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Prescribing Patterns of Opioids in the Pediatric Population

A look at trends in the emergency department setting from 2006 to 2015

A PPM Brief

As opioid use among pediatric patients remains a controversial subject, concerns regarding abuse and the effects of use on this vulnerable population continue to be made. In an effort to effectively adjust policy regarding opioids for pediatrics, prescribing patterns of opioids in the emergency care setting were looked at in a cross-sectional study,1 utilizing data from the National Hospital Ambulatory Medical Care Survey from January 1, 2006, to December 31, 2015.

Practitioners from emergency departments throughout the United States were surveyed, and data were collected using a representative sample of visits to hospital emergency departments, analyzing all emergency department visits for patients younger than 18 years. Information regarding the participant’s medications was collected at the time of visit; those who reported taking one or more opioids were identified.

While opioid prescribing rates decreased over a nine-year period, certain factors led to differences in prescribing. (Source: 123RF)

A total of 69,152 visits with patients younger than 18 years (of which 32,727 [47.3%] were female) were included. This represented approximately 293,528,632 visits nationwide, with opioid use representing approximately 21,276,831 (7.25%). Researchers found no significant difference in opioid prescriptions across sexes, but factors including geographic region, race, age, and payment method were associated with statistically significant differences in opioid prescribing. Specifically, researchers found that:

  • The Northeast reported an opioid prescribing rate of 4.69% (95% CI, 3.69% - 5.70%) compared to 8.84% in the West (95% CI, 6.82% - 10.86%; P= .004).
  • White individuals were prescribed an opioid at 8.11% (95% CI, 7.23% - 8.99%) of visits compared to 5.31% for nonwhite individuals (95% CI, 4.31% - 6.32%; P< .001).
  • Those aged 13 to 17 years were significantly more likely to receive opioid prescriptions (16.20%; 95% CI, 14.29% - 18.12%) than those aged 3 to 12 years (6.59%; 95% CI, 5.75% - 7.43%) or 0 to 2 years (1.70%; 95% CI, 1.42% - 1.98%).
  • Those using Medicaid as payment (5.47%; 95% CI, 4.79% - 6.15%) were less likely to receive an opioid than those using private insurance (9.73%; 95% CI, 8.56% - 10.90%).

Opioid prescribing rates decreased when comparing 2006 to 2010 data (8.23%; 95% CI, 6.75% - 9.70%) with 2011 to 2015 data (6.30%; 95% CI, 5.44% - 7.17%; P< .001). However, prescribing rates remained unchanged in specific pain diagnoses, such as pelvic and back pain.

“The association of location, race, payment method, and pain diagnoses with rates of prescribing of opioids suggests areas of potential quality improvement and further research,” the authors concluded.

Last updated on: January 10, 2019
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