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J Emerg Med. Mar 29, 2022: S0736-4679(22)00040-3. doi: 10.1016/j.jemermed.2022.01.002. Online ahead of print.
BACKGROUND: Little is known about the filling of pain medication prescriptions for children. In adult populations, race and type of insurance are associated with differences in the rate of filling opioid prescriptions. We hypothesize that known disparities in pain management in children are exacerbated by differential opioid prescription filling rates between patients based on age and race.
OBJECTIVE: To determine whether there are demographic or clinical factors associated with differences in opioid prescription fill rates after discharge from the pediatric emergency department (ED).
Methods: This was a retrospective cross-sectional study of all patients under the age of 19 discharged with an opioid prescription from one of two pediatric emergency departments in 2018. We performed multivariate logistic regression for measure associations between dispensing and demographic and clinical factors.
RESULTS: There were 287 patient visits in which opioids were prescribed. Forty percent of prescriptions were filled. The majority of patients were male (53%), black (69%) and had public insurance (55%). There were no significant associations between prescription filling and age, insurance status, or race/ethnicity. Patients with sickle cell disease were more likely to fill prescriptions (odds ratio 3.87, 95% confidence interval 2.33-6.43) and patients without an identified primary care provider were less likely to fill prescriptions. prescriptions (odds ratio 0.16, 95% confidence interval 0.03-0.84).
CONCLUSION: Less than half of opioid prescriptions issued upon discharge from a pediatric emergency department are filled. Patient age, insurance status, and race/ethnicity are not associated with filling an opioid prescription. Patients with sickle cell disease and those who have a primary care provider are more likely to fill their opioid prescriptions.
PMID:35365364 | DOI:10.1016/j.jemermed.2022.01.002