دورية أكاديمية
أعرض في EDS

Preoperative vs Postoperative Opioid Prescriptions and Prolonged Opioid Refills Among US Youths.

التفاصيل البيبلوغرافية
العنوان: Preoperative vs Postoperative Opioid Prescriptions and Prolonged Opioid Refills Among US Youths.
المؤلفون: Sutherland TN; Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia (CHOP), University of Pennsylvania Perelman School of Medicine, Philadelphia.; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.; Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania Perelman School of Medicine, Philadelphia., Rabbitts JA; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California., Tasian GE; Division of Urology, Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia., Neuman MD; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.; Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania Perelman School of Medicine, Philadelphia.; Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia., Newcomb C; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia., Hadland SE; Division of Adolescent and Young Adult Medicine, Mass General for Children, Boston.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
المصدر: JAMA network open [JAMA Netw Open] 2024 Jul 01; Vol. 7 (7), pp. e2420370. Date of Electronic Publication: 2024 Jul 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Analgesics, Opioid*/therapeutic use , Pain, Postoperative*/drug therapy , Practice Patterns, Physicians'*/statistics & numerical data , Drug Prescriptions*/statistics & numerical data, Humans ; Adolescent ; Female ; Male ; Retrospective Studies ; Child ; United States ; Young Adult ; Preoperative Period ; Postoperative Period ; Opioid-Related Disorders/drug therapy
مستخلص: Importance: High-risk practices, including dispensing an opioid prescription before surgery when not recommended, remain poorly characterized among US youths and may contribute to new persistent opioid use.
Objective: To characterize changes in preoperative, postoperative, and refill opioid prescriptions up to 180 days after surgery.
Design, Setting, and Participants: This retrospective cohort study was performed using national claims data to determine opioid prescribing practices among a cohort of opioid-naive youths aged 11 to 20 years undergoing 22 inpatient and outpatient surgical procedures between 2015 and 2020. Statistical analysis was performed from June 2023 to April 2024.
Main Outcomes and Measures: The primary outcome was the percentage of initial opioid prescriptions filled up to 14 days prior to vs 7 days after a procedure. Secondary outcomes included the likelihood of a refill up to 180 days after surgery, including refills at 91 to 180 days, as a proxy for new persistent opioid use, and the opioid quantity dispensed in the initial and refill prescriptions in morphine milligram equivalents (MME). Exposures included patient and prescriber characteristics. Multivariable logistic regression models were used to estimate the association between prescription timing and prolonged refills.
Results: Among 100 026 opioid-naive youths (median [IQR] age, 16.0 [14.0-18.0] years) undergoing a surgical procedure, 46 951 (46.9%) filled an initial prescription, of which 7587 (16.2%) were dispensed 1 to 14 days before surgery. The mean quantity dispensed was 227 (95% CI, 225-229) MME; 6467 youths (13.8%) filled a second prescription (mean MME, 239 [95% CI, 231-246]) up to 30 days after surgery, and 1216 (3.0%) refilled a prescription 91 to 180 days after surgery. Preoperative prescriptions, increasing age, and procedures not typically associated with severe pain were most strongly associated with new persistent opioid use.
Conclusions and Relevance: In this retrospective study of youths undergoing surgical procedures, of which, many are typically not painful enough to require opioid use, opioid dispensing declined, but approximately 1 in 6 prescriptions were filled before surgery, and 1 in 33 adolescents filled prescriptions 91 to 180 days after surgery, consistent with new persistent opioid use. These findings should be addressed by policymakers and communicated by professional societies to clinicians who prescribe opioids.
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المشرفين على المادة: 0 (Analgesics, Opioid)
تواريخ الأحداث: Date Created: 20240705 Date Completed: 20240705 Latest Revision: 20240708
رمز التحديث: 20240708
مُعرف محوري في PubMed: PMC11227082
DOI: 10.1001/jamanetworkopen.2024.20370
PMID: 38967924
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2024.20370