The Association of Opioid Prescriptions to Children after Discharge from Surgery and New Opioid Prescription Fills in Family Members.

Abstract

Objective: To determine whether family members of pediatric surgical patients who filled a discharge opioid prescription would have higher rates of new opioid prescription fills compared with family members of patients who did not fill a pediatric surgical discharge opioid prescription.

Study design: Using OptumLabs Data Warehouse administrative claims, we performed a retrospective cohort study of pediatric surgery patients aged 5 through18 and their family members, based on whether an opioid prescription for the child was filled after surgery. Neither patients nor family members had any history of prior opioid use. We calculated the frequency of new opioids filled among family members in the 12 months following the date of surgery. We created a hierarchical logistic regression model to determine the association between having a discharge opioid prescription filled for a pediatric surgical patient and a new opioid prescription filled by family members within the same household.

Results: There were a total of 206,598 family members within 76,569 households in our study. 73.75% of pediatric surgery patients had a prescription filled after surgery, resulting in 151,693 total family members within 56,456 households exposed to a new discharge opioid prescription. 7.3% of exposed family members and 19.6% exposed households then filled a new opioid prescription within 12 months, compared with 5.2% of family members and 13.3% of households (p<0.001 for both) unexposed to a filled opioid prescription after pediatric surgical discharge . After adjusting for demographic factors, clinical attributes, and surgical factors, we found an increased risk of new opioid prescription fills among exposed family members compared with unexposed family members (OR 1.28 [95% CI 1.217, 1.352, p<0.001]).

Conclusions: Introducing a discharge opioid prescription after pediatric surgery to an opioid-naïve household is associated with increased rates of opioid prescriptions in opioid-naïve family members in the year following surgery.