Abstract
Purpose
To characterize opioid prescribing over a 5-year period to adolescents upon discharge
from one urban pediatric medical center.
Design and methods
A retrospective cross-sectional analysis of 4354 adolescents discharged with a pain
medication after an admission of ≤5 days between January 2015 and December 2019 was
performed. Two outcome groups, based on the analgesics prescribed at discharge, were
compared: those discharged with a prescription for a non-opioid only and those discharged
with an opioid prescription. The association between year of discharge and receipt
of opioid, while adjusting for relevant demographic and clinical characteristics,
was also explored.
Results
Approximately 64% of the sample was discharged with an opioid prescription. Of those,
the median daily dosage was 45.0 morphine milligram equivalents (MME) [IQR: 32.4,
45.0]. Year of discharge was associated with decreased odds of receiving an opioid
when adjusting for age, race, sex, insurance, pain scores, opioid exposure during
hospitalization, length of stay, and undergoing surgery. The odds of being discharged
with an opioid decreased each year by 29% (Adjusted Odds Ratio [AOR] = 0.71, CI:0.68–0.73).
Concurrently, the proportion of patients discharged with nonopioid pain medication
increased from 25% of adolescent patients in 2015 to 50% in 2019.
Conclusions
Overall, opioid prescribing to adolescents at time of discharge decreased over time
in our sample.
Practice implications
While prescribing has decreased opioid analgesics are dispensed to young patients.
Risk of opioid use disorder and overdose is rare in this population, but adolescence
is good opportunity for nursing to promote safe prescribing and analgesic use.
Keywords
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Article info
Publication history
Published online: June 13, 2022
Accepted:
May 27,
2022
Received in revised form:
May 10,
2022
Received:
November 29,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
