Opioid prescription rates associated with surgery among adolescents in the United States from 2015 to 2020.
Opioid prescription rates associated with surgery among adolescents in the United States from 2015 to 2020.
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2015 年至 2020 年美国青少年与手术相关的阿片类药物处方率。
DOI：
10.1111/pan.14753
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Groenewald,CorneliusB
中科院分区：
文献类型：
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作者：
Sofia,JosephT;Kim,Agnes;Jones,Ian;Rabbitts,JenniferA;Groenewald,CorneliusB
美国目前面临着阿片类药物滥用的流行病，这种流行病延伸到青少年手术人群。手术后的阿片类药物处方与阿片类药物的持续使用有关，并作为转移的水库。然而，目前尚不清楚阿片类药物处方中手术类药物的比例，而且对美国青少年与手术相关的阿片类药物处方率的趋势知之甚少。本研究旨在描述美国青少年术后阿片类药物处方率随时间的全国趋势。方法：我们对2015年至2020年医疗支出小组调查（MEPS）中获取的数据进行了基于人群的横断面分析。MEPS将10-19岁的青少年（n= 26909）归类为接受外科手术，如果他们在住院、门诊或急诊就诊期间接受了外科手术。结果样本平均年龄（SD）为14.4（0.01）岁。社会人口学特征代表了美国青少年人口。总共有4.7%的青少年接受了外科手术。手术率在2015年（4.3%）至2020年（4.4%）之间保持稳定，少数民族人群的手术率较低。在所有青少年中，手术和非手术指征的阿片类药物处方综合率从2015年的4.1%显著下降到2020年的1.4%，估计差异为2.7%（95%置信区间（CI）： 1.7%-3.7%,p< 0.0001）。然而，阿片类药物的手术处方保持相对稳定（2015年为1%，2020年为0.8%）。2015年至2020年期间，美国与手术相关的阿片类药物处方率保持稳定，尽管非手术人群的处方量显着下降。手术现在是青少年处方阿片类药物的主要来源。次要发现包括2015年至2020年间手术利用的稳定趋势，以及在手术利用和阿片类药物处方方面持续的种族差异。结论：美国每年有大量的青少年在手术中使用阿片类药物，这表明有必要制定针对青少年阿片类药物使用的国家指南，类似于最近针对成人阿片类药物使用的CDC指南。
IntroductionThe United States currently faces an epidemic of opioid misuse which extends to adolescent surgical populations. Opioid prescriptions after surgery are associated with persistent opioid use and serve as a reservoir for diversion. However, it is unclear what proportion of opioid prescriptions are surgical, and little is known about trends in opioid prescription rates associated with surgery in adolescents in the United States. This study aims to describe national trends in postsurgical opioid prescription rates over time among adolescents in the United States.MethodsWe conducted a population‐based cross‐sectional analysis of data captured in the Medical Expenditure Panel Survey (MEPS) from 2015 to 2020. MEPS classified adolescents 10–19 years of age (n= 26 909) as having a surgical procedure if they had any inpatient, outpatient, or emergency department visit during which a surgical procedure was performed.ResultsMean age (SD) of the sample was 14.4 (0.01) years. Sociodemographic characteristics were representative of the USA adolescent population. In total, 4.7% of adolescents underwent a surgical procedure. The surgery rate remained stable between 2015 (4.3%): and 2020 (4.4%) and was lower among minority populations. The combined rate of opioid prescribing for surgical and nonsurgical indications significantly decreased from 4.1% in 2015 to 1.4% in 2020 among all adolescents, an estimated difference of 2.7% (95% confidence interval (CI): 1.7%–3.7%,p< .0001). However, opioid prescribing for surgery remained relatively stable (1% in 2015 vs. 0.8% in 2020).DiscussionOpioid prescription rates associated with surgery remained stable between 2015 and 2020 in the United States, despite significant decreases in prescribing among nonsurgical populations. Surgery is now a leading source of medical prescribed opioids among adolescents. Secondary findings included a stable trend in surgery utilization between 2015 and 2020, as well as continued racial disparities, both in terms of surgery utilization and opioid prescribing.ConclusionThe large number of adolescents being prescribed opioids for surgery in the USA each year, suggests there is a need for national guidelines aimed at adolescent opioid use, similar to the recent CDC guidelines aimed at adult opioid use.