Department of Pharmaceutical Health Outcomes and Policy (AA Nair, RR Aparasu, M Johnson, and H Chen), College of Pharmacy, University of Houston, Houston, Tex.
Department of Pharmacy (JL Placencia), Texas Children's Hospital, Houston, Tex.
Acad Pediatr. 2024 Jul;24(5):776-782. doi: 10.1016/j.acap.2023.09.020. Epub 2023 Oct 4.
Our study examined the change in repeat opioid analgesic prescription trends in children and adolescents experiencing acute pain between 2013 and 2018.
Eligible individuals were children and adolescents between 1 and 17 years of age enrolled in a Medicaid Managed Care plan and filled an incident opioid analgesic prescription from 2013 to 2018. A repeat opioid prescription was defined as receiving a subsequent opioid prescription within 30 days from the end of the incident opioid prescription. A generalized linear regression analysis was conducted to examine changes in repeat opioid analgesic dispensing over time at quarterly intervals from January 1, 2013, to December 31, 2018.
The cohort comprised 17,086 children and adolescents receiving an incident opioid analgesic. Of these, 1780 (10.4%) filled a repeat opioid analgesic prescription. There was a significant decline in the repeat opioid analgesic trend from 11.5% in Q1 2013 to 9.6% in Q4 2018. Stratified analyses by age, sex, and race and ethnicity in a sub-cohort of patients undergoing surgical procedures showed that a significant decline in repeat opioid utilization over time has been observed in all racial/ethnic groups stratified by age and sex, with the most significant decline found in non-Hispanic White children and Hispanic adolescents. At the end of the 6-year follow-up, the racial and ethnic variations in repeat opioid utilization associated with surgical procedures had significantly reduced in children yet persisted among adolescents.
Approximately 10% of incident pediatric opioid analgesic recipients received a repeat opioid prescription. There has been a moderate but steady decline (∼7% per quarter) in repeat opioid analgesic utilization between 2013 and 2018.
本研究调查了 2013 年至 2018 年期间经历急性疼痛的儿童和青少年重复阿片类镇痛药处方趋势的变化。
合格的个体为 1 至 17 岁的参加医疗补助管理式医疗计划的儿童和青少年，并在 2013 年至 2018 年期间开出了阿片类镇痛药的初始处方。重复开阿片类药物处方的定义是在初始阿片类药物处方结束后 30 天内收到后续阿片类药物处方。从 2013 年 1 月 1 日至 2018 年 12 月 31 日，每季度进行一次广义线性回归分析，以检查 30 天内重复开具阿片类镇痛药的情况随时间的变化。
该队列包括 17086 名接受初始阿片类镇痛药的儿童和青少年。其中，1780 人（10.4%）开出了重复阿片类镇痛药处方。从 2013 年第一季度的 11.5%到 2018 年第四季度的 9.6%，重复阿片类镇痛药的趋势明显下降。在手术患者的亚组中按年龄、性别和种族和民族进行分层分析表明，随着时间的推移，所有按年龄和性别分层的种族/民族群体的重复阿片类药物使用率都出现了显著下降，其中非西班牙裔白人和西班牙裔青少年下降幅度最大。在 6 年的随访结束时，与手术相关的重复使用阿片类药物的种族和民族差异在儿童中显著降低，但在青少年中仍然存在。
大约 10%的儿童阿片类镇痛药初始使用者收到了重复阿片类药物处方。2013 年至 2018 年间，重复阿片类镇痛药的使用量呈中等但稳定下降趋势（每季度约 7%）。
