Variation in receipt of opioids by pediatric oncology patients who died in children's hospitals.

Abstract:

BACKGROUND:Opioids are a cornerstone of palliation of pain. We sought to assess variation in opioid prescription during the last week of life among a cohort of pediatric oncology patients who died while hospitalized. PROCEDURE:We used detailed hospital administrative data from the Pediatric Health Information System (PHIS) regarding 1,466 subjects 0-24 years of age who were treated at 33 hospitals between 2001 and 2005. RESULTS:Among the 1,466 subjects hospitalized at the time of their death, 56% received opioids every day during the hospitalized portion of their last week of life, while 44% did not. This proportion varied substantially across hospitals (range 0-90.5%). After multivariate adjustment for individual-level characteristics, the hospital-level effect on the odds of continuous prescription of opioids during the hospitalized portion of the last 7 days of life continued to vary significantly among hospitals, accounting for 10.5% of the variance in the receipt of daily opioid (P < 0.001). CONCLUSION:Opioid prescription during the hospitalized portion of the last week of life varies substantially among hospitals, even after adjustment for clinical characteristics of the patients. The reasons for this significant variation, especially the component explained by hospital-level and not patient-level factors, warrant more scrutiny.

journal_name

Pediatr Blood Cancer

journal_title

Pediatric blood & cancer

authors

Orsey AD,Belasco JB,Ellenberg JH,Schmitz KH,Feudtner C

doi

10.1002/pbc.21824

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

761-6

issue

7

eissn

1545-5009

issn

1545-5017

journal_volume

52

pub_type

杂志文章,多中心研究
  • Second cancer risk in childhood cancer survivors treated with intensity-modulated radiation therapy (IMRT).

    abstract:BACKGROUND:Treatment with radiotherapy (RT) is associated with an increased risk of second malignant neoplasms (SMNs) in childhood cancer survivors; it is unclear how treatment with intensity-modulated radiation therapy (IMRT) impacts this risk. We provide the first report of SMN risk in a cohort of childhood cancer su...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.25285

    authors: Casey DL,Friedman DN,Moskowitz CS,Hilden PD,Sklar CA,Wexler LH,Wolden SL

    更新日期:2015-02-01 00:00:00

  • Loss of antibody titers and effectiveness of revaccination in post-chemotherapy pediatric sarcoma patients.

    abstract:BACKGROUND:Little is known about the effects of chemotherapy on patient antibody titers to vaccine-preventable infectious diseases; thus, there is no standard protocol for revaccinating post-chemotherapy patients. PROCEDURES:To assess losses of detectable antibody titers due to chemotherapy, we retrospectively examine...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21277

    authors: Yu J,Chou AJ,Lennox A,Kleiman P,Wexler LH,Meyers PA,Gorlick R

    更新日期:2007-10-15 00:00:00

  • Optic pathway gliomas.

    abstract::Optic pathway gliomas represent approximately 5% of all pediatric intracranial tumors. While these tumors are most frequently low grade astrocytomas, they follow a highly variable clinical course, and accordingly, there is much debate regarding their optimal management. Their propensity to occur in very young children...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,评审

    doi:10.1002/pbc.20655

    authors: Jahraus CD,Tarbell NJ

    更新日期:2006-05-01 00:00:00

  • Medication errors on oral chemotherapy in children with acute lymphoblastic leukemia in a developing country.

    abstract:BACKGROUND:Medication errors occur universally. Inappropriate administration of chemotherapy drugs can have adverse effects in cancer patients. Our objective was to assess the rate and type of medication errors in children with acute lymphoblastic leukemia (ALL) receiving oral chemotherapy in outpatient setting. PROCE...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.25203

    authors: Oberoi S,Trehan A,Marwaha RK

    更新日期:2014-12-01 00:00:00

  • Initial testing (stage 1) of the multi-targeted kinase inhibitor sorafenib by the pediatric preclinical testing program.

