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Prescription Opioid Use in General and Pediatric Emergency Departments.
Pediatrics. 2019 11; 144(5)Ped

Abstract

BACKGROUND AND OBJECTIVES

Recent evidence reveals that exposure to emergency department (ED) opioids is associated with a higher risk of misuse. Pediatric EDs are generally thought to provide the highest-quality care for young persons, but most children are treated in general EDs. We sought to determine if ED opioid administration and prescribing vary between pediatric and general EDs.

METHODS

We analyzed the National Hospital Ambulatory Medical Care Survey (2006-2015), a representative survey of ED visits, by using multivariate logistic regressions. Outcomes of interest were the proportion of patients ≤25 years of age who (1) were administered an opioid in the ED, (2) were given a prescription for an opioid, or (3) were given a prescription for a nonopioid analgesic. The key predictor variable was ED type. A secondary analysis was conducted on the subpopulation of patients with a diagnosis of fracture or dislocation.

RESULTS

Of patients ≤25 years of age, 91.1% were treated in general EDs. The odds of being administered an opioid in the ED were similar in pediatric versus general EDs (adjusted odds ratio [OR] 0.88; 95% confidence interval [CI] 0.61-1.27; P = .49). Patients seen in pediatric EDs were less likely to receive an outpatient prescription for opioids (adjusted OR 0.38; 95% CI 0.27-0.52; P < .01) than similar patients in general EDs. This was true for the fracture subset as well (adjusted OR 0.27; 95% CI 0.13-0.54; P < .01).

CONCLUSIONS

Although children, adolescents, and young adults had similar odds of being administered opioids while in the ED, they were much less likely to receive an opioid prescription from a pediatric ED compared with a general ED.

Authors+Show Affiliations

Keck School of Medicine, University of Southern California and LAC + USC Medical Center, Los Angeles, California menchine@usc.edu.Keck School of Medicine, University of Southern California and LAC + USC Medical Center, Los Angeles, California.Keck School of Medicine, University of Southern California and LAC + USC Medical Center, Los Angeles, California.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31619511

Citation

Menchine, Michael, et al. "Prescription Opioid Use in General and Pediatric Emergency Departments." Pediatrics, vol. 144, no. 5, 2019.
Menchine M, Lam CN, Arora S. Prescription Opioid Use in General and Pediatric Emergency Departments. Pediatrics. 2019;144(5).
Menchine, M., Lam, C. N., & Arora, S. (2019). Prescription Opioid Use in General and Pediatric Emergency Departments. Pediatrics, 144(5). https://doi.org/10.1542/peds.2019-0302
Menchine M, Lam CN, Arora S. Prescription Opioid Use in General and Pediatric Emergency Departments. Pediatrics. 2019;144(5) PubMed PMID: 31619511.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prescription Opioid Use in General and Pediatric Emergency Departments. AU - Menchine,Michael, AU - Lam,Chun Nok, AU - Arora,Sanjay, Y1 - 2019/10/16/ PY - 2019/08/21/accepted PY - 2019/10/18/pubmed PY - 2020/2/14/medline PY - 2019/10/18/entrez JF - Pediatrics JO - Pediatrics VL - 144 IS - 5 N2 - BACKGROUND AND OBJECTIVES: Recent evidence reveals that exposure to emergency department (ED) opioids is associated with a higher risk of misuse. Pediatric EDs are generally thought to provide the highest-quality care for young persons, but most children are treated in general EDs. We sought to determine if ED opioid administration and prescribing vary between pediatric and general EDs. METHODS: We analyzed the National Hospital Ambulatory Medical Care Survey (2006-2015), a representative survey of ED visits, by using multivariate logistic regressions. Outcomes of interest were the proportion of patients ≤25 years of age who (1) were administered an opioid in the ED, (2) were given a prescription for an opioid, or (3) were given a prescription for a nonopioid analgesic. The key predictor variable was ED type. A secondary analysis was conducted on the subpopulation of patients with a diagnosis of fracture or dislocation. RESULTS: Of patients ≤25 years of age, 91.1% were treated in general EDs. The odds of being administered an opioid in the ED were similar in pediatric versus general EDs (adjusted odds ratio [OR] 0.88; 95% confidence interval [CI] 0.61-1.27; P = .49). Patients seen in pediatric EDs were less likely to receive an outpatient prescription for opioids (adjusted OR 0.38; 95% CI 0.27-0.52; P < .01) than similar patients in general EDs. This was true for the fracture subset as well (adjusted OR 0.27; 95% CI 0.13-0.54; P < .01). CONCLUSIONS: Although children, adolescents, and young adults had similar odds of being administered opioids while in the ED, they were much less likely to receive an opioid prescription from a pediatric ED compared with a general ED. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/31619511/Prescription_Opioid_Use_in_General_and_Pediatric_Emergency_Departments_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=31619511 DB - PRIME DP - Unbound Medicine ER -