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
| 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.