(HealthDay News) — Racial differences exist in opioid pain management for Medicare beneficiaries after a hip fracture, according to a study published online Sept. 11 in the Journal of the American Geriatrics Society.
Kaleen N. Hayes, Pharm.D., Ph.D., from Brown University in Providence, Rhode Island, and colleagues assessed whether the receipt and dose of opioids differed between Black and White older adult U.S. Medicare beneficiaries with a hip fracture as they transitioned back to the community setting. The analysis included 164,170 older adults (mean age, 82.7 years) with hip fracture.
The researchers found that overall use of opioids in the community was similar between Black and White Medicare beneficiaries. However, Black beneficiaries had lower average doses in their first 90 days in both total cumulative doses (institutional postacute care [PAC] group, 165 fewer milligram morphine equivalents [MMEs]; no PAC, 167 fewer MMEs) and average MME per days’ supply of medication (PAC, –3.0 fewer MMEs per day; no PAC, –4.7 fewer MMEs per day). In secondary analyses, the greatest differences were seen among Asian beneficiaries (e.g., 617 to 653 fewer cumulative mg oxycodone).
“Future work should examine whether these differences result in disparities in short- and long-term health outcomes,” the authors write.
Several authors disclosed ties to relevant organizations.
What is a hip fracture?
A hip fracture is a break in the upper part of the femur (thighbone). It typically occurs at the femoral neck or femoral head, which are parts of the ball-and-socket joint that connects your thighbone to your pelvis.
Hip fractures are a serious injury and often require immediate medical attention. They are more common in older adults, especially those with osteoporosis, but can occur at any age due to accidents or other traumatic events.
How to treat a hip fracture
Most hip fractures require surgical repair to restore the broken bone to its proper position. The specific surgical procedure will depend on the fracture type and your overall health. Common options include:
Open reduction internal fixation (ORIF): This involves making an incision to expose the fracture, repairing the bone with metal screws, plates, or rods, and closing the incision.
Hip replacement: In severe cases, hip replacement surgery may be necessary. This involves removing the damaged hip joint and replacing it with an artificial metal, ceramic, or plastic joint.
After surgery, you’ll undergo a rehabilitation program to regain strength, mobility, and independence. This may include physical therapy, occupational therapy, and home health care.
It’s important to follow your doctor’s instructions closely and participate fully in your rehabilitation program to ensure a successful recovery.
Racial differences in opioid prescriptions
Studies have shown significant racial disparities in opioid pain prescriptions in the United States.
While the exact reasons for these disparities are complex and multifaceted, several factors have been identified:
Implicit biases: Health care providers may hold implicit biases that influence their treatment decisions, leading to differences in how they prescribe opioids to patients of different races.
Stereotypes: Negative stereotypes about people of color, particularly regarding pain management and substance abuse, can lead to undertreatment of pain.
Lack of trust: Patients of color may be less likely to trust health care providers due to historical and systemic inequities.
Access to care: Disparities in access to health care, including pain management specialists, can contribute to differences in opioid prescribing.
Cultural factors: Cultural beliefs and attitudes about pain and its management can influence how patients express their pain and how health care providers respond.
It’s important to note that these disparities are a serious public health issue and efforts are underway to address them. By increasing awareness of these issues and implementing strategies to reduce bias and improve access to care, we can work towards more equitable and effective pain management for all patients.