Abstract
Background
To combat the opioid epidemic, prescribers need accurate information about pediatric
home opioid requirements to manage acute pain after surgery. Current opioid use estimates
come from retrospective surveys; this study used medication adherence technology (eCAP)
to track home opioid use.
Purpose
To describe children's pain treatment at home after laparoscopic appendectomy, and
to compare self-reported opioid analgesic use to eCAP data and counts of returned
pills.
Design
Prospective exploratory and descriptive study
Methods
A convenience sample of 96 patients, 10-17 years of age, from a single urban nonprofit
children's hospital consented to self-report pain treatment in 14-day diaries and
use eCAP to monitor prescribed opioid use at home after laparoscopic appendectomy.
Results
Patients were prescribed 5-45 opioid-containing pills (mean ± standard deviation 15
± 7.2). Of 749 opioid-containing pills prescribed to 49 patients who returned data,
689 pills were dispensed, 167.5 were used for the reason prescribed, 488 were returned
to families for disposal, and 53.5 were missing. The majority of the 49 patients were
opioid naïve (72%), Caucasian (64%), and male (56%), with a mean age of 14 years.
Patients used 6.6 ± 6.3 opioid-containing pills by pill count and 5.6 ± 5.1 by self-report,
a significant difference (p = .004). Unreported eCAP-enabled pill bottle openings typically occurred on weekends.
Conclusion
Medication adherence technology (eCAP) is a more rigorous method than self-report
to estimate opioid needs and detect early opioid misuse. Additional rigorously designed
studies of postoperative opioid use are needed to guide opioid prescribing.
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Article Info
Publication History
Published online: March 31, 2021
Accepted:
February 28,
2021
Received in revised form:
February 8,
2021
Received:
December 18,
2020
Identification
Copyright
© 2021 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
