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

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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.

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Funding

Data collection, study analyses, and manuscript preparation were funded by support from the Kay Family Foundation, Chapman University. The authors have no financial relationships relevant to this article to disclose.

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Authors and Affiliations

  1. Department of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA

    Candice D. Donaldson & Brooke N. Jenkins

  2. Center on Stress & Health, University of California Irvine, Irvine, CA, USA

    Candice D. Donaldson, Zeev N. Kain, Michelle A. Fortier & Brooke N. Jenkins

  3. Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA, USA

    Zeev N. Kain, Michelle A. Fortier & Brooke N. Jenkins

  4. Department of Information Systems, Children’s Hospital of Orange County, Orange, CA, USA

    Louis Ehwerhemuepha & William Feaster

  5. Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, USA

    Michelle A. Fortier

  6. Department of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA

    Michael T. Phan & Sun Yang

  7. Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Orange, CA, USA

    Daniel M. Tomaszewski

  8. School of Pharmacy, Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA

    Daniel M. Tomaszewski

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  1. Candice D. Donaldson
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  2. Zeev N. Kain
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  3. Louis Ehwerhemuepha
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  4. Michelle A. Fortier
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  5. Michael T. Phan
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  6. Daniel M. Tomaszewski
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  7. Sun Yang
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  8. William Feaster
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  9. Brooke N. Jenkins
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Correspondence to Brooke N. Jenkins.

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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.

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All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This study involved a secondary analysis of electronic medical record information; thus, individual informed consent was not obtained.

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Donaldson, C.D., Kain, Z.N., Ehwerhemuepha, L. et al. Anxiety and Mood Disorders Impacting Physician Opioid Prescribing in the Pediatric Hospital Setting. J Clin Psychol Med Settings 28, 757–770 (2021). https://doi.org/10.1007/s10880-021-09763-7

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