{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:14:56Z","timestamp":1785392096974,"version":"3.55.0"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["1R21CA277849-01"],"award-info":[{"award-number":["1R21CA277849-01"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study examined the trends and patterns of opioid and non-opioid pharmacotherapy use among a large national sample of privately insured pediatric patients with cancer in the United States.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We identified pediatric (aged\u2005&amp;lt;\u200521) patients diagnosed with central nervous system (CNS), lymphoma, gonadal, leukemia, or bone cancer from MarketScan data 2005-2019. We examined the proportion of patients who filled a prescription for the following 5 types of pharmacotherapy: opioid, anticonvulsant, non-steroidal anti-inflammatory drug (NSAID), antidepressant, and muscle relaxant during active cancer treatment. We assessed the trends and patterns in pharmacotherapy using multivariable logistic regressions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 4174 patients included, 2979 (71%) had an opioid prescription; 746 (18%), 384 (9%), 202 (5%), and 169 (4%) had anticonvulsant, NSAID, antidepressant and muscle relaxant prescriptions, respectively. Multivariable logistic regression showed a nonlinear trend in the use of opioids among pediatric patients with cancer over time such that use slightly increased until 2012 (OR of 1.40 [95% CI, 1.12-1.73] for 2012 vs. 2006) but then decreased thereafter (OR of 0.51 [0.37-0.68] for 2018 vs. 2012). The use of anticonvulsants, NSAIDs, and muscle relaxants increased significantly linearly over time (all P\u2005&amp;lt;\u2005.005).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>There has been a downward trend in the use of opioids in recent years among pediatric patients with cancer and an upward trend in the use of non-opioid pharmacotherapy for pain management potentially as an alternative to opioids.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyad292","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T20:49:50Z","timestamp":1699562990000},"page":"176-184","source":"Crossref","is-referenced-by-count":4,"title":["Opioid and Non-Opioid Pharmacotherapy Use for Pain Management Among Privately Insured Pediatric Patients With Cancer in the United States"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5680-3134","authenticated-orcid":false,"given":"Chan","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Surgery, The Pennsylvania State University, College of Medicine , Hershey, PA , USA"},{"name":"Department of Public Health Sciences, The Pennsylvania State University, College of Medicine , Hershey, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Douglas","family":"Thornton","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Economics and Finance, Salisbury University , Salisbury, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, The Pennsylvania State University, College of Medicine , Hershey, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shouhao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, The Pennsylvania State University, College of Medicine , Hershey, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Health, Penn State Milton S. Hershey Medical Center , Hershey, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colette","family":"Pameijer","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Pennsylvania State University, College of Medicine , Hershey, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Leslie","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, The Pennsylvania State University, College of Medicine , Hershey, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,7]]},"reference":[{"key":"2024020215172015400_CIT0001","first-page":"1420","article-title":"Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes","volume-title":"Ann Oncol","author":"Breivik","year":"2009"},{"key":"2024020215172015400_CIT0002","first-page":"1437","article-title":"Prevalence of pain in patients with cancer: a systematic review of the past 40 years","volume-title":"Ann Oncol","author":"van den Beuken-van Everdingen","year":"2007"},{"key":"2024020215172015400_CIT0003","first-page":"E382","article-title":"Nausea, pain, fatigue, and multiple symptoms in hospitalized children with cancer","volume-title":"Oncol Nurs Forum","author":"Miller","year":"2011"},{"key":"2024020215172015400_CIT0004","volume-title":"WHO Model List of Essential Medicines: 20th WHO Essential Medicines List (EML)","author":"World Health Organization","year":"2017"},{"key":"2024020215172015400_CIT0005","volume-title":"WHO Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses","author":"WHO Guidelines Approved by the Guidelines Review Committee","year":"2012"},{"key":"2024020215172015400_CIT0006","first-page":"303","article-title":"What evidence do we have that the WHO analgesic ladder is effective in cancer pain","author":"Bennett","year":"2008","journal-title":"Syst Rev Pain Res"},{"key":"2024020215172015400_CIT0007","first-page":"161","article-title":"Morphine or oxycodone for cancer-related pain? A randomized, open-label, controlled trial","volume-title":"J Pain Symptom Manage","author":"Riley","year":"2015"},{"key":"2024020215172015400_CIT0008","first-page":"1107","article-title":"Are strong opioids equally effective and safe in the treatment of chronic cancer pain? A multicenter randomized phase