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

Candice D Donaldson; Zeev N Kain; Louis Ehwerhemuepha; Michelle A Fortier; Michael T Phan; Daniel M Tomaszewski; Sun Yang; William Feaster; Brooke N Jenkins

doi:10.1007/s10880-021-09763-7

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

J Clin Psychol Med Settings. 2021 Dec;28(4):757-770. doi: 10.1007/s10880-021-09763-7. Epub 2021 Feb 9.

Authors

Candice D Donaldson^{1

2}, Zeev N Kain^{2

3}, Louis Ehwerhemuepha⁴, Michelle A Fortier^{2

3

5}, Michael T Phan⁶, Daniel M Tomaszewski^{7

8}, Sun Yang⁶, William Feaster⁴, Brooke N Jenkins^{9

10

11}

Affiliations

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. bjenkins@chapman.edu.
¹⁰ Center on Stress & Health, University of California Irvine, Irvine, CA, USA. bjenkins@chapman.edu.
¹¹ Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA, USA. bjenkins@chapman.edu.

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.

Keywords: Anxiety disorders; Mood disorders; Opioids; Pain management; Pediatric pain.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Analgesics, Opioid* / therapeutic use
Anxiety
Anxiety Disorders / complications
Anxiety Disorders / drug therapy
Child
Cross-Sectional Studies
Hospitals, Pediatric
Humans
Mood Disorders / drug therapy
Physicians*
Practice Patterns, Physicians'

Substances

Analgesics, Opioid

Grants and funding

K08 CA179084/CA/NCI NIH HHS/United States