PT  - JOURNAL ARTICLE
AU  - Lauren Krystine Kahl
AU  - Martha W Stevens
AU  - Andrea C Gielen
AU  - Eileen M McDonald
AU  - Leticia Ryan
TI  - Characteristics of opioid prescriptions for discharged pediatric emergency department patients with acute injuries
AID  - 10.1136/jim-2019-001035
DP  - 2019 May 17
TA  - Journal of Investigative Medicine
PG  - jim-2019-001035
4099  - http://hw-f5-jim.highwire.org/content/early/2019/05/17/jim-2019-001035.short
4100  - http://hw-f5-jim.highwire.org/content/early/2019/05/17/jim-2019-001035.full
AB  - This study describes the characteristics of opioid prescriptions for pediatric patients discharged from the emergency department (ED) with acute injuries, including type, formulation, quantity dispensed, and associations with patient age group and prescriber level of training. This retrospective cohort study enrolled all acutely injured patients receiving opioid prescriptions at discharge from an urban academic pediatric ED in a 1-year period. Electronic medical records were reviewed to abstract clinical and prescription data and prescriber level of training. Descriptive statistics were used for analysis. We identified 254 patients with injuries who received opioid prescriptions at ED discharge during the study period (mean age 9.5 years, 65% male). The most common injury was fracture (71%). Oxycodone was the opioid most frequently prescribed (96.1%). Liquid formulations were prescribed in 51.6% of cases. The median number of doses prescribed per prescription was 12 (SD±9.1), with a range of 1–50. Residents wrote 72.9% of prescriptions and prescribed more doses than non-residents (15.5 vs 12.2, p=0.01). Post-graduate year 2 (PGY2) residents prescribed more doses than PGY1 or PGY3+ residents. Our data show wide variation in the number of opioid doses prescribed to acutely injured pediatric patients at ED discharge and frequent use of liquid formulation; both factors may place this population at risk for accidental ingestion. These findings also support the development of pediatric clinical guidelines to define appropriate quantities of opioids to prescribe, promote poisoning prevention strategies, and design post-graduate education for medical trainees about safe prescribing practices.