Opioid prescribing to preteen children undergoing ambulatory surgery in the United States
Autor: | Jonathan E. Kohler, Randi Cartmill, Tony L. Kille, Yasmin S. Bradfield, Ruthie Su, Dou-Yan Yang, Benjamin J. Walker |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
MEDLINE Inappropriate Prescribing 030230 surgery 03 medical and health sciences 0302 clinical medicine medicine Humans Practice Patterns Physicians' Medical prescription Child Pain Postoperative Codeine business.industry Age Factors Infant Perioperative Ambulatory Surgical Procedure United States Surgery Analgesics Opioid Ambulatory Surgical Procedures Otorhinolaryngology Opioid Child Preschool 030220 oncology & carcinogenesis Ambulatory business medicine.drug |
Zdroj: | Surgery. 170:925-931 |
ISSN: | 0039-6060 |
Popis: | Background Overuse and misuse of opioids is a continuing crisis. The most common reason for children to receive opioids is postoperative pain, and they are often prescribed more than needed. The amount of opioids prescribed varies widely, even for minor ambulatory procedures. This study uses a large national sample to describe filled opioid prescriptions to preteen patients after all ambulatory surgical procedures and common standard procedures. Methods We analyzed Truven Health MarketScan data for July 2012 through December 2016 to perform descriptive analyses of opioid fills by age and geographic area, change over time, second opioid fills in opioid-naive patients, and variation in the types and amount of medication prescribed for 18 common and standard procedures in otolaryngology, urology, general surgery, ophthalmology, and orthopedics. Results Over 10% of preteen children filled perioperative opioid prescriptions for ambulatory surgery in the period 2012 to 2016. The amount prescribed varied widely (median 5 days’ supply, IQR 3–8, range 1–90), even for the most minor procedures, for example, frenotomy (median 4 days’ supply, IQR 2–5, range 1–60). Codeine fills were common despite safety concerns. Second opioid prescriptions were filled by opioid-naive patients after almost all procedures studied. The rate of prescribing declined significantly over time and varied substantially by age and across census regions. Conclusions We identified opioid prescribing outside of the norms of standard practice in all of the specialties studied. Standardizing perioperative opioid prescribing and developing guidelines on appropriate prescribing for children may reduce the opioids available for misuse and diversion. |
Databáze: | OpenAIRE |
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