TY - JOUR
KW - Adolescent
KW - Adult
KW - Analgesics, Opioid/therapeutic use
KW - Child
KW - Cross-Sectional Studies
KW - Emergency Service, Hospital
KW - ethnicity
KW - Female
KW - Humans
KW - Pain/drug therapy
KW - Young Adult
KW - adolescents
KW - Analgesics
KW - Emergency department
KW - Ethnology
KW - minority
KW - National
KW - pain
KW - Pediatrics
KW - Race
AU - M. T. Phan
AU - D. M. Tomaszewski
AU - C. Arbuckle
AU - S. Yang
AU - C. Donaldson
AU - M. Fortier
AU - B. Jenkins
AU - E. Linstead
AU - Z. Kain
A1 - 
AB - BACKGROUND: Racial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED. METHODS: This was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11-21 years old were analyzed. Races/ethnicities were stratified as non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. In addition to race, statistical analysis included the following covariates: pain score, pain diagnosis, age, region, sex, and payment method. RESULTS: There was a weighted total of 189,256,419 ED visits. Those visits involved 109,826,315 (58%) non-Hispanic Whites, 46,314,977 (24%) non-Hispanic Blacks, and 33,115,127 (18%) Hispanics, with 21.6% (95% CI, 21.1%-22.1), 15.2% (95% CI, 14.6-15.9%), and 17.4% (95% CI, 16.5-18.2%) of those visits reporting use of opioids, respectively. Regardless of age, sex, and region, non-Hispanic Whites received opioids at a higher rate than non-Hispanic Blacks and Hispanics. Based on diagnosis, non-Hispanic Whites received opioids at a higher rate in multiple pain diagnoses. Additionally, non-Hispanic Blacks and Hispanics were less likely to receive an opioid when reporting moderate pain (aOR = 0.738, 95% CI 0.601-0.906, aOR = 0.739, 95% CI 0.578-0.945, respectively) and severe pain (aOR = 0.580, 95% CI 0.500-0.672, aOR = 0.807, 95% CI 0.685-0.951, respectively) compared to non-Hispanic Whites. CONCLUSIONS: Differences in the receipt of opioid agonists in EDs among the races/ethnicities exist, with more non-Hispanic Whites receiving opioids than their minority counterparts. Non-Hispanic Black women may be an especially marginalized population. Further investigation into sex-based and regional differences are needed.
AD - Chapman University, School of Pharmacy, Irvine, CA, 92618, USA.; Department of Pharmaceutical & Health Economics, University of Southern California, School of Pharmacy, University Park Campus, 635 Downey Way, Bldg. #331, Los Angeles, CA, 90089, USA. dtomasze@usc.edu.; Schmid College of Science and Technology, Chapman University, Orange, CA, 92866, USA.; Chapman University, School of Pharmacy, Irvine, CA, 92618, USA.; Irvine School of Medicine, University of California, Irvine, CA, 92617, USA.; Center on Stress & Health, University of California School of Medicine, Irvine, USA.; Department of Anesthesiology and Perioperative Care, University of California, Irvine, USA.; Department of Pediatric Psychology, Children's Hospital of Orange County, Orange, CA, USA.; Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA.; Department of Psychological Science, University of California, Irvine, CA, USA.; Center on Stress & Health, University of California School of Medicine, Irvine, USA.; Department of Anesthesiology and Perioperative Care, University of California, Irvine, USA.; Department of Psychology, Chapman University, Orange, CA, 92866, USA.; Schmid College of Science and Technology, Chapman University, Orange, CA, 92866, USA.; Center on Stress & Health, University of California School of Medicine, Irvine, USA.; Department of Anesthesiology and Perioperative Care, University of California, Irvine, USA.; Department of Pediatrics, CHOC Children's, Orange, CA, USA.; Yale Child Study Center, Yale University, New Haven, CT, USA.
BT - BMC pediatrics
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CP - 1
DO - 10.1186/s12887-021-02715-y
IS - 1
JF - BMC pediatrics
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Racial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED. METHODS: This was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11-21 years old were analyzed. Races/ethnicities were stratified as non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. In addition to race, statistical analysis included the following covariates: pain score, pain diagnosis, age, region, sex, and payment method. RESULTS: There was a weighted total of 189,256,419 ED visits. Those visits involved 109,826,315 (58%) non-Hispanic Whites, 46,314,977 (24%) non-Hispanic Blacks, and 33,115,127 (18%) Hispanics, with 21.6% (95% CI, 21.1%-22.1), 15.2% (95% CI, 14.6-15.9%), and 17.4% (95% CI, 16.5-18.2%) of those visits reporting use of opioids, respectively. Regardless of age, sex, and region, non-Hispanic Whites received opioids at a higher rate than non-Hispanic Blacks and Hispanics. Based on diagnosis, non-Hispanic Whites received opioids at a higher rate in multiple pain diagnoses. Additionally, non-Hispanic Blacks and Hispanics were less likely to receive an opioid when reporting moderate pain (aOR = 0.738, 95% CI 0.601-0.906, aOR = 0.739, 95% CI 0.578-0.945, respectively) and severe pain (aOR = 0.580, 95% CI 0.500-0.672, aOR = 0.807, 95% CI 0.685-0.951, respectively) compared to non-Hispanic Whites. CONCLUSIONS: Differences in the receipt of opioid agonists in EDs among the races/ethnicities exist, with more non-Hispanic Whites receiving opioids than their minority counterparts. Non-Hispanic Black women may be an especially marginalized population. Further investigation into sex-based and regional differences are needed.
PY - 2021
SN - 1471-2431; 1471-2431
SP - 252
T1 - Racial and ethnic disparities in opioid use for adolescents at US emergency departments
T2 - BMC pediatrics
TI - Racial and ethnic disparities in opioid use for adolescents at US emergency departments
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 34059005
U3 - 10.1186/s12887-021-02715-y
VL - 21
VO - 1471-2431; 1471-2431
Y1 - 2021
Y2 - May 31
ER -