Opioid Prescribing Practices for Pediatric Headache

Garth D. Meckler, David C. Sheridan, Christina J. Charlesworth, Nicoleta Lupulescu-Mann, Hyunjee Kim, Benjamin Sun

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)240-244.e2
JournalJournal of Pediatrics
StatePublished - Jan 2019


  • ambulatory care
  • emergency department
  • migraine
  • narcotic

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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