Abstract：
Purpose: To investigate opioid prescription fills following pediatric/adolescent dental procedures in central/southeastern Ohio. Methods: This population-based, retrospective cohort study utilized health insurance claims from a pediatric public accountable care organization (???Medicaid???) in central/southeastern Ohio. Patients aged 18 years and younger who had a dental procedure between January 2012 and February 2019 were identified, and claims were searched for opioid prescription fills within 14 days post-procedure. Trends in prescription fill percentages, types of opioid, procedure classification and patient characteristics were examined. Results: A total of 512,922 encounters among 212,813 patients were included. The overall opioid prescription fill was 4.9 percent. Percentages decreased throughout the study period from 6.1 percent (95 percent confidence interval [95% CI]=5.9 to 6.3) in 2012 to 3.4 percent (95% CI=3.1 to 3.8) in early 2019. When limited to extractions and endodontic procedures, the overall prescription fill percentage fell from 15.7 percent (95% CI=15.2 to 16.1) in 2012 to 9.5 percent (95% CI=8.5 to 10.4) in early 2019. The most common opioids were hydrocodone (68.6 percent) and codeine (24.7 percent), with marked annual reductions in codeine prescription fills among children younger than 14 years. From 2017 to 2018, surgical extractions compared to endodontics-only procedures (risk difference [RD]=40.7; 95% CI=38.6 to 42.9) and older patient age (RD for 18-year-olds versus 13-year-olds=21.9; 95% CI=19.8 to 24.0) were strong risk factors for filling an opioid prescription. Conclusion: Post-procedure opioid prescription fill percentages have decreased since 2012 among pediatric/adolescent Medicaid enrollees undergoing dental procedures in central/southeastern Ohio. Substantial differences in the likelihood of filling a prescription remained by procedural and demographic variables. There were marked trends in the types of opioid for which prescriptions were filled, which varied by patient age.
摘要：
目的：调查俄亥俄州中部/东南部儿童/青少年牙科手术后的阿片类药物处方填充。方法：以人群为基础，回顾性队列研究利用了俄亥俄州中部/东南部的儿科公共负责医疗组织（Medicaid）的健康保险索赔。确定了在2012年1月至2019年2月期间进行牙科手术的18岁及以下的患者。并在手术后14天内搜索了阿片类药物处方的配药。处方填充百分比的趋势，阿片类药物的类型，检查了程序分类和患者特征。结果：共纳入212,813例患者中的512,922例。阿片类药物处方的总剂量为4.9％。在整个研究期间，百分比从2012年的6.1％（95％置信区间[95％CI]=5.9至6.3）下降到2019年初的3.4％（95％CI=3.1至3.8）。当限于提取和牙髓手术时，总体处方按剂量百分比从2012年的15.7%(95%CI=15.2~16.1)降至2019年初的9.5%(95%CI=8.5~10.4).最常见的阿片类药物是氢可酮（68.6%）和可待因（24.7%）。14岁以下儿童的可待因处方填充量每年显著减少。从2017年到2018年，与仅接受牙髓治疗的手术相比（风险差异[RD]=40.7;95％CI=38.6至42.9）和年龄较大的患者（18岁与13岁的RD=21.9;95％CI=19.8至24.0）是服用阿片类药物处方的强风险因素。结论：自2012年以来，在俄亥俄州中部/东南部接受牙科手术的儿科/青少年医疗补助参与者中，术后阿片类药物处方的填充百分比有所下降。根据程序和人口统计学变量，配药的可能性仍然存在很大差异。处方的阿片类药物类型有明显的趋势，因患者年龄而异。
