• Laura S Gold, Zachary A Marcum, Eric N Meier, Judith A Turner, Kathryn T James, David F Kallmes, Patrick H Luetmer, Brent Griffith, Karen J Sherman, Janna L Friedly, Pradeep Suri, Richard A Deyo, Sandra K Johnston, Andrew L Avins, Patrick J Heagerty, and Jeffrey G Jarvik.
• From the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA). goldl@uw.edu.
• J Am Board Fam Med. 2021 Sep 1; 34 (5): 950963950-963.

BackgroundTo 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.MethodsIn 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).ResultsCompared 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.ConclusionsAfter 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.© Copyright 2021 by the American Board of Family Medicine.

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