Evaluating the 0–10 Point Pain Scale on Adolescent Opioid Use in US Emergency Departments
Objective: To evaluate trends in national emergency department (ED) adolescent opioid use in relation to reported pain scores. Methods: A retrospective, cross-sectional analysis on National Hospital Ambulatory Medical Care Survey (NHAMCS) data was conducted on ED visits involving patients aged 11–21...
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MDPI AG
2021-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/1/38 |
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| author | Michael T. Phan Daniel M. Tomaszewski Cody Arbuckle Sun Yang Brooke Jenkins Michelle A. Fortier Theodore Heyming Erik Linstead Candice Donaldson Zeev Kain |
| author_facet | Michael T. Phan Daniel M. Tomaszewski Cody Arbuckle Sun Yang Brooke Jenkins Michelle A. Fortier Theodore Heyming Erik Linstead Candice Donaldson Zeev Kain |
| author_sort | Michael T. Phan |
| collection | DOAJ |
| description | Objective: To evaluate trends in national emergency department (ED) adolescent opioid use in relation to reported pain scores. Methods: A retrospective, cross-sectional analysis on National Hospital Ambulatory Medical Care Survey (NHAMCS) data was conducted on ED visits involving patients aged 11–21 from 2008–2017. Crude observational counts were extrapolated to weighted estimates matching total population counts. Multivariate models were used to evaluate the role of a pain score in the reported use of opioids. Anchors for pain scores were 0 (no pain) and 10 (worst pain imaginable). Results: 31,355 observations were captured, which were extrapolated by the NHAMCS to represent 162,515,943 visits nationwide. Overall, patients with a score of 10 were 1.35 times more likely to receive an opioid than patients scoring a 9, 41.7% (CI95 39.7–43.8%) and 31.0% (CI95 28.8–33.3%), respectively. Opioid use was significantly different between traditional pain score cutoffs of mild (1–3) and moderate pain (4–6), where scores of 4 were 1.76 times more likely to receive an opioid than scores of 3, 15.5% (CI95 13.7–17.3%) and 8.8% (CI95 7.1–10.6%), respectively. Scores of 7 were 1.33 times more likely to receive opioids than scores of 6, 24.7% (CI95 23.0–26.3%) and 18.5% (CI95 16.9–20.0%), respectively. Fractures had the highest likelihood of receiving an opioid, as 49.2% of adolescents with a fracture received an opioid (CI95 46.4–51.9%). Within this subgroup, only adolescents reporting a fracture pain score of 10 had significantly higher opioid use than adjacent pain scores, where fracture patients scoring a 10 were 1.4 times more likely to use opioids than those scoring 9, 82.2% (CI95 76.1–88.4%) and 59.8% (CI95 49.0–70.5%), respectively. Conclusions: While some guidelines in the adult population have revised cut-offs and groupings of the traditional tiers on a 0–10 point pain scale, the adolescent population may also require further examination to potentially warrant a similar adjustment. |
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| format | Article |
| id | doaj.art-c6db1cdb601749829a2c31e21284bb02 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:37:02Z |
| publishDate | 2021-12-01 |
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| spelling | doaj.art-c6db1cdb601749829a2c31e21284bb022023-11-23T11:42:42ZengMDPI AGJournal of Clinical Medicine2077-03832021-12-011113810.3390/jcm11010038Evaluating the 0–10 Point Pain Scale on Adolescent Opioid Use in US Emergency DepartmentsMichael T. Phan0Daniel M. Tomaszewski1Cody Arbuckle2Sun Yang3Brooke Jenkins4Michelle A. Fortier5Theodore Heyming6Erik Linstead7Candice Donaldson8Zeev Kain9Department of Pharmacy Practice, Chapman University School of Pharmacy, Irvine, CA 92618, USADepartment of Pharmaceutical and Health Economics, University of Southern California, Los Angeles, CA 90007, USASchmid College of Science and Technology, Chapman University, Orange, CA 92866, USADepartment of Pharmacy Practice, Chapman University School of Pharmacy, Irvine, CA 92618, USADepartment of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USADepartment of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA 92697, USADepartment of Pediatric Emergency Medicine, Children’s Hospital of Orange County, Orange, CA 92868, USAFowler School of Engineering, Chapman University, Orange, CA 92866, USADepartment of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USADepartment of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA 92697, USAObjective: To evaluate trends in national emergency department (ED) adolescent opioid use in relation to reported pain scores. Methods: A retrospective, cross-sectional analysis on National Hospital Ambulatory Medical Care Survey (NHAMCS) data was conducted on ED visits involving patients aged 11–21 from 2008–2017. Crude observational counts were extrapolated to weighted estimates matching total population counts. Multivariate models were used to evaluate the role of a pain score in the reported use of opioids. Anchors for pain scores were 0 (no pain) and 10 (worst pain imaginable). Results: 31,355 observations were captured, which were extrapolated by the NHAMCS to represent 162,515,943 visits nationwide. Overall, patients with a score of 10 were 1.35 times more likely to receive an opioid than patients scoring a 9, 41.7% (CI95 39.7–43.8%) and 31.0% (CI95 28.8–33.3%), respectively. Opioid use was significantly different between traditional pain score cutoffs of mild (1–3) and moderate pain (4–6), where scores of 4 were 1.76 times more likely to receive an opioid than scores of 3, 15.5% (CI95 13.7–17.3%) and 8.8% (CI95 7.1–10.6%), respectively. Scores of 7 were 1.33 times more likely to receive opioids than scores of 6, 24.7% (CI95 23.0–26.3%) and 18.5% (CI95 16.9–20.0%), respectively. Fractures had the highest likelihood of receiving an opioid, as 49.2% of adolescents with a fracture received an opioid (CI95 46.4–51.9%). Within this subgroup, only adolescents reporting a fracture pain score of 10 had significantly higher opioid use than adjacent pain scores, where fracture patients scoring a 10 were 1.4 times more likely to use opioids than those scoring 9, 82.2% (CI95 76.1–88.4%) and 59.8% (CI95 49.0–70.5%), respectively. Conclusions: While some guidelines in the adult population have revised cut-offs and groupings of the traditional tiers on a 0–10 point pain scale, the adolescent population may also require further examination to potentially warrant a similar adjustment.https://www.mdpi.com/2077-0383/11/1/38pain managementadolescentemergency departmentnationalopioidpain scale |
| spellingShingle | Michael T. Phan Daniel M. Tomaszewski Cody Arbuckle Sun Yang Brooke Jenkins Michelle A. Fortier Theodore Heyming Erik Linstead Candice Donaldson Zeev Kain Evaluating the 0–10 Point Pain Scale on Adolescent Opioid Use in US Emergency Departments Journal of Clinical Medicine pain management adolescent emergency department national opioid pain scale |
| title | Evaluating the 0–10 Point Pain Scale on Adolescent Opioid Use in US Emergency Departments |
| title_full | Evaluating the 0–10 Point Pain Scale on Adolescent Opioid Use in US Emergency Departments |
| title_fullStr | Evaluating the 0–10 Point Pain Scale on Adolescent Opioid Use in US Emergency Departments |
| title_full_unstemmed | Evaluating the 0–10 Point Pain Scale on Adolescent Opioid Use in US Emergency Departments |
| title_short | Evaluating the 0–10 Point Pain Scale on Adolescent Opioid Use in US Emergency Departments |
| title_sort | evaluating the 0 10 point pain scale on adolescent opioid use in us emergency departments |
| topic | pain management adolescent emergency department national opioid pain scale |
| url | https://www.mdpi.com/2077-0383/11/1/38 |
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