Variability in opioid pain medication prescribing for adolescent trauma patients in a sample of US pediatric trauma centers

Trauma Surgery & Acute Care Open

article

Lois K Lee¹  Emily R Christison-Lagay²  Stephanie M Ruest³  Charles W Pruitt⁵  Karla A Lawson⁶  Andrew W Kiragu⁷  Isam Nasr⁸  Jeremy T Aidlen⁹  Beth E Ebel^1,10  R Todd Maxson^1,11  Kelli Scott^1,12  Sara J Becker^1,12  Michael J Mello³  Janette Baird³  Julie R Bromberg³  Anthony Spirito^1,14  Mark R Zonfrillo³ 

[1] Emergency Medicine , Boston Children's Hospital;Surgery , Yale-New Haven Hospital;Emergency Medicine , Brown University;Emergency Medicine , Hasbro Children's Hospital;Pediatrics , Primary Children's Hospital;Dell Children's Trauma and Injury Research Center;Pediatrics , Hennepin County Medical Center;Surgery , Johns Hopkins Children's Center;Pediatric Surgery , UMass Memorial Medical Center;Pediatrics , Harborview Medical Center;Pediatric Surgery , Arkansas Children's Hospital;Behavioral and Social Sciences , Brown University School of Public Health;Emergency Medicine , Rhode Island Hospital;Psychiatry and Human Behavior , Brown University

关键词: analgesics;    opioid;    pediatrics;   

DOI  :  10.1136/tsaco-2022-000894

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Objectives The primary objective of this study was to examine opioid prescription frequency and identify differences across a national cohort of pediatric trauma centers in rates of prescribing opioids to injured adolescents at discharge.Methods This was a retrospective observational study using electronic health records of injured adolescents (12–17 years) admitted to one of 10 pediatric trauma centers.Results Of the 1345 electronic health records abstracted, 720 (53.5%, 95% CI 50.8 to 56.2) patients received opioid prescriptions at discharge with variability across sites (28.6%–72%). There was no association between patient factors and frequency of prescribing opioids. Center’s trauma volume was significantly positively correlated with a higher rate of opioid prescribing at discharge (r=0.92, p=0.001). There was no significant difference between the frequency of opioid prescriptions at discharge among alcohol and other drugs (AOD)-positive patients (53.8%) compared with AOD-negative patients (53.5%).Conclusions Across a sample of 10 pediatric trauma centers, just over half of adolescent trauma patients received an opioid prescription at discharge. Prescribing rates were similar for adolescent patients screening positive for AOD use and those screening negative. The only factor associated with a higher frequency of prescribing was trauma center volume. Consensus and dissemination of outpatient pain management best practices for adolescent trauma patients is warranted.

【 授权许可】

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