IV \u201creal life\u201d trial on the variability of response to opioids","volume-title":"Ann Oncol","author":"Corli","year":"2016"},{"key":"2024020215172015400_CIT0009","first-page":"409","article-title":"Methadone for pain management in children with cancer","volume-title":"Paediatr Drugs","author":"Habashy","year":"2018"},{"key":"2024020215172015400_CIT0010","first-page":"587","article-title":"Paediatric cancer pain management using the WHO analgesic ladder--results of a prospective analysis from 2265 treatment days during a quality improvement study","volume-title":"Eur J Pain","author":"Zernikow","year":"2006"},{"key":"2024020215172015400_CIT0011","first-page":"1329","article-title":"Transdermal fentanyl for cancer pain management in opioid-naive pediatric cancer patients","volume-title":"Pain Med","author":"Othman","year":"2016"},{"key":"2024020215172015400_CIT0012","first-page":"e186558","article-title":"US national trends in pediatric deaths from prescription and illicit opioids, 1999-2016","volume-title":"JAMA Netw Open","author":"Gaither","year":"2018"},{"key":"2024020215172015400_CIT0013","first-page":"670","article-title":"Prescription drug misuse: sources of controlled medications in adolescents","volume-title":"J Am Acad Child Adolesc Psychiatry","author":"Schepis","year":"2019"},{"key":"2024020215172015400_CIT0014","first-page":"e201018","article-title":"Association of opioids prescribed to family members with opioid overdose among adolescents and young adults","volume-title":"JAMA Netw Open","author":"Nguyen","year":"2020"},{"key":"2024020215172015400_CIT0015","first-page":"141","article-title":"Association of opioid prescribing patterns with prescription opioid overdose in adolescents and young adults","volume-title":"JAMA Pediatr","author":"Chua","year":"2020"},{"key":"2024020215172015400_CIT0016","first-page":"166","article-title":"Laws limiting the prescribing or dispensing of opioids for acute pain in the United States: a national systematic legal review","volume-title":"Drug Alcohol Depend","author":"Davis","year":"2019"},{"key":"2024020215172015400_CIT0017","first-page":"S22","article-title":"Targeting practitioners: a review of guidelines, training, and policy in pain management","volume-title":"Drug Alcohol Depend","author":"Barth","year":"2017"},{"key":"2024020215172015400_CIT0018","first-page":"1624","article-title":"CDC guideline for prescribing opioids for chronic pain--United States, 2016","volume-title":"JAMA","author":"Dowell","year":"2016"},{"key":"2024020215172015400_CIT0019","volume-title":"Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2019 Draft Call Letter","author":"Centers for Medicare and Medicaid Services","year":"2018"},{"key":"2024020215172015400_CIT0020","first-page":"468","article-title":"An educational intervention decreases opioid prescribing after general surgical operations","volume-title":"Ann Surg","author":"Hill","year":"2018"},{"key":"2024020215172015400_CIT0021","first-page":"e207","article-title":"A quality improvement intervention to decrease postoperative opioid prescriptions in pediatric oncology patients","volume-title":"J Pediatr Hematol Oncol","author":"Mansfield","year":"2020"},{"key":"2024020215172015400_CIT0022","first-page":"61","article-title":"Survivors of childhood and adolescent cancer: life-long risks and responsibilities","volume-title":"Nat Rev Cancer","author":"Robison","year":"2014"},{"key":"2024020215172015400_CIT0023","first-page":"161","article-title":"Early post-therapy prescription drug usage among childhood and adolescent cancer survivors","volume-title":"J Pediatr","author":"Smitherman","year":"2018"},{"key":"2024020215172015400_CIT0024","volume-title":"Clinical classification software (CCS) fact sheet","author":"Agency for Healthcare Research and Quality (AHRQ)"},{"key":"2024020215172015400_CIT0025","volume-title":"Clinical classification software refined (CCSR) fact sheet","author":"Agency for Healthcare Research and Quality (AHRQ)"},{"key":"2024020215172015400_CIT0026","doi-asserted-by":"crossref","DOI":"10.23970\/AHRQEPCCER228","volume-title":"Nonopioid Pharmacologic Treatments for Chronic Pain","author":"McDonagh","year":"2020"},{"key":"2024020215172015400_CIT0027","author":"American Cancer Society"},{"key":"2024020215172015400_CIT0028","first-page":"553","article-title":"Effectiveness of antiepileptic or antidepressant drugs when added to opioids for cancer pain: systematic review","volume-title":"Palliat Med","author":"Bennett","year":"2011"},{"key":"2024020215172015400_CIT0029","first-page":"276","article-title":"Opioids combined with antidepressants or antiepileptic drugs for cancer pain: systematic review and meta-analysis","volume-title":"Palliat Med","author":"Kane","year":"2018"},{"key":"2024020215172015400_CIT0030","first-page":"571","article-title":"Adjuvant analgesics in cancer pain management","volume-title":"Oncologist","author":"Lussier","year":"2004"},{"key":"2024020215172015400_CIT0031","volume-title":"Categorical Data Analysis","author":"Agresti","year":"2012"},{"key":"2024020215172015400_CIT0032","doi-asserted-by":"crossref","DOI":"10.1201\/9780203753736","volume-title":"Generalized Linear Models","author":"McCullagh","year":"2019"},{"key":"2024020215172015400_CIT0033","first-page":"CD012564","article-title":"Opioids for cancer-related pain in children and adolescents","volume-title":"Cochrane Database Syst Rev","author":"Wiffen","year":"2017"},{"key":"2024020215172015400_CIT0034","first-page":"93","article-title":"Pharmacological