Opioid and Non-Opioid Pharmacotherapy Use for Pain Management Among Privately Insured Pediatric Patients With Cancer in the United States.

Autor:	Shen C; Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA., Thornton JD; Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, TX, USA., Li N; Department of Economics and Finance, Salisbury University, Salisbury, MD, USA., Schaefer E; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA., Zhou S; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA., Kawasaki S; Department of Psychiatry and Behavioral Health, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA., Pameijer C; Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA., Leslie D; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2024 Feb 02; Vol. 29 (2), pp. 176-184.
DOI:	10.1093/oncolo/oyad292
Abstrakt:	Background: This study examined the trends and patterns of opioid and non-opioid pharmacotherapy use among a large national sample of privately insured pediatric patients with cancer in the United States. Materials and Methods: We identified pediatric (aged < 21) patients diagnosed with central nervous system (CNS), lymphoma, gonadal, leukemia, or bone cancer from MarketScan data 2005-2019. We examined the proportion of patients who filled a prescription for the following 5 types of pharmacotherapy: opioid, anticonvulsant, non-steroidal anti-inflammatory drug (NSAID), antidepressant, and muscle relaxant during active cancer treatment. We assessed the trends and patterns in pharmacotherapy using multivariable logistic regressions. Results: Among 4174 patients included, 2979 (71%) had an opioid prescription; 746 (18%), 384 (9%), 202 (5%), and 169 (4%) had anticonvulsant, NSAID, antidepressant and muscle relaxant prescriptions, respectively. Multivariable logistic regression showed a nonlinear trend in the use of opioids among pediatric patients with cancer over time such that use slightly increased until 2012 (OR of 1.40 [95% CI, 1.12-1.73] for 2012 vs. 2006) but then decreased thereafter (OR of 0.51 [0.37-0.68] for 2018 vs. 2012). The use of anticonvulsants, NSAIDs, and muscle relaxants increased significantly linearly over time (all P < .005). Conclusion: There has been a downward trend in the use of opioids in recent years among pediatric patients with cancer and an upward trend in the use of non-opioid pharmacotherapy for pain management potentially as an alternative to opioids. (© The Author(s) 2023. Published by Oxford University Press.)
Databáze:	MEDLINE
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