Background: To describe characteristics of patients, providers, and clinics associated with opioid or non-opioid pain medication prescribing patterns for patients who received lower spine imaging in primary care clinics. Methods: In these secondary analyses of the Lumbar Imaging with Reporting of Epidemiology (LIRE) study, a randomized controlled trial conducted in 4 health systems in the United States, we evaluated characteristics associated with receipt of pain medication prescriptions. The outcomes were receipt of prescriptions for opioid or, separately, non-opioid pain medications within 90 days after imaging. Among patients who received opioid or non-opioid prescriptions, we evaluated receipt of multiple prescriptions in the year following imaging. Mixed models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Compared with whites, patients identified as Asian (OR, 0.53; 95% CI, 0.51–0.56), Native Hawaiian/Pacific Islander (OR, 0.73; 95% CI, 0.64–0.83), multiracial (OR, 0.84; 95% CI, 0.71–0.98) or Black (OR, 0.92; 95% CI, 0.89–0.96) had significantly reduced odds for receiving prescriptions for opioids within 90 days. Patients identified as Native American/Alaska Native had greater odds for receiving prescriptions for non-opioid pain medications within 90 days (OR, 1.12; 95% CI, 1.01–1.24). Receipt of pain prescriptions 120 days before imaging was strongly predictive of subsequent receipt of pain prescriptions across all categories. Conclusions: After adjusting for factors that could affect prescribing, the strongest differences observed in pain-medication prescribing were across racial categories and for patients with previous pain prescriptions. Further research is needed to understand these differences and to optimize prescribing.

中文翻译：

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与在初级保健中接受腰背成像的患者的阿片类和非阿片类疼痛处方相关的患者、提供者和临床特征

背景：描述与在初级保健诊所接受下脊柱成像的患者的阿片类或非阿片类止痛药处方模式相关的患者、提供者和诊所的特征。方法：在腰椎影像与流行病学报告 (LIRE) 研究（一项在美国 4 个卫生系统中进行的随机对照试验）的二次分析中，我们评估了与接受止痛药处方相关的特征。结果是在成像后 90 天内收到阿片类药物或单独的非阿片类止痛药的处方。在接受阿片类药物或非阿片类药物处方的患者中，我们评估了成像后一年内多次处方的接受情况。混合模型用于估计调整后的优势比 (OR) 和 95% 置信区间 (CI)。结% CI, 0.71–0.98) 或 Black (OR, 0.92; 95% CI, 0.89–0.96) 在 90 天内接受阿片类药物处方的几率显着降低。被确定为美洲原住民/阿拉斯加原住民的患者在 90 天内接受非阿片类止痛药处方的几率更大（OR，1.12；95% CI，1.01–1.24）。在成像前 120 天收到疼痛处方可以强烈预测随后收到所有类别的疼痛处方。结论：在调整可能影响处方的因素后，在止痛药处方中观察到的最大差异是跨种族和以前开过止痛药的患者。需要进一步研究以了解这些差异并优化处方。