Late Breaking Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction:
In 2022, the CDC updated clinical practice guidelines for opioid prescription in pain management. However, these guidelines didn't address opioid use in pediatrics. Given the lack of evidence, evaluating high-risk opioid prescribing patterns in pediatric patients becomes essential.
Research Question or Hypothesis: Our study aimed to examine high-risk opioid prescription patterns among pediatric patients aged 2-21in 2010-2021.
Study Design: This cross-sectional study employed data from the California Prescription Drug Monitoring Program (PDMP).
Methods: We assessed opioid dispensing rates, dosage, and treatment duration across five age groups (2-5, 6-9, 10-14, 15-19, and 20-21 years). High-risk opioid prescribing was measured by persistent use (>30 days), high-dosage opioids (=50 morphine mg equivalents/day), multiple providers episodes (>2 prescribers/pharmacies within 30 days), therapy duration> 7 days for opioid-naïve patients, and concomitant opioid-benzodiazepine use. Joinpoint regressions were applied for trend analysis.
Results: The study encompassed 4,049,729 pediatric patients in California receiving opioid prescriptions from 2010 to 2021. Opioid dispensing rates demonstrated a substantial decline since 2019, indicating an annual percent change (APC) of 7.77% (p<0.05). Opioid prescription dosage exhibited a consistent decrease over the study duration. The mean days of prescribed opioids per patient increased during 2013-2016 and then decreased during 2016-2021. Persistent opioid use peaked in 2012-2016 and declined in 2016-2021. High-dosage opioid usage decreased in all age groups except 6-9 years, with an APC of -7.12% from 2010 to 2015. Multiple provider episodes increased (APC=32.9%, P<0.05) during 2010-2012 and subsequently decreased since 2012 (APC=-1.13%, P<0.05). Therapy duration >7 days for opioid-naïve patients rose significantly (APC=15.71%, P<0.05) during 2012-2016, then dropped since 2016 (APC=-14.13%, p<0.05). Concurrent opioid-benzodiazepine use decreased in all age groups post-2016 except for 2-9 years.
Conclusion: Opioid dispensing rates among pediatric patients in California decreased since 2019. High-risk opioid prescription patterns have generally decreased since 2016, except for high-dosage opioids.
Presenting Author
Yun Wang Ph.D.Chapman University
Authors
Amy Kang PharmD
Chapman University
Jianwei Zheng Ph.D.
Chapman University
Emmanuelle Schwartzman PharmD
Chapman University