Admin_Adham
Which Surgeries Drive the Most Opioid Prescriptions in Youth
TOPLINE:
A small pool of major surgeries accounts for a large portion of opioids prescribed to children and teens, according to a new study published in Pediatrics.
METHODOLOGY:
- The researchers analyzed national commercial and Medicaid claims from December 2020 to November 2021 in children aged 0-21 years.
- More than 200,000 procedures were included in the study.
- For each type of surgery, researchers calculated the total amount of opioids given within 3 days of discharge, measured in morphine milligram equivalents (MMEs).
TAKEAWAY:
- In children up to age 11 years, three procedures accounted for 59.1% of MMEs: Tonsillectomy and/or adenoidectomy (50.3%), open treatment of upper extremity fracture (5.3%), and removal of deep implants (3.5%).
- In patients aged 12-21 years, three procedures accounted for 33.1% of MMEs: Tonsillectomy and/or adenoidectomy (12.7%), knee arthroscopy (12.6%), and analgesia after cesarean delivery (7.8%).
- Refill rates for children were all 1% or less.
- Refill rates for adolescents ranged from 2.3% to 9.6%.
IN PRACTICE:
"Targeting these procedures in opioid stewardship initiatives could help minimize the risks of opioid prescribing while maintaining effective postoperative pain control," the researchers wrote.
SOURCE:
The study was led by Kao-Ping Chua, MD, PhD, of the Department of Pediatrics at the University of Michigan Medical School, in Ann Arbor, Michigan, and published on June 26, 2024, in Pediatrics.
LIMITATIONS:
The researchers analyzed opioids prescribed only after major surgeries. The sources of data used in the analysis may not fully represent all pediatric patients.
DISCLOSURES:
Chua reported consulting fees from the US Department of Justice and The Benter Foundation outside the submitted work. Other authors reported a variety of financial interests, including consulting for the pharmaceutical industry.
