Trends in Postpartum Opioid Prescribing: A Time Series Analysis.
Adult
Analgesics, Opioid
/ therapeutic use
Breast Feeding
Codeine
/ therapeutic use
Female
Humans
Hydromorphone
/ therapeutic use
Infant, Newborn
Interrupted Time Series Analysis
Lactation
Morphine
/ therapeutic use
Ontario
Oxycodone
/ therapeutic use
Postpartum Period
Practice Patterns, Physicians'
/ trends
Pregnancy
Young Adult
Journal
Clinical pharmacology and therapeutics
ISSN: 1532-6535
Titre abrégé: Clin Pharmacol Ther
Pays: United States
ID NLM: 0372741
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
09
02
2021
accepted:
14
04
2021
pubmed:
26
5
2021
medline:
12
10
2021
entrez:
25
5
2021
Statut:
ppublish
Résumé
Opioids are commonly prescribed following childbirth, but data are lacking on trends in postpartum opioid prescribing over time. We examined whether a highly publicized 2006 case report questioning the safety of codeine during lactation was associated with changes in postpartum opioid prescribing. We conducted a cross-sectional time series analysis of all publicly funded prescriptions for opioids to postpartum women in Ontario, Canada, from April 1, 2000, to March 31, 2017. The intervention was the publication of a case report in 2006 attributing the death of a breastfeeding neonate to maternal codeine use. The primary outcome was the rate of opioid prescribing to postpartum women. Among postpartum women eligible for prescription drug coverage, 17.5% filled an opioid prescription in the third quarter of 2006 (immediately prior to the intervention), with codeine representing 89.8% of all prescriptions. By the fourth quarter of 2010, only 12.2% of postpartum women filled an opioid prescription, representing a decline of 30% (P < 0.01), with codeine representing 71.9% of all prescriptions. During this period, we observed sizeable relative increases in the proportion of opioid prescriptions filled for morphine, hydromorphone, and oxycodone. By 2017, among women prescribed opioids post partum, 39.0% filled a prescription for codeine, while the remainder filled prescriptions for oxycodone (18.6%), morphine (25.5%), and hydromorphone (16.9%). A highly publicized case report questioning the safety of maternal codeine use during breastfeeding was associated with significant changes in opioid prescribing to postpartum women, including a decline in overall opioid prescribing and a shift from codeine to stronger opioids.
Substances chimiques
Analgesics, Opioid
0
Morphine
76I7G6D29C
Oxycodone
CD35PMG570
Hydromorphone
Q812464R06
Codeine
UX6OWY2V7J
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1004-1010Subventions
Organisme : CIHR
Pays : Canada
Informations de copyright
© 2021 The Authors. Clinical Pharmacology & Therapeutics © 2021 American Society for Clinical Pharmacology and Therapeutics.
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