Adverse Events And Emergency Department Opioid Prescriptions In Adolescents.
Adverse Events And Emergency Department Opioid Prescriptions In Adolescents.
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DOI：
10.1377/hlthaff.2020.01762
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Barnett ML
中科院分区：
文献类型：
--
作者：
Worsham CM;Woo J;Jena AB;Barnett ML
了解青少年阿片类药物处方相关的风险对于了解阿片类药物政策至关重要，但由于缺乏随机试验数据，这些风险很难量化。使用断点回归设计，我们利用青少年在 18 岁时从“儿童”过渡到“成人”时急诊科 (ED) 阿片类药物处方的不连续增加来估计 ED 阿片类药物处方对后续阿片类药物相关不良事件的影响。我们发现，刚刚超过 18 岁的青少年患者与刚刚不满 18 岁的青少年患者相似，但他们在一年内服用阿片类药物的可能性高出 9.7%，发生阿片类药物相关不良事件（定义为过量、诊断为阿片类药物使用障碍或长期使用阿片类药物）的可能性高出 12.6%。我们估计，当 18 岁以上的“成年人”服用阿片类药物时，出现不良后果的风险会增加 14.1%，而如果他们刚满 18 岁并被视为“儿童”，则不会开阿片类药物。我们的结果表明，儿科与成人护理环境中提供的护理差异可能对于了解处方者在阿片类药物流行中的作用很重要。
Understanding the risks associated with opioid prescription in adolescents is critical for informing opioid policy, but the risks are challenging to quantify given the lack of randomized trial data. Using a regression discontinuity design, we exploited a discontinuous increase in opioid prescribing in the emergency department (ED) when adolescents transition from “child” to “adult” at age eighteen to estimate the effect of an ED opioid prescription on subsequent opioid-related adverse events. We found that adolescent patients just over age eighteen were similar to those just under age eighteen, but they were 9.7 percent more likely to be prescribed an opioid and 12.6 percent more likely to have an adverse opioid-related event, defined as overdose, diagnosis of opioid use disorder, or long-term opioid use, within one year. We estimated a 14.1 percent increased risk for an adverse outcome when “adults” just over age eighteen were prescribed opioids that would not have been prescribed if they were just under age eighteen and considered “children.” Our results suggest that differences in care provided in pediatric versus adult care settings may be important to understanding prescribers’ roles in the opioid epidemic.
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DOI：
10.15585/mmwr.mm6610a1
发表时间：
2017-03-17
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Shah A;Hayes CJ;Martin BC
通讯作者：
Martin BC
影响因子：
8
作者：
Black, Sandra E.;Devereux, Paul J.;Salvanes, Kjell G.
通讯作者：
Salvanes, Kjell G.
影响因子：
16.9
作者：
Harbaugh, Calista M.;Lee, Jay S.;Waljee, Jennifer F.
通讯作者：
Waljee, Jennifer F.
影响因子：
8
作者：
Miech, Richard;Johnston, Lloyd;Heard, Kennon
通讯作者：
Heard, Kennon
影响因子：
8
作者：
Hardin, Amy Peykoff;Hackell, Jesse M.
通讯作者：
Hackell, Jesse M.