    abstract:BACKGROUND:Sorafenib is an inhibitor of multiple kinases (e.g., VEGF receptors, PDGFR, FLT3, RET, BRAF, KIT) and is approved by FDA for treatment of two adult cancers. The activity of sorafenib was evaluated against the PPTP's in vitro and in vivo panels. PROCEDURES:Sorafenib was evaluated against the PPTP in vitro pa...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.22712

    authors: Keir ST,Maris JM,Lock R,Kolb EA,Gorlick R,Carol H,Morton CL,Reynolds CP,Kang MH,Watkins A,Houghton PJ,Smith MA

    更新日期:2010-12-01 00:00:00

  • Thymic carcinoma in children.

    abstract::Thymic epithelial neoplasms consist of thymomas, thymic carcinoids, and thymic carcinomas. Carcinomas are malignant tumors of the thymus characterized by obvious cytological anaplasia. They constitute only 4%-14% of thymic epithelial neoplams. Thymic carcinoma rarely occurs in children. Research in the English literat...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,评审

    doi:10.1002/pbc.20468

    authors: Yaris N,Nas Y,Cobanoglu U,Yavuz MN

    更新日期:2006-08-01 00:00:00

  • A meta-analysis of MTHFR C677T and A1298C polymorphisms and risk of acute lymphoblastic leukemia in children.

    abstract:BACKGROUND:Methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms have been implicated in childhood acute lymphoblastic leukemia (ALL) risk, but previously published studies were inconsistent and recent meta-analyses were not adequate. PROCEDURES:In a meta-analysis of 21 publications with 4,706 cas...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/pbc.23137

    authors: Yan J,Yin M,Dreyer ZE,Scheurer ME,Kamdar K,Wei Q,Okcu MF

    更新日期:2012-04-01 00:00:00

  • Imatinib has adverse effect on growth in children with chronic myeloid leukemia.

    abstract:BACKGROUND:Long-term adverse effects of Imatinib in children with chronic myeloid leukemia (CML) are uncertain. The aim was to study the effect of imatinib on growth in children with CML. PROCEDURE:Children ≤13 years of age at diagnosis were enrolled retrospectively, from 2004 to 2011, from a single center in India. P...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.23389

    authors: Bansal D,Shava U,Varma N,Trehan A,Marwaha RK

    更新日期:2012-09-01 00:00:00

  • 2007 Standards, Options, and Recommendations: use of erythropoiesis-stimulating agents (ESA: epoetin alfa, epoetin beta, and darbepoetin) for the management of anemia in children with cancer.

    abstract::The Standards, Options, and Recommendations (SOR) project undertaken by the French National Federation of Cancer Centers (FNCLCC) to develop and disseminate clinical practice guidelines in oncology has now been taken over by the French National Cancer Institute. In 2007, the SOR updated the information related to the ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,评审

    doi:10.1002/pbc.21953

    authors: Marec-Berard P,Chastagner P,Kassab-Chahmi D,Casadevall N,Marchal C,Misset JL,Ray-Coquard I

    更新日期:2009-07-01 00:00:00

  • Recurrent metastatic neuroblastoma followed by myelodysplastic syndrome: possible leukemogenic role of temozolomide.

    abstract::An 8-year old child had a pelvic MYCN-nonamplified neuroblastoma (NB) with retroperitoneal nodal extension. Multi-modality therapy achieved complete remission (CR). Small recurrences confined to left supraclavicular nodes were treated with surgery alone at 4.9, 6.5, 7.5, 9.5, and 12.9 years from diagnosis. Monitoring ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21658

    authors: Kushner BH,Laquaglia MP,Kramer K,Modak S,Cheung NK

    更新日期:2008-10-01 00:00:00

  • Fludarabine-based reduced toxicity yet myeloablative conditioning is effective and safe particularly in patients with high-risk thalassemia undergoing allogeneic transplantation.

    abstract:INTRODUCTION:Thalassemia major (TM) is an inherited disorder caused by ineffective erythropoiesis. At the present time, allogeneic stem cell transplantation (allo-SCT) is a curative option. Conventional busulfan and cyclophosphamide based myeloablative conditioning regimens are limited by increased toxicity, especially...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.27312

    authors: Sheth V,Grisariu S,Avni B,Stepensky P,Ashkenazi M,Shapira MY,Or R

    更新日期:2018-11-01 00:00:00

  • Addressing implicit bias in pediatric hematology-oncology.

