Table 2.
Variables associated with OPR dose reduction
| Independent Variables | OPR Dose Reduction (N = 463) | No OPR Dose Reduction (N = 634) | Bivariate P Value* | Adjusted Odds Ratio† (95% CI) |
|---|---|---|---|---|
| Clinical | ||||
| Baseline OPR dose, median (IQR), MME‡ | 75.0 (41.3–165.0) | 100.0 (52.5–220.0) | <0.001 | 0.98 (0.96–0.99) |
| Concurrent benzodiazepines, No. (%) | 79 (37.4) | 132 (62.6) | 0.12 | 0.85 (0.61–1.17) |
| Sociodemographic | ||||
| Race/ethnicity, No. (%) | 0.003 | |||
| White | 60 (36.1) | 106 (63.9) | Ref. | |
| Black | 175 (49.9) | 176 (50.1) | 1.82 (1.22–2.70) | |
| Hispanic | 147 (41.2) | 210 (58.8) | 1.21 (0.82–1.79) | |
| Other/unknown | 81 (36.3) | 142 (63.7) | 0.97 (0.63–1.49) | |
| Gender, No. (%) | 0.003 | |||
| Male | 183 (37.3) | 308 (62.7) | Ref. | |
| Female | 280 (46.2) | 326 (53.8) | 1.43 (1.11–1.83) | |
| Covariates | ||||
| Age, No. (%) | 0.007 | |||
| <60 y | 349 (40.2) | 520 (59.8) | Ref. | |
| ≥60 y | 114 (50.0) | 114 (50.0) | 1.44 (1.06–1.95) | |
| No. of medical comorbidities (%)§ | 0.60 | |||
| 0–1 | 93 (43.1) | 123 (56.9) | – | |
| 2–3 | 148 (40.1) | 221 (59.9) | – | |
| 4+ | 222 (43.4) | 290 (56.6) | – | |
| English speaking, No. (%) | 402 (42.8) | 538 (57.2) | 0.56 | – |
| Year of cohort entry, median (IQR) | 2009 (2008–2011) | 2009 (2008–2011) | 0.87 | – |
| Tobacco use disorder, No. (%) | 155 (41.2) | 221 (58.8) | 0.63 | – |
| Alcohol use disorder, No. (%) | 45 (45.0) | 55 (55.0) | 0.55 | – |
| Nonopioid drug use disorder, No. (%) | 113 (39.1) | 176 (60.9) | 0.21 | – |
| Opioid abuse, No. (%) | 9 (37.5) | 15 (62.5) | 0.64 | – |
| Mental health disorder, No. (%)¶ | 272 (41.7) | 381 (58.3) | 0.65 | – |
| Pain diagnosis category, No. (%)‖ | ||||
| Extremity | 369 (43.3) | 484 (56.7) | 0.19 | – |
| Neck | 76 (52.1) | 70 (47.8) | 0.01 | 1.59 (1.10–2.29) |
| Headache | 136 (46.0) | 160 (54.0) | 0.13 | – |
| Back | 352 (42.2) | 482 (57.8) | 1.00 | – |
| Neuropathic | 165 (39.8) | 250 (60.2) | 0.20 | – |
| Abdomen | 178 (46.1) | 208 (53.9) | 0.05 | – |
| Chest | 130 (45.3) | 157 (54.7) | 0.22 | – |
CI = confidence interval; IQR = interquartile range; MME = morphine-milligram equivalents; OPR = opioid pain reliever.
Bivariate P values calculated using t test (if normally distributed) or Mann-Whitney U test (if not normally distributed) for continuous variables; chi-square test for categorical variables.
Multivariable logistic regression adjusted for age, race/ethnicity, gender, baseline OPR dose (continuous), concurrent benzodiazepines, and neck pain diagnosis.
Unadjusted and adjusted odds ratio calculated for increments of 20 MME.
Calculated using modified Elixhauser category diagnosis coding algorithm developed by Quan et al. [40].
Based on provider ICD-9 coding, including codes for anxiety, depression, bipolar disorder, post-traumatic stress disorder, or schizophrenia.
Based on ICD-9 coding, based on the approach of Larochelle et al. [41]. Patients may have multiple pain diagnoses.