Opioid Prescribing Practices in Pediatric Acute Care Settings.
Document Type
Article
Publication Date
1-2019
Identifier
DOI: 10.1097/PEC.0000000000001239
Abstract
OBJECTIVES: Deaths due to prescription opioid overdoses are at record-high levels. Limiting the amount of opioid prescribed has been suggested as a prevention strategy. The purpose of this study was to describe the opioid prescribing practices in the emergency departments and urgent care sites of a Midwestern tertiary care children's hospital system.
METHODS: This retrospective medical record review examined the visits from the 2 pediatric emergency departments and 2 pediatric urgent care sites in the system from June 1, 2012, to May 31, 2013, during which an outpatient opioid prescription was written. The primary outcome was number of days of opioid prescribed. Other data collected included patient demographics, diagnosis, and prescriber information; factors associated with prescriptions written for more than 5 days were identified.
RESULTS: A total of 4075 opioid prescriptions were included in the 1-year study period, and 3991 of these had complete data for analysis. The median amount prescribed was 3.3 days with an interquartile range of 2.5 days. Odds of receiving a prescription of more than 5 days' duration were higher for children younger than 1 year (odds ratio [OR], 12.3; 95% confidence interval [CI], 7.3-21.0), 1 to 4 years of age (OR, 7.7; 95% CI, 5.5-10.8), and 5 to 9 years of age (OR, 2.4; 95% CI, 1.7-3.4); for children with noninjury diagnoses (OR, 1.4; 95% CI, 1.2-1.7); or if prescribed by a resident physician (OR, 1.4; 95% CI, 1.1-1.8) or from the urgent care (OR, 1.4; 95% CI, 1.1-1.7).
CONCLUSIONS: Opioid prescriptions of more than 5 days were more frequently prescribed for younger patients, noninjury diagnoses, or if prescribed by a resident physician or from the urgent care. We need to focus on medical student, resident, and provider education as well as further opioid research in order to decrease unnecessary prescribing.
Journal Title
Pediatric emergency care
Volume
35
Issue
1
First Page
16
Last Page
21
MeSH Keywords
Adolescent; Ambulatory Care Facilities; Analgesics, Opioid; Child; Child, Preschool; Drug Prescriptions; Emergency Service, Hospital; Female; Hospitals, Pediatric; Humans; Infant; Male; Practice Patterns, Physicians'; Retrospective Studies
Keywords
Adolescent; Ambulatory Care Facilities; Analgesics, Opioid; Child; Child, Preschool; Drug Prescriptions; Emergency Service, Hospital; Female; Hospitals, Pediatric; Humans; Infant; Male; Practice Patterns, Physicians'; Retrospective Studies
Recommended Citation
DePhillips M, Watts J, Lowry J, Dowd MD. Opioid Prescribing Practices in Pediatric Acute Care Settings. Pediatr Emerg Care. 2019;35(1):16-21. doi:10.1097/PEC.0000000000001239
COinS
