Racial and Ethnic Disparities in the Evaluation and Management of Pain in the Outpatient Setting, 2006–2015

Ly, Dan P.

doi:10.1093/pm/pny074

Cited by 55 publications

(56 citation statements)

References 20 publications

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“…Despite statistically significant differences in age, insurance status, perineal lacerations, and BMI at time of delivery, inpatient postpartum use of oxycodone 5 mg tablets was nearly identical between Black and White patients. This is in contrast to the findings of other institutions, which note significant differences in opioid prescription practices both in the postpartum period and in numerous other specialties and situations between Black and White patients [ 8 , 10 , 11 ]. In addition, we found that the amount of opioid tablets prescribed at discharge were not associated with patient race.…”

Section: Discussioncontrasting

confidence: 99%

The impact of race on postpartum opioid prescribing practices: a retrospective cohort study

McKinnish

Lewkowitz

Carter

et al. 2021

BMC Pregnancy Childbirth

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Background To identify the association between inpatient postpartum opioid consumption, race, and amount of opioids prescribed at discharge after vaginal or cesarean delivery. Methods A total of 416 women who were prescribed an oral opioid following vaginal or cesarean delivery at a single tertiary academic institution between July 2018 and October 2018 were identified. Women with postoperative wound complications, third and fourth degree lacerations, cesarean hysterectomy, or a history of opioid abuse were excluded. The primary outcome was the number of oxycodone 5 mg tablets prescribed at discharge, stratified by race and mode of delivery. Only “Black” and “White” women were included in analyses due to low absolute numbers of other identities. Black women were compared to white women using multivariable logistic regression. Multiple sensitivity analyses were performed. Results The median number of oxycodone tablets consumed during hospitalization following cesarean delivery was seven (IQR: 2.5–12 tablets) and following vaginal delivery was one (IQR: 0–3). White women were more likely to be older at delivery regardless of route (median 32 vs. 30 years for cesarean delivery, and 29 vs. 27 years for vaginal delivery; p < 0.01 for both). White women undergoing cesarean delivery did so at a lower maternal BMI (31.6 vs. 34.5; p = 0.02). White women were also significantly more likely to have private insurance and to experience perineal lacerations following vaginal delivery. The number of inpatient opioid tablets consumed, as well as the number prescribed at discharge, were not statistically different between Black and White women, regardless of mode of delivery. These findings persisted in sensitivity analyses. Conclusion At our large, academic hospital the number of tablets prescribed at discharge had no association with patient race or inpatient usage regardless of mode of delivery.

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Section: Discussioncontrasting

confidence: 99%

The impact of race on postpartum opioid prescribing practices: a retrospective cohort study

McKinnish

Lewkowitz

Carter

et al. 2021

BMC Pregnancy Childbirth

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“…Male patients report more time spent with clinicians during health care visits, 37 while women report less positive experiences with provider communication regarding medication management. 38 Further, non-Caucasians continue to experience potential bias 39,40 and report poor quality of care. 41 Non-Caucasians, particularly African Americans, are subject to shorter office visits, 42,43 resulting in the reduction of key activities that may influence self-care.…”

Section: Discussionmentioning

confidence: 99%

The influence of gender and race on heart failure self-care

et al. 2019

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Objectives To explore gender and racial differences in heart failure (HF) self-care processes and examine whether gender and race predict HF self-care. Methods A secondary analysis of baseline data ( n = 107) from a longitudinal HF study (54.2% males; 56% non-Caucasians) was conducted. The self-care of heart failure index was used to measure self-care maintenance, management, and confidence. Descriptive statistics and univariate analyses examined gender and racial differences in HF self-care outcomes. Multiple linear regression examined whether gender and race predicted HF self-care maintenance, management, and confidence. Results Univariate analyses indicated that Caucasians reported significantly better self-care maintenance ( p = 0.042), while non-Caucasians reported significantly better self-care management ( p = 0.003). Males had significantly higher self-care confidence scores versus women ( p = 0.017). Multiple regression analysis indicated Caucasian race predicted significantly worse self-care management (β = −11.188; p = 0.006) versus non-Caucasian, while male gender predicted significantly higher self-care confidence scores (β = 7.592; p = 0.010) versus female gender. Gender nor race significantly predicted self-care maintenance. Discussion Although gender and race may influence HF self-care, other factors may be more important. More research is needed to identify individual factors that contribute to HF self-care to improve education and intervention.

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“…This is in contrast to the ndings of other institutions, which note signi cant differences in opioid prescription practices both in the postpartum period and in numerous other specialties and situations between Black and White patients. 8,10,11 In addition, we found that the amount of opioid tablets prescribed at discharge…”

Section: Discussionmentioning

confidence: 83%

The Impact of Race on Postpartum Opioid Prescribing Practices: A Retrospective Cohort Study

McKinnish

Lewkowitz

Carter

et al. 2020

Preprint

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BackgroundTo identify the association between inpatient postpartum opioid consumption, race, and amount of opioids prescribed at discharge after vaginal or cesarean delivery. MethodsA total of 416 women who were prescribed an oral opioid following vaginal or cesarean delivery at a single tertiary academic institution between July 2018 and October 2018 were identified. Women with postoperative wound complications, third and fourth degree lacerations, cesarean hysterectomy, or a history of opioid abuse were excluded. The primary outcome was the number of oxycodone 5 mg tablets prescribed at discharge, stratified by race and mode of delivery. Only “Black” and “White” women were included in analyses due to low absolute numbers of other identities. Black women were compared to white women using multivariable logistic regression. Multiple sensitivity analyses were performed.ResultsThe median number of oxycodone tablets consumed during hospitalization following cesarean delivery was seven (IQR: 2.5–12 tablets) and following vaginal delivery was one (IQR: 0-3). White women were more likely to be older at delivery regardless of route (median 32 vs. 30 years for cesarean delivery, and 29 vs. 27 years for vaginal delivery; p<0.01 for both). White women undergoing cesarean delivery did so at a lower maternal BMI (31.6 vs. 34.5; p=0.02). White women were also significantly more likely to have private insurance and to experience perineal lacerations following vaginal delivery. The number of inpatient opioid tablets consumed, as well as the number prescribed at discharge, were not statistically different between Black and White women, regardless of mode of delivery. These findings persisted in sensitivity analyses.ConclusionAt our large, academic hospital the number of tablets prescribed at discharge had no association with patient race or inpatient usage regardless of mode of delivery.

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Racial and Ethnic Disparities in the Evaluation and Management of Pain in the Outpatient Setting, 2006–2015

Abstract: Identifying causes of racial and ethnic disparities in the evaluation and treatment of pain in the outpatient setting is important to improving the health and function of patients.

Cited by 55 publications

References 20 publications

The impact of race on postpartum opioid prescribing practices: a retrospective cohort study

The impact of race on postpartum opioid prescribing practices: a retrospective cohort study

The influence of gender and race on heart failure self-care

The Impact of Race on Postpartum Opioid Prescribing Practices: A Retrospective Cohort Study

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