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Racial and Ethnic Disparities in the Prescribing of Pain Medication in US Primary Care Settings, 1999-2019: Where Are We Now?
Thompson, Trevor; Stathi, Sofia; Shin, Jae Il; Carvalho, Andre; Solmi, Marco; Liang, Chih-Sung.
Afiliação
  • Thompson T; Centre for Chronic Illness and Ageing, University of Greenwich, London, UK. t.thompson@gre.ac.uk.
  • Stathi S; Centre for Inequalities, University of Greenwich, London, UK. t.thompson@gre.ac.uk.
  • Shin JI; Centre for Inequalities, University of Greenwich, London, UK.
  • Carvalho A; Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Solmi M; Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia.
  • Liang CS; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
J Gen Intern Med ; 39(9): 1597-1605, 2024 Jul.
Article em En | MEDLINE | ID: mdl-38302811
ABSTRACT

BACKGROUND:

Policy initiatives have attempted to reduce healthcare inequalities in the USA, but evidence on whether these initiatives have reduced racial and ethnic disparities in pain treatment in primary care is lacking.

OBJECTIVE:

To determine whether racial and ethnic disparities in medication prescribed for pain in primary care settings have diminished over a 21-year period from 1999 to 2019.

DESIGN:

An annual, representative cross-sectional probability sample of visits to US primary care physicians, taken from the National Ambulatory Medical Care Survey. PATIENTS Pain-related visits to primary care physicians. MAIN

MEASURES:

Prescriptions for opioid and non-opioid analgesics. KEY

RESULTS:

Of 599,293 (16%) sampled visits, 94,422 were pain-related, representing a population-weighted estimate of 143 million visits made annually to primary care physicians for pain. Relative risk analysis controlling for insurance, pain type, and other potential confounds showed no difference in pain medication prescribed between Black and White patients (p = .121). However, White patients were 1.61 (95% CI 1.32-1.97) and Black patients 1.57 (95% CI 1.26-1.95) times more likely to be prescribed opioids than a more underrepresented group consisting of Asian, Native-Hawaiian/Pacific-Islander, and American-Indian/Alaska-Natives (ps < .001). Non-Hispanic/Latino patients were 1.32 (95% CI 1.18-1.45) times more likely to receive opioids for pain than Hispanic/Latino patients (p < .001). Penalized cubic spline regression found no substantive narrowing of disparities over time.

CONCLUSIONS:

These findings suggest that additional intervention strategies, or better implementation of existing strategies, are needed to eliminate ethnic and racial disparities in pain treatment towards the goal of equitable healthcare.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Padrões de Prática Médica / Disparidades em Assistência à Saúde País/Região como assunto: America do norte Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Padrões de Prática Médica / Disparidades em Assistência à Saúde País/Região como assunto: America do norte Idioma: En Ano de publicação: 2024 Tipo de documento: Article