Kids frequently receive Opioids and steroids for pneumonia and sinusitis during ED visits
USA: Children receive opioid and steroid prescriptions for pneumonia or sinusitis at a higher frequency in the emergency department (ED) than in the ambulatory settings, according to a recent study published in the AAP journal Pediatrics.
Karina G. Phang, Geisinger Medical Center in Danville, Pa, and colleagues compared the frequency of opioid and corticosteroid prescriptions dispensed for children with pneumonia or sinusitis visits on the basis of the location of care.
They evaluated 2016 South Carolina Medicaid claims data for 5 to 18 years olds with pneumonia or sinusitis. Visits were associated with 1 of 3 locations: the emergency department (ED), urgent care, or the ambulatory setting. A total of 31 838 children were included in the study.
Key findings of the study include:
- Pneumonia visits were more often linked to an opioid prescription in the ED (34 of 542 [6.3%]) than in ambulatory settings (24 of 1590 [1.5%]) and were more frequently linked to a steroid prescription in the ED (106 of 542 [19.6%]) than in ambulatory settings (196 of 1590 [12.3%];).
- Sinusitis visits were more often linked to an opioid prescription in the ED (202 of 2705 [7.5%]) than in ambulatory settings (568 of 26 866 [2.1%]) and were more frequently linked to a steroid prescription in the ED (510 of 2705 [18.9%]) than in ambulatory settings (1922 of 26 866 [7.2%]).
- In logistic regression for children with pneumonia, the ED setting was associated with increased odds of receiving an opioid (adjusted odds ratio [aOR] 4.69) or steroid (aOR 1.67).
- Patients with sinusitis were more likely to be prescribed opioids (aOR 4.02) or steroids (aOR 3.05) in the ED than in ambulatory sites.
"School-aged children received opioid and steroid prescriptions for pneumonia or sinusitis at a higher frequency in the ED versus the ambulatory setting," concluded the authors.
The study, "Opioids or Steroids for Pneumonia or Sinusitis," were published in the AAP journal Pediatrics.
DOI: https://doi.org/10.1542/peds.2019-3690
