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The epidemiology of outpatient pain treatment in pediatrics

Stacy Baldridge¹, Laura Wallace¹, Aditi Kadakia¹

¹Purdue Pharma L.P., Stamford, CT, USA.

Journal of Pain Research

|May 17, 2018

Insights

Real-world data reveals significant variation in pediatric pain treatment. Many children with pain conditions do not receive prescription treatments, and opioid use is common, particularly immediate-release formulations.

Area of Science:

Pediatric Pain Management
Real-World Evidence in Healthcare
Pharmacological Treatments for Children

Background:

Limited real-world data exists on pediatric pain prevalence and treatment.
Understanding pediatric pain is crucial for provider education and guideline development.
This study addresses the need for population-level insights into childhood pain conditions.

Purpose of the Study:

To determine the prevalence of acute and chronic pain conditions in pediatric patients.
To characterize the treatment landscape for pediatric pain, including various analgesic classes.
To analyze treatment patterns across different demographics and pain etiologies.

Main Methods:

Utilized administrative claims data from over 30 million US pediatric patients.
Employed descriptive statistics to analyze pain diagnoses and treatment proportions.
Stratified analyses by patient demographics (e.g., insurance type, age).

Main Results:

Surgery, orthopedic conditions, and trauma were leading pain-related diagnoses in children.
Over 50% of children with evaluated conditions did not receive prescription pain treatments.
Immediate-release opioids were the most common prescription opioid for pain, while extended-release were rare.

Conclusions:

Pediatric pain treatment is highly variable, depending on the condition and patient age.
Treatment patterns show a higher prevalence of use in older children.
Significant gaps exist in prescription pain management for pediatric populations.

Read full analysis

Abstract

Background:

There is limited real-world, population-level data on the prevalence and treatment of pain in children. An understanding of pediatric pain conditions and its management can help inform provider education, treatment guidelines, and design of pediatric pain studies. Therefore, in this study, we aimed to describe the prevalence of conditions associated with acute and chronic pain in pediatric patients and to characterize pediatric pain treatment with nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 (COX-2) inhibitors, opioids (immediate release or extended release), antidepressants, topical analgesics, anticonvulsants, and other therapies based on a large, real-world sample.

Materials And Methods:

In this cohort study, we used administrative claims data from the Truven Health MarketScan^® Research Databases, which contain data regarding demography, prescription, diagnosis, and procedure performed. Descriptive statistics were used to assess the prevalence of various conditions associated with pediatric pain and to estimate the proportion of patients who received various analgesic and nonanalgesic treatments. All analyses were stratified according to demographics.

Results:

This study included data on more than 30 million pediatric patients from throughout the US. Overall, among patients with commercial insurance, surgery was the most common pain-related diagnosis, followed by orthopedic conditions, malignancies, trauma, and genetic conditions. For patients with Medicaid, surgery was also the most common diagnosis, followed by traumatic injury, orthopedic conditions, malignancies, and genetic conditions. These diagnoses varied by age, with most showing higher prevalence in older children. Treatment varied substantially by condition, and many children (more than 50% for most of the conditions evaluated) did not receive any prescription pain treatments. For patients with either commercial insurance or Medicaid who were using prescription opioids, immediate-release opioids were the most commonly used analgesic treatment for pain. Overall, prescription pain treatments were more common in the Medicaid population. Extended-release opioids were rarely used.

Conclusion:

The types of pain treatments varied substantially by condition and age of the patient, with the highest prevalence of use in older children.

Keywords:

analgesia pain conditions pain treatment pediatric prevalence

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