Table 4

The association between physician characteristics and the odds of prescribing an opioid for the 65 012 patients seen by 7373 physicians for common chronic pain problems, and the morphine milligram equivalent (MME) dose prescribed for the 9870 patients who received an opioid prescription

CharacteristicOdds of prescribing an opioid for the 65 012 patientsMME opioid dose prescribed for the 9870 patients who received an opioid prescription
N patients (%)N patients with opioid (%)OR (95% CI)P valueN patients (%)Mean (SD)Estimated difference (95% CI)P value
Physician gender
Female20 202 (31.1)2679 (13.3)Reference2679 (27.1)22.8 (30.5)Reference
Male44 810 (68.9)7191 (16.0)1.11 (1.03 to 1.19)0.0067191 (72.9)29.1 (38.1)2.60 (0.90 to 4.31)0.003
Citizenship
Asia8900 (13.7)1284 (14.4)Reference1284 (13.0)25.1 (34.0)Reference
Europe7508 (11.5)940 (12.5)0.94 (0.82 to 1.07)0.354940 (9.5)26.5 (31.9)0.47 (−4.30 to 2.60)0.793
India and Pakistan17 457 (26.9)2520 (14.4)0.98 (0.88 to 1.10)0.7542520 (25.5)25.9 (38.8)−0.14 (−2.89 to 2.60)0.919
Middle East5714 (8.8)853 (14.9)0.97 (0.85 to 1.12)0.718853 (8.6)24.8 (27.4)−0.87 (−4.38 to 2.63)0.626
Other8814 (13.6)1371 (15.6)0.92 (0.81 to 1.04)0.1781371 (13.9)25.8 (41.9)−1.38 (−4.51 to 1.75)0.387
USA and Canada16 619 (25.6)2902 (17.5)1.03 (0.92 to 1.16)0.5692902 (29.4)31.5 (35.6)3.56 (0.70 to 6.42)0.015
Physician specialty
Primary care18 505 (28.5)3407 (18.4)Reference3407 (34.5)23.9 (31.4)Reference
Internal medicine15 719 (24.2)2441 (15.5)0.85 (0.79 to 0.92)<0.0012441 (24.7)22.2 (22.6)0.09 (−1.50 to 1.69)0.907
Medical specialty12 495 (19.2)754 (6.0)0.34 (0.29 to 0.40)<0.001754 (7.6)29.3 (51.7)1.42 (−3.16 to 6.00)0.543
Surgery specialty2573 (4.0)376 (14.6)0.65 (0.52 to 0.82)<0.001376 (3.8)40.2 (23.0)11.62 (7.51 to 15.73)<0.001
Hospital-based specialty12 241 (18.8)2104 (17.2)0.90 (0.81 to 1.01)0.0762104 (21.3)35.4 (52.3)9.80 (6.66 to 12.95)<0.001
Emergency medicine3479 (5.4)788 (22.7)0.85 (0.75 to 0.96)0.012788 (8.0)29.2 (14.4)1.51 (−0.50 to 3.52)0.142
Physio-NSAID before opioid
Yes27 232 (41.9)5071 (18.6)1.56 (1.49 to 1.63)<0.0015071 (51.4)27.4 (36.9)0.64 (−1.07 to 2.36)0.462
No37 780 (58.1)4799 (12.7)Reference4799 (48.6)27.4 (35.8)Reference
Study physician region of practice
North16 860 (25.9)1866 (11.1)0.63 (0.58 to 0.69)<0.0011866 (18.9)29.5 (47.3)0.40 (−1.81 to 2.62)0.720
Midwest11 402 (17.5)2079 (18.2)1.04 (0.96 to 1.13)0.3642079 (21.1)26.1 (30.4)−0.79 (−2.76 to 1.18)0.433
West13 728 (21.1)1931 (14.1)0.88 (0.80 to 0.96)0.0061931 (19.6)27.9 (34.0)2.71 (0.52 to 4.89)0.016
South23 022 (35.4)3994 (17.3)Reference3994 (40.5)26.9 (34.3)Reference
Physician age (per 10 years)
30–40 years old21 119 (32.5)3151 (14.9)1.00 (0.99 to 1.00)0.2073151 (31.9)28.2 (38.8)1.82 (−0.03 to 3.67)0.053
41–50 years old35 633 (54.8)5518 (15.5)5518 (55.9)26.6 (32.8)
51 years old and more8260 (12.7)1201 (14.5)1201 (12.2)29.0 (44.3)
  • Models were adjusted for clinical competence score, physician’s gender, citizenship, specialty, region of practice, age, prescribed physio-NSAID before opioid, score and patient confounder scores.

  • NSAID, non-steroidal anti-inflammatory drug.