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Opioid Prescribing Practices for Pediatric Headache

Garth D Meckler1, David C Sheridan2, Christina J Charlesworth3

  • 1Division of Pediatric Emergency Medicine, Department of Pediatrics and Emergency Medicine, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia, Canada.

The Journal of Pediatrics
|October 3, 2018
PubMed

Insights

Opioid prescribing for pediatric headache is low but varies by setting and provider. Non-pediatricians may be a focus for improving opioid prescribing practices in children.

Area of Science:

  • Pediatric Medicine
  • Pain Management
  • Pharmacology

Background:

  • Opioid prescribing for pediatric headache is a concern.
  • Understanding prescribing patterns is crucial for patient safety.

Purpose of the Study:

  • To determine the frequency of opioid prescriptions for pediatric headaches.
  • To analyze prescribing rates in ambulatory and emergency departments (ED).
  • To examine variations in prescribing by provider type.

Main Methods:

  • Retrospective cohort study of Washington State Medicaid beneficiaries (aged 7-17).
  • Data collected for headache visits between January 2012 and September 2015.
  • Primary outcome: opioid prescription within 1 day of visit.

Main Results:

  • 51,720 headache visits analyzed (83% outpatient, 17% ED).
  • Opioid prescription rates: 3.9% in ED vs. 1.0% in outpatient settings (P < .001).
  • Pediatricians prescribed opioids less frequently than non-pediatricians in both settings.

Conclusions:

  • Opioid prescribing for pediatric headaches is generally low.
  • Significant variations exist based on care setting and provider specialty.
  • Targeting non-pediatrician prescribing offers a quality improvement opportunity.
Abstract

Keywords:
ambulatory careemergency departmentmigrainenarcotic

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