Filled Opioid Prescriptions Following Pediatric Dental Procedures Among Medicaid-Insured Children in Ohio.

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE
JOURNAL OF DENTISTRY FOR CHILDREN Pub Date : 2024-05-15
Enrique Ramirez, Yuri Sebastião, Jennifer Cooper, Homa Amini, Janice A Townsend
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引用次数: 0

Abstract

Purpose: To investigate opioid prescription fills following pediatric/adolescent dental procedures in central/southeastern Ohio. Methods: This population-based, retrospective cohort study utilized health insurance claims from a pediatric public accountable care organization (???Medicaid???) in central/southeastern Ohio. Patients aged 18 years and younger who had a dental procedure between January 2012 and February 2019 were identified, and claims were searched for opioid prescription fills within 14 days post-procedure. Trends in prescription fill percentages, types of opioid, procedure classification and patient characteristics were examined. Results: A total of 512,922 encounters among 212,813 patients were included. The overall opioid prescription fill was 4.9 percent. Percentages decreased throughout the study period from 6.1 percent (95 percent confidence interval [95% CI]=5.9 to 6.3) in 2012 to 3.4 percent (95% CI=3.1 to 3.8) in early 2019. When limited to extractions and endodontic procedures, the overall prescription fill percentage fell from 15.7 percent (95% CI=15.2 to 16.1) in 2012 to 9.5 percent (95% CI=8.5 to 10.4) in early 2019. The most common opioids were hydrocodone (68.6 percent) and codeine (24.7 percent), with marked annual reductions in codeine prescription fills among children younger than 14 years. From 2017 to 2018, surgical extractions compared to endodontics-only procedures (risk difference [RD]=40.7; 95% CI=38.6 to 42.9) and older patient age (RD for 18-year-olds versus 13-year-olds=21.9; 95% CI=19.8 to 24.0) were strong risk factors for filling an opioid prescription. Conclusion: Post-procedure opioid prescription fill percentages have decreased since 2012 among pediatric/adolescent Medicaid enrollees undergoing dental procedures in central/southeastern Ohio. Substantial differences in the likelihood of filling a prescription remained by procedural and demographic variables. There were marked trends in the types of opioid for which prescriptions were filled, which varied by patient age.

俄亥俄州医疗补助计划(Medicaid)保险儿童接受小儿牙科手术后的阿片类药物处方。
目的: 调查俄亥俄州中部/东南部儿童/青少年牙科手术后阿片类药物处方的使用情况。方法:这项基于人群的回顾性队列研究利用了俄亥俄州中部/东南部一家儿科公共责任医疗组织(Medicaid)的医疗保险报销单。确定了在 2012 年 1 月至 2019 年 2 月期间接受过牙科手术的 18 岁及以下患者,并搜索了手术后 14 天内阿片类药物处方的报销情况。研究了处方填充百分比、阿片类药物类型、手术分类和患者特征的变化趋势。结果:共纳入 212,813 名患者的 512,922 次就诊。阿片类药物处方的总使用率为 4.9%。在整个研究期间,该比例从2012年的6.1%(95%置信区间[95% CI]=5.9至6.3)下降到2019年初的3.4%(95% CI=3.1至3.8)。如果仅限于拔牙和牙髓手术,总体处方填充率从2012年的15.7%(95% CI=15.2至16.1)下降到2019年初的9.5%(95% CI=8.5至10.4)。最常见的阿片类药物是氢可酮(68.6%)和可待因(24.7%),14 岁以下儿童的可待因处方用量每年都有明显减少。从 2017 年到 2018 年,手术拔牙与单纯牙髓治疗相比(风险差异 [RD]=40.7; 95% CI=38.6 到 42.9),以及患者年龄较大(18 岁与 13 岁相比的风险差异 =21.9; 95% CI=19.8 到 24.0),是阿片类药物处方配药的强风险因素。结论自 2012 年以来,俄亥俄州中部/东南部接受牙科手术的儿童/青少年医疗补助参保者中,手术后阿片类药物处方配药率有所下降。根据手术和人口统计学变量,开具处方的可能性仍存在很大差异。开具处方的阿片类药物类型有明显的趋势,因患者年龄而异。
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来源期刊
JOURNAL OF DENTISTRY FOR CHILDREN
JOURNAL OF DENTISTRY FOR CHILDREN DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
1.00
自引率
0.00%
发文量
19
期刊介绍: Acquired after the merger between the American Society of Dentistry for Children and the American Academy of Pediatric Dentistry in 2002, the Journal of Dentistry for Children (JDC) is an internationally renowned journal whose publishing dates back to 1934. Published three times a year, JDC promotes the practice, education and research specifically related to the specialty of pediatric dentistry. It covers a wide range of topics related to the clinical care of children, from clinical techniques of daily importance to the practitioner, to studies on child behavior and growth and development. JDC also provides information on the physical, psychological and emotional conditions of children as they relate to and affect their dental health.
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