Factors Associated With Frequent Opioid Use in Children With Acute Recurrent and Chronic Pancreatitis.
Abdominal Pain
/ drug therapy
Acute Disease
Adolescent
Analgesics, Opioid
/ therapeutic use
Child
Chronic Disease
Cross-Sectional Studies
Emergency Service, Hospital
/ statistics & numerical data
Female
Hospitalization
/ statistics & numerical data
Humans
Male
Odds Ratio
Pain Management
/ statistics & numerical data
Pancreatitis
/ complications
Patient Acceptance of Health Care
/ statistics & numerical data
Phenotype
Recurrence
Journal
Journal of pediatric gastroenterology and nutrition
ISSN: 1536-4801
Titre abrégé: J Pediatr Gastroenterol Nutr
Pays: United States
ID NLM: 8211545
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
pubmed:
1
10
2019
medline:
5
3
2021
entrez:
1
10
2019
Statut:
ppublish
Résumé
The aim of the study was to understand the association of frequent opioid use with disease phenotype and pain pattern and burden in children and adolescents with acute recurrent (ARP) or chronic pancreatitis (CP). Cross-sectional study of children <19 years with ARP or CP, at enrollment into the INSPPIRE cohort. We categorized patients as opioid "frequent use" (daily/weekly) or "nonfrequent use" (monthly or less, or no opioids), based on patient and parent self-report. Of 427 children with ARP or CP, 17% reported frequent opioid use. More children with CP (65%) reported frequent opioid use than with ARP (41%, P = 0.0002). In multivariate analysis, frequent opioid use was associated with older age at diagnosis (odds ratio [OR] 1.67 per 5 years, 95% confidence interval [CI] 1.13-2.47, P = 0.01), exocrine insufficiency (OR 2.44, 95% CI 1.13-5.24, P = 0.02), constant/severe pain (OR 4.14, 95% CI 2.06-8.34, P < 0.0001), and higher average pain impact score across all 6 functional domains (OR 1.62 per 1-point increase, 95% CI 1.28-2.06, P < 0.0001). Children with frequent opioid use also reported more missed school days, hospitalizations, and emergency room visits in the past year than children with no frequent use (P < 0.0002 for each). Participants in the US West and Midwest accounted for 83% of frequent opioid users but only 56% of the total cohort. In children with CP or ARP, frequent opioid use is associated with constant pain, more healthcare use, and higher levels of pain interference with functioning. Longitudinal and prospective research is needed to identify risk factors for frequent opioid use and to evaluate nonopioid interventions for reducing pain and disability in these children.
Identifiants
pubmed: 31567889
doi: 10.1097/MPG.0000000000002502
pmc: PMC6934913
mid: NIHMS1540181
pii: 00005176-202001000-00020
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
106-114Subventions
Organisme : NIDDK NIH HHS
ID : K23 DK099253
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK054759
Pays : United States
Organisme : NIDDK NIH HHS
ID : R21 DK096327
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK108334
Pays : United States
Références
Frossard J, Steer M, Pastor C. Acute pancreatitis. Lancet 2008; 371:143–152.
Kleef J, Whitcomb D, Shimosegawa T, et al. Chronic pancreatitis. Nat Rev Dis Primers 2017; 3:17060.
Morinville V, Husain S, Bai H, et al. INSPPIRE Group. Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr 2012; 55:261–265.
Pendharkar S, Salt K, Plank L, et al. Quality of life after acute pancreatitis: a systemic review and meta-analysis. Pancreas 2014; 43:1194–1200.
Pezzilli R, Bini L, Fantini L, et al. Quality of life in chronic pancreatitis. World J Gastroenterol 2006; 12:6249–6251.
Keller C, Wilcox C, Gudleski G, et al. Beyond abdominal pain: pain beliefs, pain affect, and distress as determinants of quality of life in patients with chronic pancreatitis. J Clin Gastroenterol 2018; 52:563–568.
Gachago C, Draganov P. Pain Management in chronic pancreatitis. World J Gastroenterol 2008; 14:3137–3148.
Ting J, Wilson L, Schwarzenberg S, et al. Direct costs of acute recurrent and chronic pancreatitis in children in the INSPPIRE study. J Pediatr Gastroenterol Nutr 2016; 62:443–449.
Kumar S, Ooi C, Werlin S, et al. Risk factors associated with pediatric acute recurrent and chronic pancreatitis: lessons from INSPPIRE. JAMA Pediatr 2016; 170:562–569.
Morinville V, Lowe M, Ahuja M, et al. Design and implementation of INSPPIRE. J Pediatr Gastroenterol Nutr 2014; 59:360–364.
Wong D, Baker C. Pain in children: comparison of assessment scales. Pediatr Nurs 1988; 14:9–17.
Keck J, Gerkensmeyer J, Joyce B, et al. Reliability and validity of the FACES and Word Descriptor Scales to measure procedural pain. J Pediatr Nurs 1996; 11:368–374.
