OBJECTIVES

Case reports suggested that opioids could potentially increase the risk of asthma exacerbation either via chronic airway inflammation or via epithelial destruction leading to hyper-irritable airways. The study determined the opioid utilization pattern in children with pre-existing asthma.

METHODS

2013 to 2016 claims data of Texas Children’s Health Plan (TCHP) were used in the study. TCHP is a Medicaid Managed Care Plan that covers approximately 800,000 children and adolescents during the study period. Enrollees were first categorized as with or without asthma based on diagnoses and treatments received. The utilization patterns of opioid prescriptions in children with and without asthma were described.

RESULTS

The study included 94,268 (12.2%) children with and 677,653 (87.8%) without asthma. The prevalence of opioid analgesic use was 11.6% (10,978) in the asthmatic cohort and 5.9% (40,264) in the non-asthmatic cohort. While the prevalence of opioid anti-tussive use was 1.2% (1,164) in those with asthma and 0.4% (2,735) in those without. The most commonly prescribed opioid prescription was codeine which comprised 6,580 (59.5%) opioid analgesic prescriptions and 5,721 (98.9%) cough suppressant prescriptions. The 11,862 opioid recipients with asthma were primarily males (56.5%) with an average age of 9.6 ± 4.9 years. Of these individuals 5,679 (47.9%) filled 3 or more opioid prescriptions. The total number of opioid prescriptions filled by asthmatic children decreased from 13,133 (13.9%) in 2013 to 12,597 (13.4%) in 2016.

CONCLUSIONS

The opioid utilization is high in children with asthma. Although the utilization trend has decreased during the study period, the overall utilization rate remained high, and the long term use was common. Further analysis is needed to quantify the risk of asthma exacerbation associated with the use of opioids in children with asthma.