    abstract::Although awareness of implicit bias and its influence on providers and patients is increasing, the effects of implicit bias on the field of pediatric hematology-oncology are less clear. This Special Report reviews the literature on implicit bias in pediatrics and medical oncology and further provides case examples and...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,评审

    doi:10.1002/pbc.28204

    authors: Tsai JW,Kesselheim JC

    更新日期:2020-05-01 00:00:00

  • Phase I trial and pharmacokinetic study of sorafenib in children with neurofibromatosis type I and plexiform neurofibromas.

    abstract:BACKGROUND:Sorafenib targets multiple pathways thought to be crucial in growth of plexiform neurofibroma (PN) in children with neurofibromatosis type 1 (NF1). Sorafenib has been tolerated with manageable toxicities in adults and children with refractory cancer. We conducted a separate study in this population. Monitori...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.24281

    authors: Kim A,Dombi E,Tepas K,Fox E,Martin S,Wolters P,Balis FM,Jayaprakash N,Turkbey B,Muradyan N,Choyke PL,Reddy A,Korf B,Widemann BC

    更新日期:2013-03-01 00:00:00

  • The involvement of primary care physicians in care for childhood cancer survivors.

    abstract:BACKGROUND:Childhood cancer survivors (CCS) are at risk of developing long-term morbidity, which is likely to be presented to a primary care physician (PCP). Therefore, insight into CCS's PCP-based health care use is needed. We investigated the volume and underlying health problems of PCP-based health care use and the ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.27774

    authors: Streefkerk N,Heins MJ,Teepen JC,Feijen EAM,Bresters D,van Dulmen-den Broeder E,van der Heiden-van der Loo M,van den Heuvel-Eibrink MM,van Leeuwen FE,Loonen JJ,van der Pal HJH,Ronckers CM,Versluys AB,Tissing WJE,Korevaar JC,

    更新日期:2019-08-01 00:00:00

  • Pediatric residents' perceived barriers to opioid use in sickle cell disease pain management.

    abstract:OBJECTIVE:Current guidelines recommend high-priority treatment of severe sickle cell disease (SCD) pain with opioids; however, patients with SCD have historically been undertreated. We used mixed methods to assess pediatric residents' perceptions toward opioid use in SCD pain management. METHODS:We distributed a surve...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.27535

    authors: Fearon A,Marsh A,Kim J,Treadwell M

    更新日期:2019-02-01 00:00:00

  • Prevalence of daily medication adherence among children with sickle cell disease: a 1-year retrospective cohort analysis.

    abstract::The objective of this study is to determine the prevalence of adherence to daily medications among children with sickle cell disease (SCD). Prescription records for 12 months were obtained from participants who had insurance in a Medicaid-based single health maintenance organization. Adherence was measured as a ratio ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.22605

    authors: Patel NG,Lindsey T,Strunk RC,DeBaun MR

    更新日期:2010-09-01 00:00:00

  • Comparison of clinical features and outcomes in patients with extraskeletal versus skeletal localized Ewing sarcoma: A report from the Children's Oncology Group.

    abstract:BACKGROUND:The prognostic significance of having extraskeletal (EES) versus skeletal Ewing sarcoma (ES) in the setting of modern chemotherapy protocols is unknown. The purpose of this study was to compare the clinical characteristics, biologic features, and outcomes for patients with EES and skeletal ES. METHODS:Patie...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.26096

    authors: Cash T,McIlvaine E,Krailo MD,Lessnick SL,Lawlor ER,Laack N,Sorger J,Marina N,Grier HE,Granowetter L,Womer RB,DuBois SG

    更新日期:2016-10-01 00:00:00

  • Antiphospholid antibody syndrome and Hb E/Beta thalassemia disease post-allogeneic stem cell transplantation.

