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

Affiliation

Donaldson CD(1)(2), Kain ZN(2)(3), Ehwerhemuepha L(4), Fortier MA(2)(3)(5), Phan MT(6), Tomaszewski DM(7)(8), Yang S(6), Feaster W(4), Jenkins BN(9)(10)(11).
Author information:
(1)Department of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA.
(2)Center on Stress & Health, University of California Irvine, Irvine, CA, USA.
(3)Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA, USA.
(4)Department of Information Systems, Children's Hospital of Orange County, Orange, CA, USA.
(5)Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, USA.
(6)Department of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA.
(7)Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Orange, CA, USA.
(8)School of Pharmacy, Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
(9)Department of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA. [Email]
(10)Center on Stress & Health, University of California Irvine, Irvine, CA, USA. [Email]
(11)Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA, USA. [Email]

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.