Pielech Melissa, Kruger Eric, Portis Samantha M, Wilson Khirsten J, Rivers W Evan, Vowles Kevin E
Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02903, USA.
Children (Basel). 2024 Nov 8;11(11):1356. doi: 10.3390/children11111356.
BACKGROUND/OBJECTIVES: Prescription opioid use before adulthood is typically effective for acute pain control and is also associated with adverse short- and long-term consequences.
This study examined pediatric opioid prescribing trends over time across different age groups (early childhood, school age, adolescence, young adult) and sociodemographic subgroups (sex, ethnicity, race, language, payer type) from 2005 to 2016.
Utilizing 42,020 first outpatient opioid prescriptions for youth aged 0-21 years from a large US children's hospital, this research found notable trends and disparities. Prescription rates increased by 35% from 2005-2007 to 2008-2010, then decreased by 14% from 2008-2010 to 2011-2013, and decreased again by 22% from 2011-2013 to 2014-2016. Chi-squared tests indicated significant changes in prescription rates across all sociodemographic subgroups, though only age group, ethnicity, and payer type (i.e., the party responsible for payment for hospital services) had changes with non-negligible effect sizes (Cramer's V). Specifically, age group showed small to medium effects (V = 0.16), while ethnicity and payer demonstrated small effects (V = 0.10 each). This study highlights variations in opioid prescribing trends, particularly among different age groups, ethnicities, and payer statuses up to 2016.
These findings reveal differing trends in pediatric opioid prescribing during the peak of the opioid epidemic, highlighting the importance of considering age and sociodemographic variables for understanding prescribing patterns fully and raising potential concerns about inequities in pain management. Future studies should explore similar trends from 2016 onward.
背景/目的：成年前使用处方阿片类药物通常对急性疼痛控制有效，但也与短期和长期不良后果相关。
本研究调查了2005年至2016年不同年龄组（幼儿期、学龄期、青春期、青年期）和社会人口统计学亚组（性别、种族、民族、语言、付款方类型）随时间变化的儿科阿片类药物处方趋势。
利用一家大型美国儿童医院42,020份0至21岁青少年的首次门诊阿片类药物处方，本研究发现了显著的趋势和差异。处方率从2005 - 2007年到2008 - 2010年增加了35%，然后从2008 - 2010年到2011 - 2013年下降了14%，从2011 - 2013年到2014 - 2016年又下降了22%。卡方检验表明，所有社会人口统计学亚组的处方率都有显著变化，不过只有年龄组、种族和付款方类型（即负责支付医院服务费用的一方）的变化具有不可忽视的效应量（克莱默V系数）。具体而言，年龄组显示出小到中等的效应（V = 0.16），而种族和付款方显示出较小的效应（各V = 0.10）。本研究突出了阿片类药物处方趋势的差异，特别是在2016年前不同年龄组、种族和付款方状态之间的差异。
这些发现揭示了阿片类药物流行高峰期儿科阿片类药物处方的不同趋势，强调了考虑年龄和社会人口统计学变量对于全面理解处方模式以及引发对疼痛管理不平等的潜在担忧的重要性。未来的研究应探索2016年以后的类似趋势。