    abstract::We report a 10-year-old male with Hb E/Beta thalassemia disease who developed chronic graft-versus-host disease (cGVHD) of antiphospholipid antibody syndrome after successful allogeneic stem cell transplantation (SCT). He exhibited a recurrent ischemic stroke on day 368 post-SCT while on cyclosporine A, azathioprine, ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.23020

    authors: Sirachainan N,Pakakasama S,Hongeng S,Chuansumrit A,Tuntiyatorn L,Vilaiyuk S

    更新日期:2011-07-15 00:00:00

  • Severe neurologic side effects in patients being treated for hemophagocytic lymphohistiocytosis.

    abstract:BACKGROUND:Hemophagocytic Lymphohistiocytosis (HLH) is characterized by uncontrolled inflammation that is generally fatal without immune modulating chemotherapy. At Texas Children's Hospital, we have observed significant central nervous system (CNS) toxicity in several patients treated for HLH according to the Histiocy...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21838

    authors: Thompson PA,Allen CE,Horton T,Jones JY,Vinks AA,McClain KL

    更新日期:2009-05-01 00:00:00

  • Center-Based Quality Initiative Targets Youth Preparedness for Medical Independence: HEMO-Milestones Tool in a Comprehensive Hemophilia Clinic Setting.

    abstract:BACKGROUND:Patient transition readiness self-assessment tools and investigation into patient and parent perceptions of the transition process from pediatric to adult care models have informed recognition of gaps in care, particularly for those with chronic disease. Implementation of a longitudinal transition process wi...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.25807

    authors: Croteau SE,Padula M,Quint K,D'Angelo L,Neufeld EJ

    更新日期:2016-03-01 00:00:00

  • Phase II study of intermediate-dose cytarabine in patients with relapsed or refractory Ewing sarcoma: a report from the Children's Oncology Group.

    abstract:BACKGROUND:Patients with relapsed or refractory Ewing sarcoma have a poor outcome with conventional therapies. Cytarabine decreases EWS/FLI1 protein levels in Ewing sarcoma cells and has demonstrated preclinical activity against Ewing sarcoma in vitro and in vivo. The purpose of this phase II clinical trial was to esti...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21822

    authors: DuBois SG,Krailo MD,Lessnick SL,Smith R,Chen Z,Marina N,Grier HE,Stegmaier K,Children's Oncology Group.

    更新日期:2009-03-01 00:00:00

  • Health-related quality of life in children with sickle cell disease: a report from the Comprehensive Sickle Cell Centers Clinical Trial Consortium.

    abstract:BACKGROUND:Pediatric health-related quality of life (HRQOL) questionnaires have been validated in children with sickle cell disease (SCD), but small sample sizes in these studies have limited clinical comparisons. We used the baseline clinical data from the Collaborative Data (C-Data) Project of the Comprehensive Sickl...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,多中心研究

    doi:10.1002/pbc.22497

    authors: Dampier C,Lieff S,LeBeau P,Rhee S,McMurray M,Rogers Z,Smith-Whitley K,Wang W,Comprehensive Sickle Cell Centers (CSCC) Clinical Trial Consortium (CTC).

    更新日期:2010-09-01 00:00:00

  • Exploring barriers and facilitators to clinical trial enrollment in the context of sickle cell anemia and hydroxyurea.

    abstract:BACKGROUND:Several sickle cell clinical trials have closed due to inability to enroll patients. To limit the early cessation of a proposed clinical trial due to low accrual rates, we sought to better understand barriers and facilitators to enrolling parents of children with sickle cell anemia (SCD) into clinical trials...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/pbc.24486

    authors: Lebensburger JD,Sidonio RF,Debaun MR,Safford MM,Howard TH,Scarinci IC

    更新日期:2013-08-01 00:00:00

  • Long-term outcomes of children with extracutaneous juvenile xanthogranulomas in Japan.

    abstract:BACKGROUND:Juvenile xanthogranuloma (JXG) is the most common non-Langerhans cell histiocytosis in children. The mortality and morbidity of JXG with extracutaneous lesions remain unclear. METHODS:Data of patients aged < 18 years who were diagnosed with JXG between 2001 and 2010 were retrospectively collected through a ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.28381

    authors: Maeda M,Morimoto A,Shioda Y,Asano T,Koga Y,Nakazawa Y,Kanegane H,Kudo K,Ohga S,Ishii E,Histiocytosis Study Group of the Japanese Society of Pediatric Hematology\/Oncology.

