TY - JOUR
T1 - Opioid Prescribing Practices for Pediatric Headache
AU - Meckler, Garth D.
AU - Sheridan, David C.
AU - Charlesworth, Christina J.
AU - Lupulescu-Mann, Nicoleta
AU - Kim, Hyunjee
AU - Sun, Benjamin
N1 - Funding Information:
Supported by National Institutes of Health (Grant R01 DA036522). The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The contents do not necessarily represent the official views of the National Institutes of Health. The authors declare no conflicts of interest.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/1
Y1 - 2019/1
N2 - Objectives: To characterize the frequency of opioid prescribing for pediatric headache in both ambulatory and emergency department (ED) settings, including prescribing rates by provider type. Study design: A retrospective cohort study of Washington State Medicaid beneficiaries, aged 7-17 years, with an ambulatory care or ED visit for headache between January 1, 2012, and September 30, 2015. The primary outcome was any opioid prescribed within 1 day of the visit. Results: A total of 51 720 visits were included, 83% outpatient and 17% ED. There was a predominance of female (63.2%) and adolescent (59.4%) patients, and 30.5% of encounters involved a pediatrician. An opioid was prescribed in 3.9% of ED and 1.0% of ambulatory care visits (P <.001). Pediatricians were less likely to prescribe opioids in both ED (-2.70 percentage point; 95% CI, -3.53 to -1.88) and ambulatory settings (-0.31 percentage point; 95% CI, -0.54 to -0.08; P <.001). Conclusions: Opioid prescribing rates for pediatric headache were low, but significant variation was observed by setting and provider specialty. We identified opioid prescribing by nonpediatricians as a potential target for quality improvement efforts.
AB - Objectives: To characterize the frequency of opioid prescribing for pediatric headache in both ambulatory and emergency department (ED) settings, including prescribing rates by provider type. Study design: A retrospective cohort study of Washington State Medicaid beneficiaries, aged 7-17 years, with an ambulatory care or ED visit for headache between January 1, 2012, and September 30, 2015. The primary outcome was any opioid prescribed within 1 day of the visit. Results: A total of 51 720 visits were included, 83% outpatient and 17% ED. There was a predominance of female (63.2%) and adolescent (59.4%) patients, and 30.5% of encounters involved a pediatrician. An opioid was prescribed in 3.9% of ED and 1.0% of ambulatory care visits (P <.001). Pediatricians were less likely to prescribe opioids in both ED (-2.70 percentage point; 95% CI, -3.53 to -1.88) and ambulatory settings (-0.31 percentage point; 95% CI, -0.54 to -0.08; P <.001). Conclusions: Opioid prescribing rates for pediatric headache were low, but significant variation was observed by setting and provider specialty. We identified opioid prescribing by nonpediatricians as a potential target for quality improvement efforts.
KW - ambulatory care
KW - emergency department
KW - migraine
KW - narcotic
UR - http://www.scopus.com/inward/record.url?scp=85054022331&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054022331&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2018.08.078
DO - 10.1016/j.jpeds.2018.08.078
M3 - Article
C2 - 30274923
AN - SCOPUS:85054022331
SN - 0022-3476
VL - 204
SP - 240-244.e2
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -