Effects of the FDA Codeine Safety Investigation on Racial and Geographic Disparities in Opioid Prescribing after Pediatric Tonsillectomy and/or Adenoidectomy

Objective. Our objective was to examine the impact of the U.S. FDA’s 2013 black box warning against codeine on codeine and other opioid prescription filling after pediatric tonsillectomy and/or adenoidectomy (T/A) overall and by child race and provider urbanity/rurality. Methods. Patients ≤ 18 who u...

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Main Authors: Amy Lawrence, Jennifer N. Cooper, Katherine J. Deans, Peter C. Minneci, Sharon K. Wrona, Deena J. Chisolm
Format: Article
Language:English
Published: SAGE Publishing 2021-01-01
Series:Global Pediatric Health
Online Access:https://doi.org/10.1177/2333794X20987444
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author Amy Lawrence
Jennifer N. Cooper
Katherine J. Deans
Peter C. Minneci
Sharon K. Wrona
Deena J. Chisolm
author_facet Amy Lawrence
Jennifer N. Cooper
Katherine J. Deans
Peter C. Minneci
Sharon K. Wrona
Deena J. Chisolm
author_sort Amy Lawrence
collection DOAJ
description Objective. Our objective was to examine the impact of the U.S. FDA’s 2013 black box warning against codeine on codeine and other opioid prescription filling after pediatric tonsillectomy and/or adenoidectomy (T/A) overall and by child race and provider urbanity/rurality. Methods. Patients ≤ 18 who underwent T/A in 8/2011 to 8/2016 were identified in Ohio Medicaid claims. Interrupted time series analyses were used to evaluate the impact of the FDA warning on codeine or other opioid prescription filling post-T/A. Results. In August 2011, codeine prescription filling was lower among black than white children ( P  < .001) and among children treated at institutions in metropolitan counties than less populous counties ( P  < .001). The FDA warning was associated with a 24.0% drop in codeine prescription filling ( P  < .001) and 5.5% increase in alternative opioid prescription filling ( P  = .046). At conclusion, there remained geographic but no longer racial disparities in codeine prescribing. Conclusion. Codeine prescribing after pediatric T/A decreased after the FDA’s black box warning. However, geographic disparities in codeine prescribing remain.
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spelling doaj.art-74bf99be496a46e8a5bd2361efdf1fcf2022-12-21T19:53:49ZengSAGE PublishingGlobal Pediatric Health2333-794X2021-01-01810.1177/2333794X20987444Effects of the FDA Codeine Safety Investigation on Racial and Geographic Disparities in Opioid Prescribing after Pediatric Tonsillectomy and/or AdenoidectomyAmy Lawrence0Jennifer N. Cooper1Katherine J. Deans2Peter C. Minneci3Sharon K. Wrona4Deena J. Chisolm5Nationwide Children’s Hospital, Columbus, OH, USANationwide Children’s Hospital, Columbus, OH, USANationwide Children’s Hospital, Columbus, OH, USANationwide Children’s Hospital, Columbus, OH, USANationwide Children’s Hospital, Columbus, OH, USANationwide Children’s Hospital, Columbus, OH, USAObjective. Our objective was to examine the impact of the U.S. FDA’s 2013 black box warning against codeine on codeine and other opioid prescription filling after pediatric tonsillectomy and/or adenoidectomy (T/A) overall and by child race and provider urbanity/rurality. Methods. Patients ≤ 18 who underwent T/A in 8/2011 to 8/2016 were identified in Ohio Medicaid claims. Interrupted time series analyses were used to evaluate the impact of the FDA warning on codeine or other opioid prescription filling post-T/A. Results. In August 2011, codeine prescription filling was lower among black than white children ( P  < .001) and among children treated at institutions in metropolitan counties than less populous counties ( P  < .001). The FDA warning was associated with a 24.0% drop in codeine prescription filling ( P  < .001) and 5.5% increase in alternative opioid prescription filling ( P  = .046). At conclusion, there remained geographic but no longer racial disparities in codeine prescribing. Conclusion. Codeine prescribing after pediatric T/A decreased after the FDA’s black box warning. However, geographic disparities in codeine prescribing remain.https://doi.org/10.1177/2333794X20987444
spellingShingle Amy Lawrence
Jennifer N. Cooper
Katherine J. Deans
Peter C. Minneci
Sharon K. Wrona
Deena J. Chisolm
Effects of the FDA Codeine Safety Investigation on Racial and Geographic Disparities in Opioid Prescribing after Pediatric Tonsillectomy and/or Adenoidectomy
Global Pediatric Health
title Effects of the FDA Codeine Safety Investigation on Racial and Geographic Disparities in Opioid Prescribing after Pediatric Tonsillectomy and/or Adenoidectomy
title_full Effects of the FDA Codeine Safety Investigation on Racial and Geographic Disparities in Opioid Prescribing after Pediatric Tonsillectomy and/or Adenoidectomy
title_fullStr Effects of the FDA Codeine Safety Investigation on Racial and Geographic Disparities in Opioid Prescribing after Pediatric Tonsillectomy and/or Adenoidectomy
title_full_unstemmed Effects of the FDA Codeine Safety Investigation on Racial and Geographic Disparities in Opioid Prescribing after Pediatric Tonsillectomy and/or Adenoidectomy
title_short Effects of the FDA Codeine Safety Investigation on Racial and Geographic Disparities in Opioid Prescribing after Pediatric Tonsillectomy and/or Adenoidectomy
title_sort effects of the fda codeine safety investigation on racial and geographic disparities in opioid prescribing after pediatric tonsillectomy and or adenoidectomy
url https://doi.org/10.1177/2333794X20987444
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