PT  - JOURNAL ARTICLE
AU  - Gold, Laura S.
AU  - Marcum, Zachary A.
AU  - Meier, Eric N.
AU  - Turner, Judith A.
AU  - James, Kathryn T.
AU  - Kallmes, David F.
AU  - Luetmer, Patrick H.
AU  - Griffith, Brent
AU  - Sherman, Karen J.
AU  - Friedly, Janna L.
AU  - Suri, Pradeep
AU  - Deyo, Richard A.
AU  - Johnston, Sandra K.
AU  - Avins, Andrew L.
AU  - Heagerty, Patrick J.
AU  - Jarvik, Jeffrey G.
TI  - Patient, Provider, and Clinic Characteristics Associated with Opioid and Non-Opioid Pain Prescriptions for Patients Receiving Low Back Imaging in Primary Care
AID  - 10.3122/jabfm.2021.05.210033
DP  - 2021 Sep 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 950--963
VI  - 34
IP  - 5
4099  - http://www.jabfm.org/content/34/5/950.short
4100  - http://www.jabfm.org/content/34/5/950.full
SO  - J Am Board Fam Med2021 Sep 01; 34
AB  - Background: To describe characteristics of patients, providers, and clinics associated with opioid or non-opioid pain medication prescribing patterns for patients who received lower spine imaging in primary care clinics.Methods: In these secondary analyses of the Lumbar Imaging with Reporting of Epidemiology (LIRE) study, a randomized controlled trial conducted in 4 health systems in the United States, we evaluated characteristics associated with receipt of pain medication prescriptions. The outcomes were receipt of prescriptions for opioid or, separately, non-opioid pain medications within 90 days after imaging. Among patients who received opioid or non-opioid prescriptions, we evaluated receipt of multiple prescriptions in the year following imaging. Mixed models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).Results: Compared with whites, patients identified as Asian (OR, 0.53; 95% CI, 0.51–0.56), Native Hawaiian/Pacific Islander (OR, 0.73; 95% CI, 0.64–0.83), multiracial (OR, 0.84; 95% CI, 0.71–0.98) or Black (OR, 0.92; 95% CI, 0.89–0.96) had significantly reduced odds for receiving prescriptions for opioids within 90 days. Patients identified as Native American/Alaska Native had greater odds for receiving prescriptions for non-opioid pain medications within 90 days (OR, 1.12; 95% CI, 1.01–1.24). Receipt of pain prescriptions 120 days before imaging was strongly predictive of subsequent receipt of pain prescriptions across all categories.Conclusions: After adjusting for factors that could affect prescribing, the strongest differences observed in pain-medication prescribing were across racial categories and for patients with previous pain prescriptions. Further research is needed to understand these differences and to optimize prescribing.