Department of Pediatrics, College of Medicine, The Medical University of South Carolina, Charleston, SC 29425, USA.
Department of Clinical Pharmacy and Outcome Sciences, College of Pharmacy, The Medical University of South Carolina, Charleston, SC 29425, USA.
Int J Environ Res Public Health. 2023 Apr 28;20(9):5681. doi: 10.3390/ijerph20095681.
Understanding patterns of opioid receipt by children and adolescents over time and understanding differences between age groups can help identify opportunities for future opioid stewardship. We conducted a retrospective cohort study, using South Carolina Medicaid data for children and adolescents 0-18 years old between 2000-2020, calculating the annual prevalence of opioid receipt for medical diagnoses in ambulatory settings. We examined differences in prevalence by calendar year, race/ethnicity, and by age group. The annual prevalence of opioid receipt for medical diagnoses changed significantly over the years studied, from 187.5 per 1000 in 2000 to 41.9 per 1000 in 2020 (Cochran-Armitage test for trend, < 0.0001). In all calendar years, older ages were associated with greater prevalence of opioid receipt. Adjusted analyses (logistic regression) assessed calendar year differences in opioid receipt, controlling for age group, sex, and race/ethnicity. In the adjusted analyses, calendar year was inversely associated with opioid receipt (aOR 0.927, 95% CI 0.926-0.927). Males and older ages were more likely to receive opioids, while persons of Black race and Hispanic ethnicity had lower odds of receiving opioids. While opioid receipt declined among all age groups during 2000-2020, adolescents 12-18 had persistently higher annual prevalence of opioid receipt when compared to younger age groups.
了解儿童和青少年随时间推移接受阿片类药物的模式，并了解不同年龄组之间的差异，有助于确定未来阿片类药物管理的机会。我们进行了一项回顾性队列研究，使用南卡罗来纳州医疗补助数据，对 2000 年至 2020 年间 0-18 岁的儿童和青少年进行分析，计算出在门诊环境中，每一种医疗诊断接受阿片类药物的年度患病率。我们研究了按日历年度、种族/民族和年龄组划分的患病率差异。研究期间，每一种医疗诊断接受阿片类药物的年度患病率发生了显著变化，从 2000 年的每 1000 人 187.5 例降至 2020 年的每 1000 人 41.9 例（Cochran-Armitage 趋势检验，<0.0001）。在所有的日历年度中，年龄较大的人群与接受阿片类药物的比例较高有关。调整分析（logistic 回归）评估了在控制年龄组、性别和种族/民族的情况下，接受阿片类药物的日历年度差异。在调整分析中，日历年度与接受阿片类药物呈负相关（aOR 0.927，95%CI 0.926-0.927）。男性和年龄较大的人群更有可能接受阿片类药物，而黑人和西班牙裔的人群接受阿片类药物的可能性较低。虽然 2000-2020 年期间所有年龄组的阿片类药物使用率都有所下降，但与年龄较小的人群相比，12-18 岁的青少年接受阿片类药物的年患病率仍持续较高。
