{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:46:17Z","timestamp":1779187577291,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T00:00:00Z","timestamp":1602028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["T32DC01520904"],"award-info":[{"award-number":["T32DC01520904"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Assess national trends in opioid prescription following pediatric tonsillectomy: 1) overall percentage receiving opioids and mean quantity, 2) changes during 2009\u20132017, and 3) determinants of prescription patterns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional analysis using 2009\u20132017 Optum claims data to identify opioid\u2010na\u00efve children aged 1\u201318 with claims codes for tonsillectomy (n = 82,842). Quantities of opioids filled in outpatient pharmacies during the perioperative period were extracted and converted into milligram morphine equivalents (MMEs) for statistical comparison. Demographic, clinical, and socioeconomic predictors of opioid fill rate and quantity were determined using regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 2009, 83.3% of children received opioids, decreasing to 58.3% by 2017. Rates of all\u2010cause readmissions and post\u2010tonsillectomy hemorrhages were similar over time. Mean quantity received was 153.47MME (95% confidence intervals [95%CI]: 151.19, 155.76) and did not significantly change during 2009\u20132017. Opioids were more likely in older children and those with higher household income, but less likely in children with obstructive sleep apnea, other comorbidities, and Hispanic race. Higher quantities of opioids were more likely in older children, while lower quantities were associated with female sex, Hispanic race, and higher household income. Outpatient steroids were prescribed to 8.04% of patients, who were less likely to receive opioids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While the percentage of children receiving post\u2010tonsillectomy opioids decreased during 2009\u20132017, prescribed quantities remain high and have not decreased over time. Prescription practices were also influenced by clinical and sociodemographic factors. These results highlight the need for guidance, particularly with regard to opioid quantity, in children after tonsillectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>N\/A <jats:italic>Laryngoscope<\/jats:italic>, 131:E1722\u2013E1729, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29159","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T17:57:38Z","timestamp":1602093458000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Opioid Prescribing Patterns Following Pediatric Tonsillectomy in the United States, 2009\u20132017"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4150-1023","authenticated-orcid":false,"given":"Z. Jason","family":"Qian","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer C.","family":"Alyono","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7709-1551","authenticated-orcid":false,"given":"Michael C.","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shayna P.","family":"Cooperman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4702-8401","authenticated-orcid":false,"given":"Alan G.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karthik","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,7]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1","article-title":"Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010","volume":"102","author":"Hall MJ","year":"2017","journal-title":"Natl Health Stat Rep"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(97)00202-9"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818757999"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1905045"},{"key":"e_1_2_6_7_1","unstructured":"Centers for Medicare & Medicaid Services.Opioid oral morphine milligram equivalent (MME) conversion factors. Available at:https:\/\/www.cms.gov\/Medicare\/Prescription\u2010Drug\u2010coverage\/PrescriptionDrugCovContra\/Downloads\/Opioid\u2010Morphine\u2010EQ\u2010Conversion\u2010Factors\u2010Aug\u20102017.pdf. Accessed July 6 2020."},{"key":"e_1_2_6_8_1","unstructured":"U.S. Food and Drug Administration.Safety review update of codeine use in children: new boxed warning and contraindication on use after tonsillectomy and\/or adenoidectomy. 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