Table 2.
Characteristics of outpatient visits for pain and odds of filling an opioid prescription within 1 week
| Initial pain encounters without opioid fill (N = 210,017) |
Initial pain encounters with opioid fill (N = 20,941) |
Univariate analysis: opioid fill |
Multivariable analysis: opioid fill |
|
|---|---|---|---|---|
| % | % | OR (95% CI) | OR (95% CI) | |
| Condition | ||||
| Joint pain | 31.9 | 22.5 | Ref | Ref |
| Back pain without radiculopathy | 22.3 | 38.0 | 2.42 (2.33, 2.52) | 1.65 (1.58, 1.72) |
| Headache | 18.3 | 8.0 | 0.62 (0.59, 0.66) | 0.63 (0.59, 0.67) |
| Neck pain | 8.1 | 9.2 | 1.61 (1.53, 1.71) | 1.08 (1.02, 1.15) |
| Tendonitis/ Bursitis | 8.6 | 4.5 | 0.74 (0.69, 0.80) | 0.75 (0.69, 0.80) |
| Muscular strains/sprains | 5.5 | 6.1 | 1.58 (1.48, 1.68) | 1.51 (1.41, 1.61) |
| Back pain with radiculopathy | 2.7 | 6.7 | 3.61 (3.38, 3.85) | 2.57 (2.40, 2.75) |
| Nephrolithiasis | 1.5 | 2.6 | 2.57 (2.34, 2.83) | 2.66 (2.41, 2.93) |
| Musculoskeletal injury | 0.9 | 0.8 | 1.21 (1.03, 1.42) | 1.28 (1.09, 1.50) |
| Dental pain | 0.4 | 1.6 | 5.64 (4.96, 6.41) | 5.97 (5.24, 6.80) |
| Clinician type | ||||
| Physician | 97.9 | 97.0 | Ref | Ref |
| Nurse Practitioner | 1.9 | 2.6 | 1.41 (1.29, 1.55) | 1.29 (1.18, 1.42) |
| Physician’s Assistant | 0.3 | 0.4 | 1.68 (1.34, 2.10) | 1.55 (1.22, 1.96) |
| Patient demographics | ||||
| Age (years) | ||||
| 18–45 | 51.7 | 51.0 | Ref | Ref |
| 46–55 | 26.0 | 27.8 | 1.09 (1.05, 1.12) | 1.07 (1.04, 1.11) |
| 56–65 | 18.9 | 18.4 | 0.99 (0.95, 1.03) | 0.99 (0.95, 1.03) |
| >65 | 3.4 | 2.9 | 0.87 (0.80, 0.94) | 0.93 (0.85, 1.01) |
| Male | 48.9 | 56.1 | 1.34 (1.30, 1.38) | 1.26 (1.22, 1.30) |
| Other medications (in one month prior to index visit) | ||||
| Antidepressants | 6.1 | 7.2 | 1.18 (1.12, 1.25) | 1.15 (1.08, 1.22) |
| Benzodiazepines | 3.3 | 6.4 | 1.99 (1.87, 2.11) | 2.01 (1.87, 2.15) |
| Gabapentin | 0.9 | 1.7 | 1.95 (1.74, 2.19) | 1.57 (1.39, 1.77) |
| Muscle relaxants | 9.5 | 32.4 | 4.56 (4.41, 4.71) | 3.67 (3.54, 3.80) |
| Sedative hypnotic | 2.4 | 2.8 | 1.20 (1.10, 1.30) | 1.23 (1.12, 1.35) |
| Chronic diseases (in 180 days prior to visit) | ||||
| COPD/Asthma | 5.9 | 6.1 | 1.05 (0.99, 1.11) | 0.98 (0.92, 1.05) |
| Liver disease | 1.0 | 0.8 | 0.81 (0.70, 0.95) | 0.79 (0.67, 0.93) |
| Renal disease | 1.1 | 1.3 | 1.23 (1.08, 1.40) | 1.16 (0.99, 1.35) |
| Psychiatric disorders ( in 180 days prior to visit) | ||||
| Anxiety | 6.4 | 6.5 | 1.01 (0.95, 1.07) | 0.88 (0.83, 0.94) |
| Psychosis | 0.2 | 0.1 | 0.74 (0.49, 1.13) | 0.72 (0.47, 1.10) |
| Depression | 6.0 | 6.1 | 1.02 (0.96, 1.08) | 0.97 (0.91, 1.04) |
| Non-prescription drug use( in 180 days prior to visit) | ||||
| Smoking | 2.4 | 3.1 | 1.34 (1.24, 1.46) | 1.23 (1.13, 1.34) |
| Alcohol Abuse/dependence | 0.3 | 0.5 | 1.43 (1.17, 1.76) | 1.25 (1.00, 1.55) |
| Drug abuse | 0.1 | 0.2 | 1.24 (0.87, 1.77) | 1.05 (0.72, 1.52) |
| Charlson Comorbidity Score | ||||
| 0 | 86.9 | 86.2 | Ref | Ref |
| 1 | 10.6 | 11.1 | 1.06 (1.01, 1.10) | 1.09 (1.03, 1.15) |
| 2 | 1.9 | 2.1 | 1.11 (1.00, 1.23) | 1.08 (0.97, 1.21) |
| 3 + | 0.5 | 0.6 | 1.19 (0.99, 1.43) | 1.13 (0.91, 1.41) |