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Racial disparities in opioid prescriptions for fractures in the pediatric population
Emily Wing1, Soheil Saadat1, Rishi Bhargava2
1University of California, Irvine, 333 City Boulevard West Suite 640, Orange, CA 92868, USA.
Insights
Racial disparities exist in pediatric opioid prescriptions for fractures. Non-Hispanic White children were more likely to receive opioid pain medication compared to Black and Hispanic White children.
Area of Science:
- Pediatric Pain Management
- Health Disparities
- Pharmacology
Background:
- Racial disparities in pain management are documented.
- Limited research exists on these disparities in pediatric populations.
- This study addresses the gap in understanding racial influences on pediatric pain management.
Purpose of the Study:
- To investigate the association between race and opioid prescription patterns in pediatric patients diagnosed with fractures.
- To identify potential racial biases in pain management for children.
Main Methods:
- Retrospective analysis of analgesic prescriptions for pediatric patients (0-21 years) discharged over five years.
- Inclusion criteria: patients with a fracture diagnosis.
- Statistical analysis: Multiple logistic regression to adjust for covariates.
Main Results:
- 58,402 prescriptions reviewed; 5,061 for fractures.
- 52% of fracture prescriptions were for opioids.
- Non-Hispanic White patients had 1.44 times higher odds of receiving opioid prescriptions compared to Black patients, adjusted for covariates.
Conclusions:
- Evidence suggests racial bias in pediatric opioid prescribing for fractures.
- Disparities may lead to negative downstream health effects.
- Need for standardized pain management protocols to reduce prescriber variability.
Background And Objectives:
Racial disparities have been well documented in literature regarding pain management. However, few studies have focused on its effect in the pediatric population. This study seeks to examine the relationship between race and opioid prescription patterns for children with fractures.
Methods:
A retrospective study was conducted by reviewing all analgesic prescriptions of discharged pediatric patients (ages 0-21, median 10 years) from a large children's hospital over a five-year period. Multiple logistic regression analysis was applied to examine racial differences in opioid prescriptions for patients with long bone fractures after adjusting for sex, age, length of stay, and payer type.
Results:
58,402 analgesic prescriptions were reviewed in this study; 5061 were given for the primary discharge diagnosis of "fracture" of any bone. Overall, 52% of analgesics prescribed for this diagnosis were opioid medications. The relative frequency of opioid prescriptions was 48.7% in Hispanic White patients and 63.1% in non-Hispanic White patients. The odds ratio for non-Hispanic White patients to be prescribed an opioid medication was 1.44 (CI 1.20-1.73) compared to Black patients and to Hispanic White patients after adjustment for sex, age, length of hospital stay, and payer type. The same racial disparity pattern was observed in patients regardless of long bone fracture location.
Conclusions:
Racial bias is suggested in opioid prescription patterns, even in the pediatric population, which may have untoward negative downstream effects. This study delineates the need for improved and standardized methods to adequately treat pain and reduce variations in prescriber habits.
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