Anxiety and Mood Disorders Impacting Physician Opioid Prescribing in the Pediatric Hospital Setting - PubMed (original) (raw)

Anxiety and Mood Disorders Impacting Physician Opioid Prescribing in the Pediatric Hospital Setting

Candice D Donaldson et al. J Clin Psychol Med Settings. 2021 Dec.

Abstract

This research examined whether pediatric inpatients without an anxiety/mood disorder are more likely to receive opioids in response to pain compared to patients diagnosed with a mental health condition. Research questions were tested using cross-sectional inpatient electronic medical record data. Propensity score matching was used to match patients with a disorder with patients without the disorder (anxiety analyses: N = 2892; mood analyses: N = 1042). Although patients with anxiety and mood disorders experienced greater pain, physicians were less likely to order opioids for these patients. Analyses also disclosed an interaction of anxiety with pain-the pain-opioid relation was stronger for patients without an anxiety disorder than for patients with an anxiety diagnosis. Instead, physicians were more likely to place non-opioid analgesic orders to manage the pain of patients with anxiety disorders. Findings imply that pain management decisions might be influenced by patient's mental health.

Keywords: Anxiety disorders; Mood disorders; Opioids; Pain management; Pediatric pain.

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.

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Conflict of interest statement

Conflict of interest Dr. Zeev N. Kain serves as a consultant for Edwards Lifesciences, Medtronic and Huron consulting, is the President of the American College of Perioperative Medicine, and a speaker for Covidien and Owner of Progressive Medical Services.

Figures

Fig. 1

Fig. 1

Interaction of pain severity and anxiety disorder diagnosis on the number of opioid analgesics ordered. Values reflect standardized estimates controlling for all model covariates and 95% confidence intervals. The number of ordered opioid analgesics ranged from 0 to 10, but was truncated to maintain conceptual clarity

Fig. 2

Fig. 2

Interaction of pain severity and anxiety disorder diagnosis on the number of non-opioid analgesics ordered. Values reflect standardized estimates controlling for all model covariates and 95% confidence intervals. The number of ordered non-opioid analgesics ranged from 0 to 9, but was truncated to maintain conceptual clarity

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