Present: Marianne Burke, Kat Cheung, Abby Crocker, Kairn
Kelley, Ben Littenberg, Connie van Eeghen
Guest: Kathleen Bryant, NP from Associates in
Pediatrics
Start Up: Welcome to Kathleen B., who
is working on a poster presentation and interested in our research group.
1.
Discussion:
Marianne – Literature review results based on a query re: adolescents and
opioids/analgesic with 172 matched publications (PubMed), plus a GoogleScholar
search, and an Ovid search with 19 matches.
a. The
literature can be divided into 2 overlapping groups: prescribing of opioids and
use/misuse of opioids (both related to adolescents). NAMCS (National Ambulatory Medical Care
Survey) includes prescribing data but might not include the reason for
prescribing (e.g. “palpitations due to opioid use). Articles reviewed that were
of future interest to the group:
i.
Han, H on the rate of dose escalation in long term
opioid therapy
ii.
Lankenau, 2012, on prescription opioids and their
misuse
iii.
McCabe, 2013, nonmedical users of prescription opioids
who used leftover medications form their own previous prescriptions
iv.
McCabe, 2011, Medical misuse of controlled medications
(possibly used YRBS)
v.
McCabe, 2012, medical and nonmedical use of
prescription opioids among high school seniors (same study as before, different
target populations)
vi.
Meier, 2012, Extramedical use of prescription pain
relievers (National Survey on Drug Use and Health) (Michigan State University)
vii.
Osgood, 2012, Oxycodone abuse patterns in adolescents
viii.
Platts-Mills, 2012, age discrimination and pain
medication in emergency departments (National Hospital Ambulatory Medical Care
Survey)
ix.
Shield, 2013, Use of prescription opioid analgesic –
prevalence study from pharmacy data set, Canadian data set
x.
Sjogren, 2010, population-based cohort study on chronic
pain: the role of opioids – Danish health interview survey
xi.
Vogel, 2011, prolonged use of benzos associated with childhood
trauma in opioid maintained patients
b. Also,
the Ovid search produced another 300 studies based on the criteria used for the
above list
2.
Discussion: Abby
– NAMCS data exploration, supported by the CDC.
a. Abby
briefly reported on what can be found in this data source:
i.
Focus on prescriptions, including new and continued
prescriptions
ii.
Proportion of visits that include a anew or continued
prescription
iii.
Three new years for analysis: 2008-2010;
cross-sectional study only
iv.
Use of drugs based on standard of care, e.g. long term
use of Percocet
b. Summary:
characteristics of continued versus new prescriptions in adolescents with
covariates
c. Two
strategies for moving forward:
i.
Brief descriptive statistics on the above
characteristics (Abby). Describe prescriptions
in data base and the covariates in the data base (may want to learn more about
what is available in the data set before deciding). Consider reviewing covariates for further
study at later CROW session.
ii.
Follow up on literature search to condense and focus
(Marianne)
d. Also
consider a comparison study of changes in prescription patterns; as well as
changes in the environment of regulation and evidence that may have affected
prescription patterns.
a. October
24: Abby review of NAMCS data source and Marianne – results from literature
review
b. October
31: Kat Cheung
c. November
7: Rodger Kessler
d. November
14: Abby: cracking open the prescribing data base
e.
Future agenda to consider:
i.
Peter Callas or other faculty on multi-level modeling
ii.
Charlie MacLean: demonstration of Tableau; or Rodger’s
examples of Prezi
iii.
Journal article: Gomes, 2013, Opioid Dose and MVA in
Canada (Charlie)
iv.
Ben: Tukey chapter reading assignments, or other book
of general interest
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