Trends in opioid prescriptions among children and adolescents in the United States: a nationally representative study from 1996 to 2012
Trends in opioid prescriptions among children and adolescents in the United States: a nationally representative study from 1996 to 2012
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DOI：
10.1097/j.pain.0000000000000475
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发表时间：
2016-05-01
期刊：
影响因子：
7.4
通讯作者：
Palermo, Tonya M.
中科院分区：
文献类型：
--
作者：
Groenewald, Cornelius B.;Rabbitts, Jennifer A.;Palermo, Tonya M.
处方阿片类药物滥用在美国是一个主要的公共卫生问题，但人们对国家处方模式知之甚少。我们的目标是评估1996年至2012年期间向美国儿童和青少年、他们的家庭和成年人开出的阿片类药物处方的趋势。样本来自具有全国代表性的数据，即医疗支出小组调查。我们使用调查设计方法来检查处方阿片类药物使用随时间的趋势，并使用Logistic回归分析来检查与阿片类药物使用相关的预测因素。调查结果表明，从1996年到2012年，儿童和青少年的阿片类药物处方保持稳定和较低水平。1996年，2.68%的儿童收到了阿片类药物处方，2012年，2.91%的儿童收到了阿片类药物处方。相比之下，在此期间，向儿童和青少年以及一般成年人的家庭成员开出的阿片类药物处方大幅增加。2012年儿童和青少年最常见的阿片类药物处方是可待因、氢可酮和羟考酮。使用多变量Logistic回归模型，白人非西班牙裔种族、年龄较大、医疗保险和父母报告的总体健康状况一般较差与儿童和青少年中较高的阿片类药物处方率相关。我们的主要发现是，尽管美国成年人的阿片类药物处方使用率有所上升，但儿童和青少年的使用率并没有变化。最近的流行病学关联研究发现，阿片类药物处方的增加与成人阿片类药物滥用和滥用比率的增加之间存在强烈的联系。未来的研究应该评估成人阿片类药物处方与儿童或青少年阿片类药物滥用之间的联系。
Prescription opioid misuse is a major public health concern in the United States, yet little is known about national prescription patterns. We aimed to assess trends in opioid prescriptions made to children and adolescents, to their families, and to adults in the United States from 1996 to 2012. The sample was drawn from nationally representative data, the Medical Expenditure Panel Surveys. We used survey design methods to examine trends in prescription opioid use over time and a logistic regression analysis to examine predictors associated with opioid use. Findings indicated that from 1996 to 2012 opioid prescriptions to children and adolescents remained stable and low. In 1996, 2.68% of children received an opioid prescription, and in 2012, 2.91% received an opioid prescription. In contrast, opioid prescriptions to family members of children and adolescents and adults in general significantly increased during this period. The most common opioid prescriptions to children and adolescents in 2012 were codeine, hydrocodone, and oxycodone. Using multivariate logistic regression models, the white non-Hispanic race, older age, health insurance, and parent-reported fair to poor general health were associated with higher rates of opioid prescriptions in children and adolescents. Our main finding was that although the rates of opioid prescriptions have increased among adults in the United States, the rates have not changed among children and adolescents. Recent epidemiologic association studies have identified a strong link between increased opioid prescriptions and increased rates of opioid misuse and abuse in adults. Future studies should assess the association between adult opioid prescriptions and children or adolescent opioid misuse.