Opioid prescribing patterns in emergency departments and future opioid use in adolescent patients.

Autor: Van Winkle PJ; Kaiser Permanente, Orange County, 3440 La Palma Ave, Anaheim, CA 92806, United States. Electronic address: patrick.j.vanwinkle@kp.org., Ghobadi A; Kaiser Permanente, Orange County, 3440 La Palma Ave, Anaheim, CA 92806, United States; Kaiser Permanente School of Medicine, Department of Clinical Science, 100 South Los Robles Ave, Pasadena, CA 91101, United States. Electronic address: ali.x.ghobadi@kp.org., Chen Q; Southern California Permanente Medical Group, 100 South Los Robles Ave, Pasadena, CA 91101, United States. Electronic address: Qiaoling.chen@kp.org., Menchine M; University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, United States., Sharp AL; Kaiser Permanente, Los Angeles, 4867 Sunset Blvd, Los Angeles, CA 90027, United States. Electronic address: Adam.l.sharp@kp.org.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2020 Nov; Vol. 38 (11), pp. 2297-2302. Date of Electronic Publication: 2019 Nov 18.
DOI: 10.1016/j.ajem.2019.10.020
Abstrakt: Objective: Evidence suggests that exposure to opioids in adolescence increases risk of future opioid use. We evaluate if exposure to high versus low intensity opioid prescribers in the Emergency Department (ED) influences the risk of future opioid use in adolescents.
Methods: Retrospective study of opioid-naïve patients 10 to 17 years seen in one of 14 EDs between January 2013 and December 2014. We categorized ED providers into quartiles according to the proportion of encounters resulting in opioid prescriptions. Primary outcome was use of opioids in the subsequent 12 months. Analysis adjusted for patient characteristics and compared future use of opioids for patients seen by the lowest versus the highest prescribing quartiles.
Results: We included 9,688 patient encounters evaluated by the lowest opioid prescribing physician quartile versus 9,467 in the highest. The highest quartile gave opioid prescriptions to 14.9% of their patients compared to 2.8% for the lowest quartile. No association with future opioid use was found for patients evaluated by low versus high prescriber quartiles (OR 0.99, 95% CI 0.90-1.08). Patients with increasing age (OR 2.15, 95% CI 1.92-2.42) and white versus Hispanic ethnicity (OR 1.55, 95% CI 1.33-1.80) were associated with recurrent opioid use.
Conclusion: We found no association between high intensity opioid prescribers and recurrent 12 month use of opioids in opioid-naïve adolescents seen in the ED. This likely reflects various factors that put adolescents at risk for recurrent opioid use and may indicate the importance of the second prescription from primary care after initial exposure to opioids.
Competing Interests: Declaration of Competing Interest All authors have no competing interests to declare.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: