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Gender and Racial Disparities in Opioid Prescriptions for Dental Diagnosis Among Medicaid Populations

Publication Type : Conference Paper

Publisher : Podium Presentation 2018 ARM Annual Meeting of Academy Health .

Source : Podium Presentation 2018 ARM Annual Meeting of Academy Health, Volume 149, Issue 4, USA , p.246-255 (2018)

Url : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152927/

Keywords : Analgesics, Opioid, Ethnic Groups, female, Humans, male, Medicaid, Pain Management, Practice Patterns, Physicians', United States.

Campus : Kochi

School : School of Dentistry

Department : Public Health Dentistry

Year : 2018

Abstract : Methods The study used medical and pharmacy claims data obtained from the multistate Truven MarketScan Medicaid Database from 2013 to 2015 for Medicaid patients receiving health care. Medicaid beneficiaries who utilized an outpatient healthcare facility for back pain, neck pain (cervicalgia), joint pain (osteoarthritis and rheumatoid arthritis), orthopedics (simple/closed fractures and muscle strains/sprains), headache (cluster headaches and migraines), dental conditions, or otorhinolaryngologic (otalgia) diagnoses, based on the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes, and received an opioid prescription within 14 days of diagnosis were included in this study. Results There were 5,051,288 patients with 1 of the 7 diagnostic groupings; 18.8% had an opioid prescription filled within 14 days of diagnosis. Orthopedic pain (34.8%) was the primary reason for an opioid prescription, followed by dental conditions (17.3%), back pain (14.0%), and headache (12.9%). Patients receiving an opioid for conditions associated with acute pain management, such as otorhinolaryngologic (OR=1.93, 95% CI=1.85, 2.0), dental (OR=1.50, 95% CI=1.48, 1.53), or orthopedic conditions (OR=1.31, 95% CI=1.29, 1.32), were more likely to receive the prescription from an emergency department provider versus a general practitioner. However, compared with general practitioners, other providers were more likely to prescribe opioids for conditions associated with chronic pain management. Conclusions More than half of Medicaid beneficiaries receiving an opioid for pain management do so for orthopedic- and dental-related reasons, with emergency department providers more likely to prescribe opioids. Modifications to the guidelines addressing temporary acute pain management practices with opioids would be likely to benefit emergency department providers the most.

Cite this Research Publication : Chandrashekar Janakiram and Chalmers, N. I., “Gender and Racial Disparities in Opioid Prescriptions for Dental Diagnosis Among Medicaid Populations”, in Podium Presentation 2018 ARM Annual Meeting of Academy Health, USA , 2018, vol. 149, no. 4, pp. 246-255.

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