Variability in opioid pain medication prescribing for adolescent trauma patients in a sample of US pediatric trauma centers

• Published in: Trauma surgery & acute care open Vol. 7; no. 1; p. e000894
• Main Authors: Mello, Michael J, Baird, Janette, Bromberg, Julie R, Spirito, Anthony, Zonfrillo, Mark R, Lee, Lois K, Christison-Lagay, Emily R, Ruest, Stephanie M, Pruitt, Charles W, Lawson, Karla A, Kiragu, Andrew W, Nasr, Isam, Aidlen, Jeremy T, Ebel, Beth E, Maxson, R Todd, Scott, Kelli, Becker, Sara J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01-04-2022; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Age; analgesics, opioid; Best practice; Drug use; Electronic health records; Ethnicity; Gender; Narcotics; Original Research; Pain management; Patients; Pediatrics; Research centers; Teenagers; Trauma; Trauma centers; Variables; United States > US; analgesics, opioid; pediatrics
• ISSN: 2397-5776; 2397-5776
• DOI: 10.1136/tsaco-2022-000894

ObjectivesThe primary objective of this study was to examine opioid prescription frequency and identify differences across a national cohort of pediatric trauma centers in rates of prescribing opioids to injured adolescents at discharge.MethodsThis was a retrospective observational study using electronic health records of injured adolescents (12–17 years) admitted to one of 10 pediatric trauma centers.ResultsOf the 1345 electronic health records abstracted, 720 (53.5%, 95% CI 50.8 to 56.2) patients received opioid prescriptions at discharge with variability across sites (28.6%–72%). There was no association between patient factors and frequency of prescribing opioids. Center’s trauma volume was significantly positively correlated with a higher rate of opioid prescribing at discharge (r=0.92, p=0.001). There was no significant difference between the frequency of opioid prescriptions at discharge among alcohol and other drugs (AOD)-positive patients (53.8%) compared with AOD-negative patients (53.5%).ConclusionsAcross a sample of 10 pediatric trauma centers, just over half of adolescent trauma patients received an opioid prescription at discharge. Prescribing rates were similar for adolescent patients screening positive for AOD use and those screening negative. The only factor associated with a higher frequency of prescribing was trauma center volume. Consensus and dissemination of outpatient pain management best practices for adolescent trauma patients is warranted.Level of evidenceIII—prognostic.Trial registration numberNCT03297060.