    更新日期:2020-07-01 00:00:00

  • A survey of clinical productivity and current procedural terminology (CPT) coding patterns of pediatric hematologist/oncologists.

    abstract:BACKGROUND:Subspecialty-specific normative values for clinical productivity of practicing pediatric hematologist/oncologists have not been well established. This information could be a useful adjunct in administrative decision-making in areas such as necessary levels of physician staffing and development of compensatio...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.20068

    authors: Griffin TC,Hutter JJ,Johnson KK,Moscow JA

    更新日期:2004-08-01 00:00:00

  • Presentation of acute promyelocytic leukemia as granulocytic sarcoma.

    abstract::Granulocytic sarcoma (GS) is a localized tumor composed of immature myeloid cells. This extramedullary tumor can present before, concurrent with or after the diagnosis of acute myeloid leukemia. GS is extremely uncommon in acute promyelocytic leukemia (APL). As a proportion of patients never develop systemic disease, ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21190

    authors: Worch J,Ritter J,Frühwald MC

    更新日期:2008-03-01 00:00:00

  • Hematopoietic stem cell transplant referral patterns for children with sickle cell disease vary among pediatric hematologist/oncologists' practice focus: A Sickle Cell Transplant Advocacy and Research Alliance (STAR) study.

    abstract:BACKGROUND:Hematopoietic stem cell transplantation (HSCT) provides a curative therapy for children severely affected by sickle cell disease (SCD). Rejection-free survival after matched sibling donor (MSD) HSCT is very high, but adoption of HSCT as a curative SCD therapy has been slow. In this study, we assess providers...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.28861

    authors: Meier ER,Abraham AA,Ngwube A,Janson IA,Guilcher GMT,Horan J,Kasow KA

    更新日期:2021-03-01 00:00:00

  • A phase II study of Campath-1H in children with relapsed or refractory acute lymphoblastic leukemia: a Children's Oncology Group report.

    abstract:BACKGROUND:Despite the increasing cure rates for children with acute lymphoblastic leukemia (ALL), patients who relapse continue to have poor prognosis. The Children's Oncology Group (COG) conducted a limited institution Phase II trial of Campath-1H, a monoclonal antibody that targets CD52 on leukemic cells, in childre...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,多中心研究

    doi:10.1002/pbc.22209

    authors: Angiolillo AL,Yu AL,Reaman G,Ingle AM,Secola R,Adamson PC

    更新日期:2009-12-01 00:00:00

  • Comparable survival for pediatric acute myeloid leukemia with poor-risk cytogenetics following chemotherapy, matched related donor, or unrelated donor transplantation.

    abstract:BACKGROUND:We sought to better define the role of hematopoietic cell transplantation (HCT) in first remission (CR1) for high-risk pediatric acute myeloid leukemia (AML). PROCEDURES:Outcomes were compared among patients aged less than 21 years with cytogenetically defined poor-risk AML treated with chemotherapy, matche...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.24739

    authors: Kelly MJ,Horan JT,Alonzo TA,Eapen M,Gerbing RB,He W,Lange BJ,Parsons SK,Woods WG

    更新日期:2014-02-01 00:00:00

  • Local lymph node involvement in pediatric renal cell carcinoma: a report from the Italian TREP project.

    abstract:BACKGROUND:One of the most important adverse prognostic factors for adult renal cell carcinoma (RCC) is the retroperitoneal lymph node involvement. The aim of this article is to study the prognostic significance of local lymph node involvement in pediatric RCC and the role of retroperitoneal lymph node dissection (RLND...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21652

    authors: Indolfi P,Bisogno G,Cecchetto G,Spreafico F,De Salvo GL,Collini P,Jenkner A,Inserra A,Schiavetti A,di Martino M,Casale F

    更新日期:2008-10-01 00:00:00