Opioid Use in Children

Matson, Kelly L.; Johnson, Peter N.; Tran, Van De; Horton, Evan R.; Sterner-Allison, Jennifer

doi:10.5863/1551-6776-24.1.72

Cited by 26 publications

(19 citation statements)

References 13 publications

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“…These findings are not surprising as nursing students in Ghana have limited care experiences with children with cancers and appear to harbour misconceptions on narcotics. Recent evidence however, points to a well-tolerated and effective opioid use among children in practice [34,35]. Compared with the nursing students, a greater proportion of the nurses acknowledged the importance of early pain treatment in children as advocated for by the International Association for the Study of Pain (IASP) as a fundamental human right [1].…”

Section: Discussionmentioning

confidence: 99%

Nursing students and nurses’ knowledge and attitudes regarding children’s pain: A comparative cross-sectional study

et al. 2019

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IntroductionNurses encounter children who report of pain of diverse and unknown causes in their professional work. The current study therefore assessed and compared nursing students and nurses’ knowledge and attitudes pertaining to children’s pain in the Ghanaian context. The goal of this was to have a baseline information to guide the development and implementation of the content for a sustainable educational programme (short-course) for nursing students and nurses in Ghana.MethodsBetween October and December 2018, a cross-sectional study was carried out among 554 final year nursing students and 65 nurses in Ghana. The Pediatric Nurses Knowledge and Attitudes Survey Regarding Pain (PNKAS) was used to collect data from participants who were affiliated to four educational institutions and eight hospitals. Data were descriptively and inferentially analyzed using chi-square test of independence, independent samples t-test and one-way analysis of variance (ANOVA).ResultsOur findings revealed that nursing students and nurses generally had unsatisfactory knowledge and attitudes towards pain management in children. Nursing students however, had significantly higher scores than nurses in the total PNKAS score and in 10 out of the 13 identified item-areas. Greater scores were obtained by nursing students in areas which were related to pain physiology, pharmacokinetics, pharmacology of analgesics and pain perceptions (p < .05). All the participating nurses could not accurately determine: the onset of action of orally administered analgesics, equianalgesia of orally administered morphine, and the right dosage of prescribed morphine for a child who consistently reported of moderate to severe pain.ConclusionFinal year nursing students and nurses have unsatisfactory knowledge and attitudes regarding children’s pain; which reiterates the need for urgent and effective educational efforts in this area. Regular in-service training should be offered to post-registration nurses to enhance their pediatric pain knowledge and attitudes for improved pain care in children.

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Section: Discussionmentioning

confidence: 99%

Nursing students and nurses’ knowledge and attitudes regarding children’s pain: A comparative cross-sectional study

et al. 2019

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“…7 Long-term opioid therapy (receiving additional opioid prescriptions following the first index opioid prescription) has limited evidence to support such use for managing pain in adults, 8 and even less in youths. 9 Long-term opioid therapy, defined as greater than 90 days of opioid use, confers additional risks for opioid misuse 10 and an added risk of developing opioid use disorder (OUD), a clinical diagnosis defined by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) as a spectrum of problematic, compulsive use associated with increasingly negative consequences. 11 More than half of adults with a substance use disorder, including OUD, report that symptoms started before the age of 18, and the majority of individuals (80%) reported onset of symptoms by the age of 24 years.…”

Section: Introductionmentioning

confidence: 99%

Trajectories of Opioid Use Following First Opioid Prescription in Opioid-Naive Youths and Young Adults

