Division of Pediatric Emergency Medicine, Children's National Hospital, Washington, DC; George Washington University School of Medicine, Washington, DC; Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelmen School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Division of Pediatric Emergency Medicine, Children's National Hospital, Washington, DC; George Washington University School of Medicine, Washington, DC.
J Emerg Med. 2022 Jun;62(6):775-782. doi: 10.1016/j.jemermed.2022.01.002. Epub 2022 Mar 29.
Little is known about prescription filling of pain medicine for children. In adult populations, race and insurance type are associated with differences in opioid prescription fill rate. We hypothesize that known disparities in pain management for children are exacerbated by the differential rates of opioid prescription filling between patients based on age and race.
To determine if there are demographic or clinical factors associated with differences in opioid prescription fill rates after discharge from the pediatric emergency department (ED).
This was a retrospective cross-sectional study of all patients younger than 19 years discharged with an opioid prescription from either of two pediatric EDs in 2018. We performed multivariable logistic regression to measure associations between prescription filling and demographic and clinical factors.
There were 287 patient visits in which opioids were prescribed. Forty percent of prescriptions were filled. The majority of patients were male (53%), black (69%), and had public insurance (55%). There were no significant associations between prescription filling and age, insurance status, or race/ethnicity. Patients with sickle cell disease were more likely to fill prescriptions (odds ratio 3.87, 95% confidence interval 2.33-6.43) and patients without an identified primary care provider were less likely to fill prescriptions (odds ratio 0.16, 95% confidence interval 0.03-0.84).
Less than half of opioid prescriptions prescribed at discharge from a pediatric emergency department are filled. Patient age, insurance status, and race/ethnicity are not associated with opioid prescription filling. Patients with sickle cell disease and those with a primary care provider are more likely to fill their opioid prescriptions.
对于儿童的疼痛药物处方配药情况知之甚少。在成年人群中，种族和保险类型与阿片类药物处方配药率的差异相关。我们假设，基于年龄和种族，儿童疼痛管理方面的已知差异会因患者之间阿片类药物处方配药率的差异而加剧。
确定在儿科急诊部门 (ED) 出院后，是否存在与阿片类药物处方配药率差异相关的人口统计学或临床因素。
这是一项回顾性横断面研究，纳入了 2018 年从两个儿科 ED 出院并开具阿片类药物处方的所有年龄小于 19 岁的患者。我们进行了多变量逻辑回归，以测量处方配药与人口统计学和临床因素之间的关联。
共有 287 例患者就诊时开具了阿片类药物处方。40%的处方被配药。大多数患者为男性 (53%)、黑人 (69%) 和拥有公共保险 (55%)。处方配药与年龄、保险状况或种族/族裔之间无显著关联。患有镰状细胞病的患者更有可能配药 (优势比 3.87，95%置信区间 2.33-6.43)，而没有确定的初级保健提供者的患者更不可能配药 (优势比 0.16，95%置信区间 0.03-0.84)。
从儿科急诊部门出院时开具的阿片类药物处方中，不到一半的处方被配药。患者年龄、保险状况和种族/族裔与阿片类药物处方配药无关。患有镰状细胞病和有初级保健提供者的患者更有可能配药。
