For Children With Sickle Cell Disease Prescribed Opioids, No Patterns of Misuse Emerged

No patterns of prolonged-term or increasing employ of opioids had been identified within 3 years among opioid-naive children with sickle cell illness (SCD) who had been prescribed the capsules for an acute pain episode, based mostly completely on a retrospective cohort gape.

Within the cohort of 725 children, mean days’ present of opioids over 3 years used to be 30, despite 45.5% of sufferers having a least one vaso-occlusive crisis, reported Angela Snyder, PhD, MPH, of the Georgia Health Coverage Center at Georgia Bellow College in Atlanta, and colleagues in a review letter in JAMA Pediatrics. The correlation between assortment of vaso-occlusive crises and days’ present used to be r=0.58 (P<0.001).

Among patients with one to three vaso-occlusive crises during follow-up, 45.6% filled less than a 10-day supply of opioids, 54.1% filled a supply for 10-36 days, and 29.8% filled a supply for >36 days. For those sufferers with greater than three vaso-occlusive crises, these charges had been 9.3%, 25.6%, and 62.8%.

Providing opioid prescriptions to children who admire skilled pain episodes “does no longer kind patterns of opioid employ that are no longer connected to the particular particular person illness course,” Snyder suggested MedPage Currently. “Due to of the opioid epidemic, it be crucial to clarify that people mark that as soon as giving prescriptions for youngsters with sickle cell illness, you are no longer establishing contributors who’re going to misuse opioids.”

Snyder pointed out that the gape confirmed many SCD sufferers had been getting opioid prescriptions at a young age. To illustrate, 11.2% of the kids in the cohort had been a year broken-down at the time of first prescription, and 14.3% had been 2 years broken-down.

Of three,215 prescriptions, 25.4% had been stuffed within 5 days of a hospitalization for a vaso-occlusive crisis. No matter when stuffed, median days’ present per prescription used to be 5.

This gape aged Medicaid enrollment and claims data from the 2011-2019 Georgia Sickle Cell Records Sequence program, and included 725 children (mean age 4.6 years, 47.4% ladies) who stuffed no longer no longer as a lot as one opioid prescription between ages 0 to 9 years after 1 year without opioid prescriptions. The principle prescription used to be codeine in 26.5% of cases, and hydrocodone/diversified in the supreme 73.5%.

These children had been adopted for as a lot as three years from 2012 to 2019. Staunch through apply-up, 23.6% of sufferers had no vaso-occlusive crises, 45.5% had one to about a, and 30.9% had over three.

Of the sufferers, 58.1% had confirmed hemoglobin SS or hemoglobin S β⁰-thalassemia, and 23.6% had hemoglobin SC.

Snyder and colleagues suggested that future review study whether or no longer low opioid employ reflects efficient non-opioid pain administration recommendations or “highlights an unintended and doubtlessly mosey medicines obtain entry to anguish secondary to the opioid epidemic.”

A limitation to the gape used to be its focal point on sufferers with Medicaid, which doubtlessly restricted generalizability to sufferers with commercial insurance coverage, they famed.