management of cancer pain in children","volume-title":"Crit Rev Oncol Hematol","author":"Mercadante","year":"2014"},{"key":"2024020215172015400_CIT0035","first-page":"e28124","article-title":"Children\u2019s cancer pain in a world of the opioid epidemic: challenges and opportunities","volume-title":"Pediatr Blood Cancer","author":"Fortier","year":"2020"},{"key":"2024020215172015400_CIT0036","first-page":"65","article-title":"Validation of World Health Organization Guidelines for cancer pain relief: a 10-year prospective study","volume-title":"Pain","author":"Zech","year":"1995"},{"key":"2024020215172015400_CIT0037","first-page":"e0192529","article-title":"Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia","volume-title":"PLoS One","author":"Getz","year":"2018"},{"key":"2024020215172015400_CIT0038","author":"Centers for Disease Control and Prevention (CDC)"},{"key":"2024020215172015400_CIT0039","author":"Centers for Disease Control and Prevention (CDC)"},{"key":"2024020215172015400_CIT0040","author":"Drug Enforcement Administration (DEA)"},{"key":"2024020215172015400_CIT0041","volume-title":"Finding Solutions to the Prescription Opioid and Heroin Crisis: A Road Map for States","author":"Murphy","year":"2016"},{"key":"2024020215172015400_CIT0042","first-page":"6464","article-title":"Seizures and anticonvulsants in brain tumours: frequency, mechanisms and anti-epileptic management","volume-title":"Curr Pharm Des","author":"Vecht","year":"2017"},{"key":"2024020215172015400_CIT0043","first-page":"251","article-title":"A prospective evaluation and literature review of levetiracetam use in patients with brain tumors and seizures","volume-title":"J Neurooncol","author":"Usery","year":"2010"},{"key":"2024020215172015400_CIT0044","first-page":"818","article-title":"Psychotropic medication use in pediatric patients with cancer","volume-title":"Arch Pediatr Adolesc Med","author":"Pao","year":"2006"},{"key":"2024020215172015400_CIT0045","first-page":"S60","article-title":"Management of brain tumor-related epilepsy","volume-title":"Neurol India","author":"Klinger","year":"2017"},{"key":"2024020215172015400_CIT0046","first-page":"6488","article-title":"The use of antiepileptic drugs in paediatric neurosurgical conditions","volume-title":"Curr Pharm Des","author":"Themistocleous","year":"2017"},{"key":"2024020215172015400_CIT0047","first-page":"603","article-title":"Epilepsy in brain tumor patients","volume-title":"Curr Opin Neurol","author":"Rossetti","year":"2010"},{"key":"2024020215172015400_CIT0048","first-page":"21r03228","article-title":"Psychiatric considerations in pediatric patients with brain tumors","volume-title":"Prim Care Companion CNS Disord","author":"Benson","year":"2022"},{"key":"2024020215172015400_CIT0049","first-page":"445","article-title":"Depression in epilepsy is associated with lack of seizure control","volume-title":"Epilepsy Behav","author":"Dias","year":"2010"},{"key":"2024020215172015400_CIT0050","first-page":"555","article-title":"Negative effects of antiepileptic drugs on mood in patients with epilepsy","volume-title":"Drug Saf","author":"Mula","year":"2007"},{"key":"2024020215172015400_CIT0051","first-page":"227","article-title":"The effect of metabolic comorbidities and commonly used drugs on the prognosis of patients with ovarian cancer","volume-title":"Eur J Obstet Gynecol Reprod Biol","author":"Bar","year":"2016"},{"key":"2024020215172015400_CIT0052","first-page":"331","article-title":"Non-aspirin NSAID use and ovarian cancer mortality","volume-title":"Gynecol Oncol","author":"Verdoodt","year":"2018"},{"key":"2024020215172015400_CIT0053","first-page":"980","article-title":"Combined application of diclofenac and celecoxib with an opioid yields superior efficacy in metastatic bone cancer pain: a randomized controlled trial","volume-title":"Int J Clin Oncol","author":"Liu","year":"2017"},{"key":"2024020215172015400_CIT0054","first-page":"761","article-title":"Variation in receipt of opioids by pediatric oncology patients who died in children\u2019s hospitals","volume-title":"Pediatr Blood Cancer","author":"Orsey","year":"2009"},{"key":"2024020215172015400_CIT0055","first-page":"1000000","article-title":"Antidepressant use pattern and disparities among cancer patients in the United States","volume-title":"Front Public Health","author":"Zou","year":"2022"},{"key":"2024020215172015400_CIT0056","first-page":"783","article-title":"Gender differences in depression in representative national samples: meta-analyses of diagnoses and symptoms","volume-title":"Psychol Bull","author":"Salk","year":"2017"}],"container-title":["The Oncologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/29\/2\/176\/56546080\/oyad292.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/29\/2\/176\/56546080\/oyad292.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T15:18:08Z","timestamp":1706887088000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/oncolo\/article\/29\/2\/176\/7379699"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,7]]},"references-count":56,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,11,7]]},"published-print":{"date-parts":[[2024,2,2]]}},"URL":"https:\/\/doi.org\/10.1093\/oncolo\/oyad292","relation":{},"ISSN":["1083-7159","1549-490X"],"issn-type":[{"value":"1083-7159","type":"print"},{"value":"1549-490X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,2,1]]},"published":{"date-parts":[[2023,11,7]]}}}