Trends in repeat opioid analgesic prescription utilization for acute pain in children: 2013-2018.

Abstract

Our study examined the change in repeat opioid analgesic prescription trends in children and adolescents experiencing acute pain between 2013 to 2018. Eligible individuals were children and adolescents between 1 - 17 years of age enrolled in a Medicaid Managed Care plan and filled an incident opioid analgesic prescription from 2013 to 2018. A repeat opioid prescription was defined as receiving a subsequent opioid prescription within 30 days from the end of the incident opioid prescription. A generalized linear regression analysis was conducted to examine changes in repeat opioid analgesic dispensing over time at quarterly intervals from January 1, 2013, to December 31, 2018. The cohort comprised 17,086 children and adolescents receiving an incident opioid analgesic. Of these, 1,780 (10.4%) filled a repeat opioid analgesic prescription. There was a significant decline in the repeat opioid analgesic trend from 11.5% in Q1 2013 to 9.6% in Q4 2018. Stratified analyses by age, sex, and race/ethnicity in a sub-cohort of patients undergoing surgical procedures showed that Non-Hispanic Whites had significantly higher repeat opioid utilization than non-Hispanic Blacks and Hispanics in all subgroups by age and sex. Over time, the most significant absolute utilization decline was observed in non-Hispanic White children and Hispanic adolescents, which has reduced racial/ethnic variations in children and persisted differences among adolescents. Approximately 10% of incident pediatric opioid analgesic recipients received a repeat opioid prescription. There has been a moderate but steady decline (~7% per quarter) in repeat opioid analgesic utilization between 2013 to 2018.