Nair Abhishek A, Placencia Jennifer L, Farber Harold J, Aparasu Rajender R, Johnson Michael, Chen Hua
Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston (AA Nair, RJ Aparasu, M Johnson, and H Chen), Houston, Tex.
Department of Pharmacy, Texas Children's Hospital (JL Placencia), Houston, Tex.
Acad Pediatr. 2023 Mar;23(2):416-424. doi: 10.1016/j.acap.2022.06.006. Epub 2022 Jul 18.
Our study evaluated the association between initial opioid prescription duration and receipt of a repeat opioid prescription in children.
Eligible individuals were children between 1 and 17 years of age who enrolled in a Medicaid Managed Care plan and filled an incident opioid prescription during 2013 to 2018. An incident prescription was defined as receipt of an opioid analgesic without a prior use for 12 months. A repeat opioid prescription was defined as receipt of a subsequent opioid prescription within 30 days since the end of incident opioid prescription. A hierarchical multivariable logistic regression model was fitted to test the association between incident opioid prescription duration and the likelihood of receiving a repeat prescription.
The cohort consisted of 17,086 children receiving an incident opioid prescription in which 6272 (36.7%) received 1 to 3 days' supply, 8442 (49.4%) received 4 to 7 days' supply, 1434 (8.4%) received 8 to 10 days' supply, and 938 (5.5%) received >10 days' supply. Of these incident opioid recipients, 1780 (10.4%) filled a repeat opioid prescription. The multilevel model results indicated that, children receiving 4 to 7 days' supply (adjusted odds ratio [aOR]: 0.98 {0.9-1.1}), 8 to 10 days' supply (aOR: 1.03 [0.8-1.3]), and >10 days' supply (aOR: 0.85 [0.7-1.1]) had comparable likelihoods of receiving a repeat prescription as those receiving 1 to 3 days' supply.
Nearly 10% of children who filled an opioid prescription for acute pain received a repeat prescription. Initial prescription duration was not associated with the risk of receiving a repeat prescription.
我们的研究评估了儿童初始阿片类药物处方时长与重复开具阿片类药物处方之间的关联。
符合条件的个体为1至17岁参加医疗补助管理式医疗计划并在2013年至2018年期间开具过阿片类药物初始处方的儿童。初始处方定义为在过去12个月内未使用过阿片类药物镇痛剂后首次开具该药物。重复阿片类药物处方定义为在初始阿片类药物处方结束后30天内再次开具阿片类药物处方。采用分层多变量逻辑回归模型来检验初始阿片类药物处方时长与重复开具处方可能性之间的关联。
该队列包括17086名开具过阿片类药物初始处方的儿童，其中6272名（36.7%）获得了1至3天的供应量，8442名（49.4%）获得了4至7天的供应量，1434名（8.4%）获得了8至10天的供应量，938名（5.5%）获得了超过10天的供应量。在这些开具过初始阿片类药物处方的儿童中，1780名（10.4%）再次开具了阿片类药物处方。多水平模型结果表明，获得4至7天供应量（调整优势比[aOR]：0.98{0.9 - 1.1}）、8至10天供应量（aOR：1.03[0.8 - 1.3]）以及超过10天供应量（aOR：0.85[0.7 - 1.1]）的儿童与获得1至3天供应量的儿童相比，再次开具处方的可能性相当。
因急性疼痛开具阿片类药物处方的儿童中，近10%的儿童再次开具了处方。初始处方时长与再次开具处方的风险无关。
