Factors associated with adequate opioid management in pediatric patients admitted to a university hospital
DOI:
https://doi.org/10.30968/jhphs.2025.163.1240Abstract
Objective: To describe the factors associated with the appropriate management of opioids in pediatric patients admitted to a university hospital ward. Methods: This was a cross-sectional study of 75 patients. Demographic, clinical and pharmacotherapeutic data were collected from the prescription system and electronic medical records. Adequate opioid management was defined as the prescription of schedule dose opioid, rescue doses and drugs to manage adverse reactions to opioids. Quantitative variables were described using medians and interquartile ranges and categorical variables were expressed as absolute and relative frequencies. The association between adequate pain management and the independent variables was analyzed univariately using Pearson’s chi-square test. For univariate analysis, the magnitude of the association was expressed by the odds ratio with a 95% confidence interval. Results: Of the 75 patients included in the study, 42 (56%) were female. The main comorbidities found were in the Neoplasms group (19; 25%). The median number of comorbidities per patient and length of stay was 3 diseases/patient and 17 days of hospitalization. Around 50% (n=40) of the patients were followed up by the Pediatric Palliative Care Clinic (PPCC) and only 9% (n=7) received opioid-related pharmaceutical intervention. The drug tramadol was the most prevalent (42; 56%). Rescue dosing was found for 36% (n=27) of patients and 49% (n=37) received polyethylene glycol and lactulose for management of opioid-induced constipation. Adequate opioid management was identified in 20% of patients and this variable had a statistically significant association for patients with a length of stay ≥ 17 days, for patients with three or more comorbidities, those who were discharged from hospital and those patients followed up by the CCPP. Conclusion: The multiprofessional team is essential for adequate care in highly complex pediatric patients, especially with regard to the adequate use of opioids.
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