Opioid prescription patterns in a children's hospital from 2012 to 2016

Nicole Titze; Rishi Bhargava; Ara Jamasbi Montalvo; Gawon Shin; Campbell Belisle Haley; Soheil Saadat; Bharath Chakravarthy

doi:10.5055/jom.0833

Authors

Nicole Titze, MD
Rishi Bhargava, MD
Ara Jamasbi Montalvo, MD
Gawon Shin, BA https://orcid.org/0000-0001-9888-9853
Campbell Belisle Haley, MD
Soheil Saadat, MD, MPH, PhD
Bharath Chakravarthy, MD, MPH

DOI:

https://doi.org/10.5055/jom.0833

Keywords:

pediatrics, opioids, pain management, pain medication

Abstract

Study objective: Pain management is a widely discussed topic, especially in the setting of the current opioid epidemic. Previous studies have shown that the use of opioids increased in the adult population. We aimed to look at the use of narcotic and non-narcotic pain medications at a large pediatric hospital to discern if patterns of pediatric pain management changed over time.

Methods: 58,402 analgesic prescriptions of patients 0-21 years of age were analyzed from May 2012 to November 2016. A logistic regression model was fitted to examine the association of age, sex, primary diagnosis, and the length of hospital stay with probability of opioid prescription.

Results: 36,560 patients aged 0-21 years (mean: 10.5, median: 11.0, and standard deviation (SD): 7.42) received analgesic pain medications. 21,847 (59.8 percent) patients were prescribed more than one analgesic. There was a male predominance in patients <15 years of age; however, in adolescents >16 years, females constituted 57.1 percent of patients. Data also showed a statistically significant reduction of opioid prescriptions from 2012 to 2016 (p < 0.001). Age and length of hospital stay were directly associated with opioid prescription (p < 0.001).

Conclusion: Data show that there is a decrease in overall opioid prescriptions among pediatric patients, which may be secondary to new Food and Drug Administration regulations and increased awareness of morbidity associated with opioid use. Not surprisingly, increased hospital stay and increase in age lead to more analgesic prescriptions. Further investigation is needed to determine the differences within opioid prescription patterns.

Author Biographies

Nicole Titze, MD

Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrence, California

Rishi Bhargava, MD

Department of Emergency Medicine, Miller Children’s & Women’s Hospital, Long Beach, California

Ara Jamasbi Montalvo, MD

Department of Emergency Medicine, Golisano Children’s Hospital, Rochester, New York

Gawon Shin, BA

University of California Irvine, School of Medicine, Irvine, California

Campbell Belisle Haley, MD

Department of Emergency Medicine, University of California Irvine, Irvine, California

Soheil Saadat, MD, MPH, PhD

Department of Emergency Medicine, University of California Irvine, Irvine, California

Bharath Chakravarthy, MD, MPH

Department of Emergency Medicine, University of California Irvine, Irvine, California

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