• Michael Hrdy, Monika K Goyal, Gia M Badolato, and Joanna S Cohen.
• Division of Pediatric Emergency Medicine, Children's National Hospital, Washington, DC; George Washington University School of Medicine, Washington, DC; Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelmen School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
• J Emerg Med. 2022 Jun 1; 62 (6): 775-782.

BackgroundLittle is known about prescription filling of pain medicine for children. In adult populations, race and insurance type are associated with differences in opioid prescription fill rate. We hypothesize that known disparities in pain management for children are exacerbated by the differential rates of opioid prescription filling between patients based on age and race.ObjectiveTo determine if there are demographic or clinical factors associated with differences in opioid prescription fill rates after discharge from the pediatric emergency department (ED).MethodsThis was a retrospective cross-sectional study of all patients younger than 19 years discharged with an opioid prescription from either of two pediatric EDs in 2018. We performed multivariable logistic regression to measure associations between prescription filling and demographic and clinical factors.ResultsThere were 287 patient visits in which opioids were prescribed. Forty percent of prescriptions were filled. The majority of patients were male (53%), black (69%), and had public insurance (55%). There were no significant associations between prescription filling and age, insurance status, or race/ethnicity. Patients with sickle cell disease were more likely to fill prescriptions (odds ratio 3.87, 95% confidence interval 2.33-6.43) and patients without an identified primary care provider were less likely to fill prescriptions (odds ratio 0.16, 95% confidence interval 0.03-0.84).ConclusionLess than half of opioid prescriptions prescribed at discharge from a pediatric emergency department are filled. Patient age, insurance status, and race/ethnicity are not associated with opioid prescription filling. Patients with sickle cell disease and those with a primary care provider are more likely to fill their opioid prescriptions.Copyright © 2022. Published by Elsevier Inc.

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