, digital marketing campaigns can become credible vehicles for health education. International best practices support this, showing that hybrid content (clinically informed, yet digitally native) can positively influence health behaviors.
From a public health strategy standpoint, this implies that effective interventions must align educational credibility with platform relevance. For example, reels and short-form video content can be used to deliver safety warnings about OTC misuse, particularly targeting populations who view social media as trustworthy. Meanwhile, thematic health portals can serve as anchors for credibility and further information, catering to more health-literate or cautious segments of the population.
Ultimately, this study reinforces the notion that digital literacy and health literacy must go hand in hand in the digital age. Developing cross-sector strategies that involve public health bodies, pharmaceutical marketers, and educational institutions could be key to supporting informed and responsible self-medication practices in the OTC sector.
International Context and Supporting Evidence
Further international research supports our findings regarding misconceptions and misuse of OTC analgesics. For instance, even among educated groups such as schoolteachers, awareness of proper over-the-counter painkiller usage-specifically regarding ibuprofen-has been found to be insufficient, suggesting that health literacy challenges span beyond general consumers and include professional cohorts as well (Alharthy et al., 2023). Similarly, patients purchasing analgesic-antipyretic medications from community pharmacies have demonstrated significant gaps in understanding dosage, indications, and potential side effects, underscoring the need for more comprehensive pharmacist-patient education (Vazquez-Alvarez et al., 2015).
In a survey conducted in Germany, primary care patients displayed a wide range of attitudes and behaviors regarding OTC drug usage, influenced by individual, cultural, and systemic factors (Koch et al., 2022). Such variability further reinforces the importance of contextualizing health education strategies and tailoring messages to different population segments. These findings emphasize that responsible self-medication is not only a matter of access, but also of comprehension and trust in health communication.
Conclusion
This study highlights the widespread use of over-the-counter (OTC) analgesics among the Hungarian adult population, particularly among younger age groups. While pain is a nearly universal experience, affecting 92% of the respondents, patterns of medication use and information-seeking behavior vary significantly by age, gender, and education level. Notably, many individuals underestimate the risks associated with OTC painkillers, especially due to the easy availability of these medications and the perception that they are inherently safe.
The results also point to concerning gaps in awareness regarding drug duplication, administration rules, and potential interactions with prescription medications. These issues arc exacerbated by the inconsistent trust placed in digital content: while health portals remain the most credible source, a growing number of younger users rely on social platforms like TikTok and Instagram for health advice.
Altogether, the findings underline the critical role that targeted digital health communication can play in promoting responsible self-medication. By recognizing the diversity in digital behaviors and trust dynamics, healthcare stakeholders and pharmaceutical marketers can design more effective educational interventions that align with users' information preferences and cognitive habits.
Recommendations
In light of the findings, several practical recommendations can be made for public health professionals, pharmaceutical companies, and digital content strategists:
* Create demographic-specific health campaigns, using engaging formats tailored to younger adults (e.g., short-form video, influencer-led reels).
* Address misconceptions around ingredient duplication, dosage intervals, and food-drug interaction through infographics and interactive guides.
* Collaborate with pharmacists to connect digital outreach with real-world counseling, particularly for vulnerable populations.
* Segment messages by trust profiles, recognizing that users with lower education levels are more likely to rely on social media platforms for health information.
* Strengthen visibility of verified medical content on platforms where misinformation is prevalent (e.g., Facebook ads, TikTok).
* Utilize Al-based self-assessment tools, like Semmelweis HELP, to guide symptom-based OTC use safely.
Limitations
This research is subject to several limitations. The data were collected exclusively through an online survey, which may have excluded participants with limited internet access or low digital literacy. Although quota sampling was applied, the representativeness of certain subgroups (e.g., rural or older populations) could be constrained. The study is also based on self-reported data, which is susceptible to recall bias or social desirability effects. Furthermore, the cross-sectional design limits causal inference and captures only a snapshot of behavior and perception. Future studies could employ longitudinal or mixed-method approaches to better understand evolving digital engagement with OTC health content.
Acknowledgement
DSZ received funding from Óbuda University Research Scholarship Programme - Cooperative Doctoral Programme (OE-EKOP-KDP-2024 25 005).
This project [OE-EKOP-KDP-2024 25 005] has been implemented with the support doctoral research work carried out at company-university cooperation - relevant to domestic R&D programs - provided by "Óbuda University Cooperative PhD Student Scholarship Program", from the "Talent Care Fund" of Óbuda University.
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