Opioid prescribing disparities in a public health crisis: The case of pediatric post-surgical pain management

公共卫生危机中阿片类药物处方的差异:儿科术后疼痛管理案例

基本信息

  • 批准号:
    9389281
  • 负责人:
  • 金额:
    $ 18.94万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2017
  • 资助国家:
    美国
  • 起止时间:
    2017-09-01 至 2019-04-30
  • 项目状态:
    已结题

项目摘要

Abstract African Americans adults are less likely to receive analgesics, particularly opioids, even after controlling for pain severity. Research in the pediatric surgical population is more limited but the pattern of disparate use of opioids appear consistent with adult research. While it cannot be assumed that opioids are always the best approach to post-operative pain treatment for children, differential use driven by non-clinical judgments is of concern. This concern, however, exists at a time when opioid addiction is a public health crisis. Although most adolescents who misuse pain medications initially receive them for free from a friend or family member, adolescent access to prescribed opioids has also increased. The relationship between racial disparities in postoperative pain management and opioid addition is complex. Allowing a child's pain to go unaddressed because of concerns driven by bias is unacceptable. On the other hand, overprescribing can enhance risk for addiction or diversion of medications to the illicit market with broad societal implications. Striking the right balance requires empirical evidence that supports data-driven decision-making. This proposal aims to strengthen the evidence base regarding use of opioid pain medications in children following surgical procedures and to explore the inter-related impacts of policy, clinical need, and socio-demographic factors by combining Medicaid claims and electronic health record data with findings from a statewide opioid policy inventory. This research will be done Ohio, a state with the 5th highest opioid mortality in the nation using clinical data from Nationwide Children's Hospital, the nation's largest pediatric surgical provider, performing over 35,000 pediatric surgical procedures each year across 10 pediatric surgical subspecialties and both in-patient and ambulatory surgery centers. We will focus on discharge prescribing of opioids in three high volume pediatric surgical procedures: tonsillectomy/adenoidectomy, supracondylar fracture, and appendectomy. Specifically, we aim to: 1) Determine the extent of and trends in racial disparities in postoperative discharge opioid prescribing since the 2011 onset of enhanced opioid prescription reduction activities; and 2) Develop an expanded model, including pain scores and other EMR data, to assess the linkage between differential opioid use for pediatric postoperative pain and opioid use-related outcomes. This analysis will enhance understanding of disparities in opioid use for pain management and support decision making for policy and practice that maximizes equity in pain management while remaining focused on reducing misuse and addiction.
摘要

项目成果

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Deena Chisolm其他文献

Deena Chisolm的其他文献

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{{ truncateString('Deena Chisolm', 18)}}的其他基金

Research Experiences in Childhood Heart, Lung, and Blood Science - REaCH LABS
儿童心脏、肺和血液科学的研究经验 - REaCH LABS
  • 批准号:
    10681038
  • 财政年份:
    2023
  • 资助金额:
    $ 18.94万
  • 项目类别:
Targeted Investment and Meaningful Engagement to Improve MCH Outcomes and Rectify Historical Structural Racism: The TIME Study
有针对性的投资和有意义的参与可改善妇幼保健成果并纠正历史结构性种族主义:《时代》杂志研究
  • 批准号:
    10622527
  • 财政年份:
    2022
  • 资助金额:
    $ 18.94万
  • 项目类别:
Targeted Investment and Meaningful Engagement to Improve MCH Outcomes and Rectify Historical Structural Racism: The TIME Study
有针对性的投资和有意义的参与可改善妇幼保健成果并纠正历史结构性种族主义:《时代》杂志研究
  • 批准号:
    10474914
  • 财政年份:
    2022
  • 资助金额:
    $ 18.94万
  • 项目类别:
Substance Use Disparities among Transgender Youth
跨性别青少年的药物使用差异
  • 批准号:
    8967009
  • 财政年份:
    2015
  • 资助金额:
    $ 18.94万
  • 项目类别:
Substance Use Disparities among Transgender Youth
跨性别青少年的药物使用差异
  • 批准号:
    9139428
  • 财政年份:
    2015
  • 资助金额:
    $ 18.94万
  • 项目类别:
Stress Reactivity and Substance Use among Sexual Minority Girls
性少数女孩的应激反应和药物使用
  • 批准号:
    9012054
  • 财政年份:
    2013
  • 资助金额:
    $ 18.94万
  • 项目类别:
Stress Reactivity and Substance Use among Sexual Minority Girls
性少数女孩的应激反应和药物使用
  • 批准号:
    8416635
  • 财政年份:
    2013
  • 资助金额:
    $ 18.94万
  • 项目类别:
Stress Reactivity and Substance Use among Sexual Minority Girls
性少数女孩的应激反应和药物使用
  • 批准号:
    9221313
  • 财政年份:
    2013
  • 资助金额:
    $ 18.94万
  • 项目类别:
Health Literacy-Disparities and transition in teens with special healthcare needs
健康素养——有特殊医疗保健需求的青少年的差异和转变
  • 批准号:
    8334492
  • 财政年份:
    2011
  • 资助金额:
    $ 18.94万
  • 项目类别:
Health Literacy-Disparities and transition in teens with special healthcare needs
健康素养——有特殊医疗保健需求的青少年的差异和转变
  • 批准号:
    8706707
  • 财政年份:
    2011
  • 资助金额:
    $ 18.94万
  • 项目类别:

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