Your browser doesn't support javascript.
loading
Opioid Fills in Children Undergoing Surgery From 2011 to 2014: A Retrospective Analysis of Relationships Among Age, Initial Days Supplied, and Refills.
Wetzel, Martha; Hockenberry, Jason M; Raval, Mehul V.
Afiliação
  • Wetzel M; Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA.
  • Hockenberry JM; Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA.
  • Raval MV; Division of Pediatric Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Ann Surg ; 274(2): e174-e180, 2021 08 01.
Article em En | MEDLINE | ID: mdl-31188211
ABSTRACT

OBJECTIVE:

The primary objective is to describe the relationship between the days supplied of postsurgical filled opioid prescriptions and refills.

BACKGROUND:

The American College of Surgeons (ACS) has called for surgeons to alter opioid prescribing to counteract the opioid epidemic while simultaneously providing pain relief. However, there is insufficient evidence to inform perioperative prescribing guidelines and quality metrics in children.

METHODS:

We performed a secondary data analysis of nationwide commercial claims from the Health Care Cost Institute (HCCI) data spanning 2010 and 2014. Based on initial opioid fill and refill rates for 11 common pediatric procedures, the refill analysis focused on anterior cruciate ligament repair, humerus fracture repair, cholecystectomy, posterior spinal fusion, and tonsillectomy.

RESULTS:

There were 178,990 cases with a median age of 6. Overall, 48.5% of patients filled an opioid prescription between 30 days before surgery through 7 days after surgery, and 14.2% filled a second opioid prescription within 30 days. There was a significant negative relationship between days supplied in the initial prescription and probability of a refill for humerus fracture, spinal fusion, and tonsillectomy. The largest effect was seen for tonsillectomy, with the odds of having a refill decreasing by approximately 12% for each day supplied in the initial prescription (odds ratio 0.88, 95% confidence interval 0.87-0.89, P < 0.001).

CONCLUSIONS:

Pediatric postoperative opioid-prescribing guidelines need to be procedure-specific and based on patient age. We provide the days supplied associated with a 20% probability of a refill by age to further guideline development.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Pós-Operatória / Prescrições de Medicamentos / Analgésicos Opioides Tipo de estudo: Observational_studies / Prognostic_studies Limite: Child / Female / Humans / Male Idioma: En Revista: Ann Surg Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Pós-Operatória / Prescrições de Medicamentos / Analgésicos Opioides Tipo de estudo: Observational_studies / Prognostic_studies Limite: Child / Female / Humans / Male Idioma: En Revista: Ann Surg Ano de publicação: 2021 Tipo de documento: Article