McHenry Nicole, Ahmed Awais, Shah Ishani, Freedman Steven D, Nee Judy, Lembo Anthony, Sheth Sunil G
From the Digestive Disease Center.
Pancreas Center, Beth IsraelDeaconess Medical Center, Boston, MA.
Pancreas. 2022;51(10):1359-1364. doi: 10.1097/MPA.0000000000002180.
Racial-ethnic disparities in pain management are common but not known among pancreatic disease patients. We sought to evaluate racial-ethnic disparities in opioid prescriptions for pancreatitis and pancreatic cancer patients.
Data from the National Ambulatory Medical Care Survey were used to examine racial-ethnic and sex differences in opioid prescriptions for ambulatory visits by adult pancreatic disease patients.
We identified 207 pancreatitis and 196 pancreatic cancer patient visits, representing 9.8 million visits, but weights were repealed for analysis. No sex differences in opioid prescriptions were found among pancreatitis (P = 0.78) or pancreatic cancer patient visits (P = 0.57). Opioids were prescribed at 58% of Black, 37% of White, and 19% of Hispanic pancreatitis patient visits (P = 0.05). Opioid prescriptions were less common in Hispanic versus non-Hispanic pancreatitis patients (odds ratio, 0.35; 95% confidence interval, 0.14-0.91; P = 0.03). We found no racial-ethnic differences in opioid prescriptions among pancreatic cancer patient visits.
Racial-ethnic disparities in opioid prescriptions were observed in pancreatitis, but not pancreatic cancer patient visits, suggesting possible racial-ethnic bias in opioid prescription practices for patients with benign pancreatic disease. However, there is a lower threshold for opioid provision in the treatment of malignant, terminal disease.
疼痛管理中的种族差异很常见，但在胰腺疾病患者中尚不明确。我们试图评估胰腺炎和胰腺癌患者阿片类药物处方中的种族差异。
使用来自国家门诊医疗调查的数据，检查成年胰腺疾病患者门诊就诊时阿片类药物处方的种族和性别差异。
我们确定了207例胰腺炎患者就诊和196例胰腺癌患者就诊，代表980万次就诊，但权重被撤销用于分析。在胰腺炎患者就诊（P = 0.78）或胰腺癌患者就诊（P = 0.57）中，未发现阿片类药物处方存在性别差异。在58%的黑人胰腺炎患者就诊、37%的白人胰腺炎患者就诊和19%的西班牙裔胰腺炎患者就诊中开具了阿片类药物（P = 0.05）。与非西班牙裔胰腺炎患者相比，西班牙裔胰腺炎患者的阿片类药物处方较少见（比值比，0.35；95%置信区间，0.14 - 0.91；P = 0.03）。我们发现胰腺癌患者就诊的阿片类药物处方不存在种族差异。
在胰腺炎患者就诊中观察到阿片类药物处方的种族差异，但在胰腺癌患者就诊中未观察到，这表明在良性胰腺疾病患者的阿片类药物处方实践中可能存在种族偏见。然而，在恶性终末期疾病的治疗中，阿片类药物的使用阈值较低。
