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.
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 -