Characteristic | Odds of prescribing an opioid for the 65 012 patients | MME opioid dose prescribed for the 9870 patients who received an opioid prescription | ||||||
N patients (%) | N patients with opioid (%) | OR (95% CI) | P value | N patients (%) | Mean (SD) | Estimated difference (95% CI) | P value | |
Physician gender | ||||||||
Female | 20 202 (31.1) | 2679 (13.3) | Reference | 2679 (27.1) | 22.8 (30.5) | Reference | ||
Male | 44 810 (68.9) | 7191 (16.0) | 1.11 (1.03 to 1.19) | 0.006 | 7191 (72.9) | 29.1 (38.1) | 2.60 (0.90 to 4.31) | 0.003 |
Citizenship | ||||||||
Asia | 8900 (13.7) | 1284 (14.4) | Reference | 1284 (13.0) | 25.1 (34.0) | Reference | ||
Europe | 7508 (11.5) | 940 (12.5) | 0.94 (0.82 to 1.07) | 0.354 | 940 (9.5) | 26.5 (31.9) | 0.47 (−4.30 to 2.60) | 0.793 |
India and Pakistan | 17 457 (26.9) | 2520 (14.4) | 0.98 (0.88 to 1.10) | 0.754 | 2520 (25.5) | 25.9 (38.8) | −0.14 (−2.89 to 2.60) | 0.919 |
Middle East | 5714 (8.8) | 853 (14.9) | 0.97 (0.85 to 1.12) | 0.718 | 853 (8.6) | 24.8 (27.4) | −0.87 (−4.38 to 2.63) | 0.626 |
Other | 8814 (13.6) | 1371 (15.6) | 0.92 (0.81 to 1.04) | 0.178 | 1371 (13.9) | 25.8 (41.9) | −1.38 (−4.51 to 1.75) | 0.387 |
USA and Canada | 16 619 (25.6) | 2902 (17.5) | 1.03 (0.92 to 1.16) | 0.569 | 2902 (29.4) | 31.5 (35.6) | 3.56 (0.70 to 6.42) | 0.015 |
Physician specialty | ||||||||
Primary care | 18 505 (28.5) | 3407 (18.4) | Reference | 3407 (34.5) | 23.9 (31.4) | Reference | ||
Internal medicine | 15 719 (24.2) | 2441 (15.5) | 0.85 (0.79 to 0.92) | <0.001 | 2441 (24.7) | 22.2 (22.6) | 0.09 (−1.50 to 1.69) | 0.907 |
Medical specialty | 12 495 (19.2) | 754 (6.0) | 0.34 (0.29 to 0.40) | <0.001 | 754 (7.6) | 29.3 (51.7) | 1.42 (−3.16 to 6.00) | 0.543 |
Surgery specialty | 2573 (4.0) | 376 (14.6) | 0.65 (0.52 to 0.82) | <0.001 | 376 (3.8) | 40.2 (23.0) | 11.62 (7.51 to 15.73) | <0.001 |
Hospital-based specialty | 12 241 (18.8) | 2104 (17.2) | 0.90 (0.81 to 1.01) | 0.076 | 2104 (21.3) | 35.4 (52.3) | 9.80 (6.66 to 12.95) | <0.001 |
Emergency medicine | 3479 (5.4) | 788 (22.7) | 0.85 (0.75 to 0.96) | 0.012 | 788 (8.0) | 29.2 (14.4) | 1.51 (−0.50 to 3.52) | 0.142 |
Physio-NSAID before opioid | ||||||||
Yes | 27 232 (41.9) | 5071 (18.6) | 1.56 (1.49 to 1.63) | <0.001 | 5071 (51.4) | 27.4 (36.9) | 0.64 (−1.07 to 2.36) | 0.462 |
No | 37 780 (58.1) | 4799 (12.7) | Reference | 4799 (48.6) | 27.4 (35.8) | Reference | ||
Study physician region of practice | ||||||||
North | 16 860 (25.9) | 1866 (11.1) | 0.63 (0.58 to 0.69) | <0.001 | 1866 (18.9) | 29.5 (47.3) | 0.40 (−1.81 to 2.62) | 0.720 |
Midwest | 11 402 (17.5) | 2079 (18.2) | 1.04 (0.96 to 1.13) | 0.364 | 2079 (21.1) | 26.1 (30.4) | −0.79 (−2.76 to 1.18) | 0.433 |
West | 13 728 (21.1) | 1931 (14.1) | 0.88 (0.80 to 0.96) | 0.006 | 1931 (19.6) | 27.9 (34.0) | 2.71 (0.52 to 4.89) | 0.016 |
South | 23 022 (35.4) | 3994 (17.3) | Reference | 3994 (40.5) | 26.9 (34.3) | Reference | ||
Physician age (per 10 years) | ||||||||
30–40 years old | 21 119 (32.5) | 3151 (14.9) | 1.00 (0.99 to 1.00) | 0.207 | 3151 (31.9) | 28.2 (38.8) | 1.82 (−0.03 to 3.67) | 0.053 |
41–50 years old | 35 633 (54.8) | 5518 (15.5) | 5518 (55.9) | 26.6 (32.8) | ||||
51 years old and more | 8260 (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.