Groenewald C, Law E, Fisher E, et al. Associations between chronic pain and prescription opioid misuse in adulthood. J Pain 2019; 20:28–37.
Fortuna R, Robbins B, Caiola E, et al. Prescribing of controlled medications to adolescents and young adults in the United States. Pediatrics 2010; 126:1108–1116.
Groenewald C, Rabbitts J, Gebert T, et al. Trends in opioid prescriptions among children and adolescents in the U.S.: a nationally representative study 1996–2012. Pain 2016; 157:1021–1027.
Shipton E, Shipton E, Shipton A. A review of the opioid epidemic: what do we do about it? Pain Ther 2018; 7:23–36.
Gomes T, Tadrous M, Mamdani M, et al. The burden of opioid-related mortality in the United States. JAMA Netw Open 2018; 1:e180217.
Gaither J, Leventhal J, Ryan S, et al. National trends in hospitalizations for opioid poisonings among children and adolescents, 1997 to 2012. JAMA Pediatr 2016; 170:1195–1201.
Miech R, Johnston L, O’Malley P, et al. Prescription opioids in adolescence and future opioid misuse. Pediatrics 2015; 136:e1169–e1177.
Manchikanti L, Kaye A, Knezevic N, et al. Responsible, safe, and effective prescriptions of opioids for chronic non-cancer pain: American Society of Interventional Pain Physicians (ASIPP) guidelines. Pain Physician 2017; 20:S3–92.
Schwarzenberg S, Bellin M, Husain S, et al. Pediatric chronic pancreatitis is associated with genetic risk factors and substantial disease burden. J Pediatr 2015; 166:890.e1–896.e1.
Cote G, Yadav D, Abberbock J, et al. Recurrent acute pancreatitis significantly reduces qualify of life in the absence of overt chronic pancreatitis. Am J Gastroenterol 2018; 113:906–912.
Keller C, Wilcox C, Gudleski G, et al. Beyond abdominal pain: pain beliefs, pain affect, and distress as determinants of quality of life in patients with chronic pancreatitis. J Clin Gastroenterol 2019; 52:563–568.
Hill R, Lewindon P, Muir R, et al. Quality of life in children with Crohn disease. J Pediatr Gastroenterol Nutr 2010; 51:35–40.
Arvantis M, DeWalt D, Martin C, et al. Patient-reported outcomes measurement information system in children with Crohn's disease. J Pediatr 2016; 174:153.e2–159.e2.
Drewes A, Bousense S, Campbell C, et al. Working group for the International (IAP – APA – JPS – EPC) Consensus Guidelines for Chronic Pancreatitis. Guidelines for the understanding and management of pain in chronic pancreatitis. Pancreatology 2017; 17:720–731.
Anaparthy R, Pasricha P. Pain and chronic pancreatitis: is it the plumbing or the wiring? Curr Gastroenterol Rep 2008; 10:101–106.
Poulsen J, Olesen S, Malver L, et al. Pain and chronic pancreatitis: a complex interplay of multiple mechanisms. World J Gastroenterol 2013; 19:7282–7291.
Chinnakotla S, Radosevich D, Dunn T, et al. Long-term outcomes of total pancreatectomy and islet auto transplantation for hereditary/genetic pancreatitis. J Am Coll Surg 2014; 218:530–543.
Wang D. Opioid medications in the management of chronic abdominal pain. Curr Pain Headache Rep 2017; 21:40.
Sun X, Hu L, Xia T, et al. Clinical features and endoscopic treatment of Chinese patients with hereditary pancreatitis. Pancreas 2015; 44:59–63.
Bellin M, Forlenza G, Majumder K, et al. Total pancreatectomy with islet autotransplantation resolved pain in young children with severe chronic pancreatitis. J Pediatr Gastroenterol Nutr 2017; 64:440–445.
Moran R, Klapheke R, John G, et al. Prevalence and predictors of pain and opioid analgesic use following total pancreatectomy with islet autotransplantation for pancreatitis. Pancreatology 2017; 17:732–737.
Rosenman R, Tennekon V, Hill LG. Measuring bias in self-reported data. Int J Behav Healthc Res 2011; 2:320–332.
Teitelbaum J, Arora R. Long-term efficacy of low-dose tricyclic antidepressants for children with functional gastrointestinal disorders. J Pediatr Gastroenterol Nutr 2011; 53:260–264.
Norgaard M, Jacobsen J, Gasse C, et al. Selective serotonin reuptake inhibitors and risk of acute pancreatitis: a population-based case-control study. J Clin Psychopharmacol 2007; 27:259–262.
Chung C, Callahan S, Cooper W, et al. Outpatient opioid prescriptions for children and opioid-related adverse events. Pediatrics 2018; 142pii: e20172156.
pii: e20172156
Uc A, Perito ER, Pohl JF, et al. Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC). INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE Cohort Study: design and rationale for INSPPIRE 2 From the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer. Pancreas 2018; 47:1222–1228.