RT Journal Article
SR Electronic
T1 Patient, Provider, and Clinic Characteristics Associated with Opioid and Non-Opioid Pain Prescriptions for Patients Receiving Low Back Imaging in Primary Care
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 950
OP 963
DO 10.3122/jabfm.2021.05.210033
VO 34
IS 5
A1 Laura S. Gold
A1 Zachary A. Marcum
A1 Eric N. Meier
A1 Judith A. Turner
A1 Kathryn T. James
A1 David F. Kallmes
A1 Patrick H. Luetmer
A1 Brent Griffith
A1 Karen J. Sherman
A1 Janna L. Friedly
A1 Pradeep Suri
A1 Richard A. Deyo
A1 Sandra K. Johnston
A1 Andrew L. Avins
A1 Patrick J. Heagerty
A1 Jeffrey G. Jarvik
YR 2021
UL http://www.jabfm.org/content/34/5/950.abstract
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.