et al. 2021

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IMPORTANCE Although prescription opioids are the most common way adolescents and young adults initiate opioid use, many studies examine population-level risks following the first opioid prescription. There is currently a lack of understanding regarding how patterns of opioid prescribing following the first opioid exposure may be associated with long-term risks. OBJECTIVETo identify distinct patterns of opioid prescribing following the first prescription using group-based trajectory modeling and examine the patient-, clinician-, and prescription-level factors that may be associated with trajectory membership during the first year. DESIGN, SETTING, AND PARTICIPANTSThis cohort study examined Pennsylvania Medicaid enrollees' claims data from 2010 through 2016. Participants were aged 10 to 21 years at time of first opioid prescription. Data analysis was performed in March 2020. MAIN OUTCOMES AND MEASURES This study used group-based trajectory modeling and defined trajectory status by opioid fill. RESULTS Among the 189 477 youths who received an initial opioid prescription, 107 562 were female (56.8%), 81 915 were non-Latinx White (59.6%), and the median age was 16.9 (interquartile range [IQR], 14.6-18.8) years. During the subsequent year, 47 477 (25.1%) received at least one additional prescription. Among the models considered, the 2-group trajectory model had the best fit. Of those in the high-risk trajectory, 65.3% (n = 901) filled opioid prescriptions at month 12, in contrast to 13.1% (n = 6031) in the low-risk trajectory. Median age among the high-risk trajectory was 19.0 years (IQR, 17.1-20.0 years) compared with the low-risk trajectory (17.8 years [IQR, 15.8-19.4 years]). The high-risk trajectory received more potent prescriptions compared with the low-risk trajectory (median dosage of the index month for high-risk trajectory group: 10.0 MME/d [IQR, 5.0-21.2 MME/d] vs the low-risk trajectory group: 4.7 MME/d [IQR, 2.5-7.8 MME/d]; P < .001). The trajectories showed persistent differences with more youths in the high-risk trajectory going on to receive a diagnosis of opioid use disorder (30.0%; n = 412) compared with the low-risk group (10.1%; n = 4638) (P < .001).CONCLUSIONS AND RELEVANCE This study's results identified 2 trajectories associated with elevated risk for persistent opioid receipt within 12 months following first opioid prescription. The high-risk trajectory was characterized by older age at time of first prescription, and longer and more potent first prescriptions. These findings suggest even short and low-dose opioid prescriptions can be associated with risks of persistent use for youths.

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“…The nation’s opioid epidemic and its associated dangers for the pediatric population have led state regulators and physicians to focus efforts on reducing opioid prescription 46–49 . In our study, the majority of pain was controlled with nonopioid analgesics in both TEES and non‐TEES patients.…”

Section: Discussionmentioning

confidence: 75%

Assessment of Pain and Analgesic Use in Children Following Otologic Surgery

Benchetrit

Kwock

Ronner

et al. 2020

Otolaryngol.--head neck surg.

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Objective To compare postoperative pain and analgesic use in children following transcanal endoscopic ear surgery (TEES) vs non–transcanal endoscopic ear surgery (non-TEES). Study Design Prospective case series. Setting Tertiary care center. Methods Surveys using the Wong-Baker FACES Pain Rating Scale and recording the frequency and dosage of consumed analgesics were administered prospectively to caregivers of children undergoing otologic surgery between May 2018 to February 2020. Pain intensity and medication use were recorded twice daily for 6 days, starting on postoperative day 0. Mean pain scores and mean number of consumed analgesic doses were compared between groups. Results Survey response rate was 57.9%. Among 53 patients who completed the survey, 35 (66.0%) underwent TEES and 18 (34.0%) underwent non-TEES. Mean pain ratings on postoperative days 0 and 1 were significantly lower among children undergoing TEES (2.2 and 2.1) vs non-TEES (4.0 and 4.1), P = .045 and P = .008, respectively (Mann-Whitney U test). The mean pain ratings across the 6 days were similar in TEES (1.7) and non-TEES (2.6) ( P = .140, Mann-Whitney U test). The mean number of analgesic doses consumed per half-day over the 6 days was significantly lower among children undergoing TEES (0.3) vs non-TEES (0.6; P = .049, Mann-Whitney U test). Conclusion Postoperative pain following TEES and non-TEES in children was overall low. Children undergoing TEES had a small but statistically significant decrease in pain on postoperative days 0 and 1 and decreased use of pain medications compared to non-TEES.

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Opioid Use in Children

Cited by 26 publications

References 13 publications

Nursing students and nurses’ knowledge and attitudes regarding children’s pain: A comparative cross-sectional study

Nursing students and nurses’ knowledge and attitudes regarding children’s pain: A comparative cross-sectional study

Trajectories of Opioid Use Following First Opioid Prescription in Opioid-Naive Youths and Young Adults

Assessment of Pain and Analgesic Use in Children Following Otologic Surgery

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