The study appears in Annals of Family Medicine.
The research team studied three risk-reduction strategies in black and white patients who were prescribed opioid painkillers: urine testing, regular office visits and restricted early drug refills.
Of the more than 1.600 patients studied, black patients were significantly more likely than white patients to be scheduled for regular office visits and have restricted early prescription refills. Though black patients were also more likely to receive urine tests, the percentage was not considered significant after adjustment for other demographic and clinical factors.
According to lead author William Becker, M.D., instructor in general internal medicine at Yale School of Medicine, “These data raise troubling questions about lax monitoring, especially for white patients taking opioids for a long period of time. In addition to drug misuse, there should be frequent monitoring for efficacy, side effects and major adverse events like accidental overdose.”
Previous studies have shown racial disparities in prescribing opioids for pain. Physicians are less likely to prescribe them for black patients than white patients, even though white patients are more likely than blacks to misuse these opioids. “These disparities may reflect a lack of physician training in managing pain among minorities,” Becker said, “leading them to rely on stereotypes in making their decisions.”
“Standardized monitoring procedures that are a routine part of comprehensive pain care show the most promise for eliminating these disparities,” Becker said.
Other authors are: Joanna L. Starrels, M.D., Moonseong Heo and Xuan Li of the Albert Einstein College of Medicine and Montefiore Medical Center; Mark G. Weiner, M.D. of the University of Pennsylvania School of Medicine; and Barbara J. Turner, M.D., of the University of Pennsylvania School of Medicine and University of Texas Health Science Center.
This study was funded by the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the Substance Abuse and Mental Health Services Administration.
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