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Decreased Opioid Prescribing in a Pediatric Emergency Department After the Rescheduling of Hydrocodone.
J Emerg Med. 2017 Apr; 52(4):547-553.JE

Abstract

BACKGROUND

The Drug Enforcement Administration (DEA) changed hydrocodone-containing products (HCPs) from Schedule III to II status on October 6, 2014, making codeine-containing products (CCPs) the only non-Schedule II oral opioid agents.

OBJECTIVES

We sought to describe prescribing patterns of oral opioid agents in the pediatric emergency department before and after the 2014 DEA rescheduling of HCPs.

METHODS

We performed a cross-sectional study evaluating prescribing patterns in the pediatric emergency department at an urban, academic, quaternary care children's hospital system for 6 months before and 6 months after the DEA rescheduling of HCPs. Differences in patient demographics, provider type, and diagnoses were assessed during the two time periods using Pearson's chi-squared test. The Breslow-Day statistic was used to assess differences in prescribing patterns by provider type.

RESULTS

There were 1256 prescriptions for HCPs and CCPs in our pediatric emergency department during the study period, and only 36 prescriptions for alternate oral opioid medications. Prescriptions of all opioid pain medications decreased by 55% after rescheduling. The odds of prescribing HCPs were reduced by 60% after the DEA rescheduling (odds ratio 0.40 [95% confidence interval {CI} 0.30-0.54]; p < 0.001). There was no difference between monthly ordering frequencies for CCPs before or after the DEA rescheduling (p = 0.75).

CONCLUSIONS

The period after rescheduling of HCPs was associated with a lower odds of HCP prescriptions in our emergency department without an increase in the prescription of CCPs.

Authors+Show Affiliations

Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Houston, Texas.Department of Pediatrics, Baylor College of Medicine, Houston, Texas.Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Houston, Texas.Department of Pharmacy, Texas Children's Hospital, Houston, Texas.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27727038

Citation

Chumpitazi, Corrie E., et al. "Decreased Opioid Prescribing in a Pediatric Emergency Department After the Rescheduling of Hydrocodone." The Journal of Emergency Medicine, vol. 52, no. 4, 2017, pp. 547-553.
Chumpitazi CE, Rees CA, Camp EA, et al. Decreased Opioid Prescribing in a Pediatric Emergency Department After the Rescheduling of Hydrocodone. J Emerg Med. 2017;52(4):547-553.
Chumpitazi, C. E., Rees, C. A., Camp, E. A., & Bernhardt, M. B. (2017). Decreased Opioid Prescribing in a Pediatric Emergency Department After the Rescheduling of Hydrocodone. The Journal of Emergency Medicine, 52(4), 547-553. https://doi.org/10.1016/j.jemermed.2016.08.026
Chumpitazi CE, et al. Decreased Opioid Prescribing in a Pediatric Emergency Department After the Rescheduling of Hydrocodone. J Emerg Med. 2017;52(4):547-553. PubMed PMID: 27727038.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decreased Opioid Prescribing in a Pediatric Emergency Department After the Rescheduling of Hydrocodone. AU - Chumpitazi,Corrie E, AU - Rees,Chris A, AU - Camp,Elizabeth A, AU - Bernhardt,M Brooke, Y1 - 2016/10/07/ PY - 2016/06/20/received PY - 2016/08/14/revised PY - 2016/08/22/accepted PY - 2016/10/12/pubmed PY - 2017/11/29/medline PY - 2016/10/12/entrez KW - DEA rescheduling KW - codeine KW - emergency department KW - hydrocodone KW - pediatric SP - 547 EP - 553 JF - The Journal of emergency medicine JO - J Emerg Med VL - 52 IS - 4 N2 - BACKGROUND: The Drug Enforcement Administration (DEA) changed hydrocodone-containing products (HCPs) from Schedule III to II status on October 6, 2014, making codeine-containing products (CCPs) the only non-Schedule II oral opioid agents. OBJECTIVES: We sought to describe prescribing patterns of oral opioid agents in the pediatric emergency department before and after the 2014 DEA rescheduling of HCPs. METHODS: We performed a cross-sectional study evaluating prescribing patterns in the pediatric emergency department at an urban, academic, quaternary care children's hospital system for 6 months before and 6 months after the DEA rescheduling of HCPs. Differences in patient demographics, provider type, and diagnoses were assessed during the two time periods using Pearson's chi-squared test. The Breslow-Day statistic was used to assess differences in prescribing patterns by provider type. RESULTS: There were 1256 prescriptions for HCPs and CCPs in our pediatric emergency department during the study period, and only 36 prescriptions for alternate oral opioid medications. Prescriptions of all opioid pain medications decreased by 55% after rescheduling. The odds of prescribing HCPs were reduced by 60% after the DEA rescheduling (odds ratio 0.40 [95% confidence interval {CI} 0.30-0.54]; p < 0.001). There was no difference between monthly ordering frequencies for CCPs before or after the DEA rescheduling (p = 0.75). CONCLUSIONS: The period after rescheduling of HCPs was associated with a lower odds of HCP prescriptions in our emergency department without an increase in the prescription of CCPs. SN - 0736-4679 UR - https://www.unboundmedicine.com/medline/citation/27727038/Decreased_Opioid_Prescribing_in_a_Pediatric_Emergency_Department_After_the_Rescheduling_of_Hydrocodone_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0736-4679(16)30685-0 DB - PRIME DP - Unbound Medicine ER -