Researchers in the Orthopedic Center at Children’s Hospital of Philadelphia (CHOP) found that white youth from wealthier socioeconomic areas were more likely to be prescribed opioids in the emergency room for supracondylar humerus (SCH) fractures, a broken elbow, compared with their same-age, non-white, peers from disadvantaged regions. The abstract will be presented at the 2024 American Academy of Pediatrics (AAP) National Conference & Exhibition in Orlando, Florida.
The new study is a follow-up to prior research published two years ago in the Journal of Bone and Joint Surgery by the CHOP Ortho team, where researchers identified factors related to opioid prescription for routine orthopedic minor procedures.
“Despite a widely publicized public health crisis, the findings underscore an ongoing urgent need to improve opioid stewardship, especially with adolescents and young adults,” said Apurva S. Shah, MD, MBA, an attending pediatric orthopedic surgeon at CHOP who authored the abstract. “We must take every precaution when it comes to pain management and children. In most cases, non-opioids are effective and safer.”
In this study, the team evaluated retrospective data on patients who sought treatment in the emergency room between 2012 and 2021 for (SCH) from the Pediatric Health Information System (PHIS), a database consisting of patient encounters across 52 pediatric hospitals. The authors investigated what factors including sex, race, ethnicity, insurance and Childhood Opportunity Index (COI) impact the likelihood of opioid prescriptions. COI, which incorporates key aspects of a child’s life, like education, environmental and socioeconomic status, measures and maps the quality of resources and conditions in their neighborhoods that impact healthy development and future success.
The research, which was funded by CHOP’s Orthopedic Center, found that of the 35,452 children (52% male) who were treated non-surgically, about one-third (30.2%) received at least one dose of opioids in the ER. Children from moderate, high, and very high COI regions were significantly more likely to receive opioids compared to very low COI regions. White patients were 10% more likely to receive an opioid prescription compared with African American patients, who were 27% less likely to receive an opioid prescription. Patients 5-13 years old were 1.4 times more likely to receive an opioid prescription than younger patients.
“Given today’s behavioral health climate, research in pediatric pain management is essential,” said Shah. “We must remain focused on a future where children can heal without unnecessary risks associated with these powerful medications.”
Shah et al, “Overprescription of Opioids in White Children from Higher Socioeconomic Backgrounds: Disparities in Opioid Utilization for Pediatric Supracondylar Humerus Fractures,” American Academy of Pediatrics Annual Meeting; September 27 – October 4, 2024; Orlando, Florida.
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Researchers in the Orthopedic Center at Children’s Hospital of Philadelphia (CHOP) found that white youth from wealthier socioeconomic areas were more likely to be prescribed opioids in the emergency room for supracondylar humerus (SCH) fractures, a broken elbow, compared with their same-age, non-white, peers from disadvantaged regions. The abstract will be presented at the 2024 American Academy of Pediatrics (AAP) National Conference & Exhibition in Orlando, Florida.
The new study is a follow-up to prior research published two years ago in the Journal of Bone and Joint Surgery by the CHOP Ortho team, where researchers identified factors related to opioid prescription for routine orthopedic minor procedures.
“Despite a widely publicized public health crisis, the findings underscore an ongoing urgent need to improve opioid stewardship, especially with adolescents and young adults,” said Apurva S. Shah, MD, MBA, an attending pediatric orthopedic surgeon at CHOP who authored the abstract. “We must take every precaution when it comes to pain management and children. In most cases, non-opioids are effective and safer.”
In this study, the team evaluated retrospective data on patients who sought treatment in the emergency room between 2012 and 2021 for (SCH) from the Pediatric Health Information System (PHIS), a database consisting of patient encounters across 52 pediatric hospitals. The authors investigated what factors including sex, race, ethnicity, insurance and Childhood Opportunity Index (COI) impact the likelihood of opioid prescriptions. COI, which incorporates key aspects of a child’s life, like education, environmental and socioeconomic status, measures and maps the quality of resources and conditions in their neighborhoods that impact healthy development and future success.
The research, which was funded by CHOP’s Orthopedic Center, found that of the 35,452 children (52% male) who were treated non-surgically, about one-third (30.2%) received at least one dose of opioids in the ER. Children from moderate, high, and very high COI regions were significantly more likely to receive opioids compared to very low COI regions. White patients were 10% more likely to receive an opioid prescription compared with African American patients, who were 27% less likely to receive an opioid prescription. Patients 5-13 years old were 1.4 times more likely to receive an opioid prescription than younger patients.
“Given today’s behavioral health climate, research in pediatric pain management is essential,” said Shah. “We must remain focused on a future where children can heal without unnecessary risks associated with these powerful medications.”
Shah et al, “Overprescription of Opioids in White Children from Higher Socioeconomic Backgrounds: Disparities in Opioid Utilization for Pediatric Supracondylar Humerus Fractures,” American Academy of Pediatrics Annual Meeting; September 27 – October 4, 2024; Orlando, Florida.
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