BRIEF REPORT
Sebastian T. Tong, MD, MPH; Zihan Zheng, MS; Maria G. Prado, MPH; Imara I. West, MPH; Joseph W. LeMaster, MD, MPH; Mary A. Hatch, PhD; Lili S. Szabo; Tracy M. Anastas, PhD; Kris Pui Kwan Ma, PhD; Kari A. Stephens, PhD
Corresponding Author: Sebastian T. Tong, MD, MPH, University of Washington
Email: setong@uw.edu
DOI: 10.3122/jabfm.2023.230359R1
Keywords: Chronic Pain, COVID-19, Healthcare Disparities, Idaho, Opioids, Pandemics, Primary Health Care, Substance Use Disorders, Washington
Dates: Submitted: 10-03-2023; Revised: 11-18-2023; Accepted: 11-27-2023
FINAL PUBLICATION: |HTML| |PDF|
BACKGROUND: The COVID-19 pandemic disrupted how primary care patients with chronic pain received care. Our study sought to understand how long-term opioid therapy (LtOT) for chronic pain changed over the course of the pandemic overall and for different demographic subgroups.
METHODS: We used data from electronic health records of 64 primary care clinics across Washington state and Idaho to identify patients who had a chronic pain diagnosis and were receiving long-term opioid therapy. We defined 10-month periods in 2019-2021 as pre-pandemic, early pandemic and late pandemic and used generalized estimating equations analysis to compare across these time periods and demographic characteristics.
RESULTS: We found a proportional decrease in LtOT for chronic pain in the early months of the pandemic (OR=0.94, p=0.007) followed by an increase late pandemic (OR=1.08, p=0.002). Comparing late pandemic to pre-pandemic, identifying as Asian or Black, having fewer co-morbidities, or living in an urban area were associated with higher likelihood of being prescribed LtOT.
DISCUSSION: The use of LtOT for chronic pain in primary care has increased from before to after the COVID-19 pandemic with racial/ethnic and geographic disparities. Future research is needed to understand these disparities in LtOT and their effect on patient outcomes.