TY - JOUR
T1 - Characterizing opioid prescribing to adolescents at time of discharge from a pediatric hospital over a five-year period
AU - Axson, Sydney A.
AU - Giordano, Nicholas A.
AU - Compton, Peggy
AU - McDonald, Catherine C.
AU - Pinto-Martin, Jennifer A.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Purpose: To characterize opioid prescribing over a 5-year period to adolescents upon discharge from one urban pediatric medical center. Design and methods: A retrospective cross-sectional analysis of 4354 adolescents discharged with a pain medication after an admission of ≤5 days between January 2015 and December 2019 was performed. Two outcome groups, based on the analgesics prescribed at discharge, were compared: those discharged with a prescription for a non-opioid only and those discharged with an opioid prescription. The association between year of discharge and receipt of opioid, while adjusting for relevant demographic and clinical characteristics, was also explored. Results: Approximately 64% of the sample was discharged with an opioid prescription. Of those, the median daily dosage was 45.0 morphine milligram equivalents (MME) [IQR: 32.4, 45.0]. Year of discharge was associated with decreased odds of receiving an opioid when adjusting for age, race, sex, insurance, pain scores, opioid exposure during hospitalization, length of stay, and undergoing surgery. The odds of being discharged with an opioid decreased each year by 29% (Adjusted Odds Ratio [AOR] = 0.71, CI:0.68–0.73). Concurrently, the proportion of patients discharged with nonopioid pain medication increased from 25% of adolescent patients in 2015 to 50% in 2019. Conclusions: Overall, opioid prescribing to adolescents at time of discharge decreased over time in our sample. Practice implications: While prescribing has decreased opioid analgesics are dispensed to young patients. Risk of opioid use disorder and overdose is rare in this population, but adolescence is good opportunity for nursing to promote safe prescribing and analgesic use.
AB - Purpose: To characterize opioid prescribing over a 5-year period to adolescents upon discharge from one urban pediatric medical center. Design and methods: A retrospective cross-sectional analysis of 4354 adolescents discharged with a pain medication after an admission of ≤5 days between January 2015 and December 2019 was performed. Two outcome groups, based on the analgesics prescribed at discharge, were compared: those discharged with a prescription for a non-opioid only and those discharged with an opioid prescription. The association between year of discharge and receipt of opioid, while adjusting for relevant demographic and clinical characteristics, was also explored. Results: Approximately 64% of the sample was discharged with an opioid prescription. Of those, the median daily dosage was 45.0 morphine milligram equivalents (MME) [IQR: 32.4, 45.0]. Year of discharge was associated with decreased odds of receiving an opioid when adjusting for age, race, sex, insurance, pain scores, opioid exposure during hospitalization, length of stay, and undergoing surgery. The odds of being discharged with an opioid decreased each year by 29% (Adjusted Odds Ratio [AOR] = 0.71, CI:0.68–0.73). Concurrently, the proportion of patients discharged with nonopioid pain medication increased from 25% of adolescent patients in 2015 to 50% in 2019. Conclusions: Overall, opioid prescribing to adolescents at time of discharge decreased over time in our sample. Practice implications: While prescribing has decreased opioid analgesics are dispensed to young patients. Risk of opioid use disorder and overdose is rare in this population, but adolescence is good opportunity for nursing to promote safe prescribing and analgesic use.
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U2 - 10.1016/j.pedn.2022.05.023
DO - 10.1016/j.pedn.2022.05.023
M3 - Article
C2 - 35709633
AN - SCOPUS:85131814406
SN - 0882-5963
VL - 66
SP - 104
EP - 110
JO - Journal of Pediatric Nursing
JF - Journal of Pediatric Nursing
ER -