RACIAL AND ETHNIC DISPARITIES IN POST-SURGICAL PAIN MANAGEMENT AMONG PATIENTS UNDERGOING ORTHOPEDIC SURGERY IN THE UNITED STATES
Author(s)
Ibrahim N. Alfayoumi, MS1, Surachat Ngorsuraches, PhD2;
1Auburn University, PhD in Health Economics and Outcomes Research, Auburn, AL, USA, 2Auburn University, Auburn, AL, USA
1Auburn University, PhD in Health Economics and Outcomes Research, Auburn, AL, USA, 2Auburn University, Auburn, AL, USA
OBJECTIVES: Postoperative pain management is essential for recovery following common orthopedic procedures. Prior studies primarily emphasized inpatient postoperative analgesic use but did not adequately examine outpatient use across racial and ethnic groups. This study aimed to assess outpatient postoperative analgesic use following major orthopedic surgeries in the United States.
METHODS: We conducted a retrospective cohort study using data from the NIH All of Us Research Program. Adults aged ≥18 years undergoing total knee arthroplasty, total hip arthroplasty, or rotator cuff repair were included if they had at least one postoperative analgesic prescription within 30 days of surgery and continuous electronic health record data for ≥180 days prior to surgery. Postoperative pain management was classified as opioid versus non-opioid therapy within 30 days after the index procedure. Multiple logistic regression was used to estimate adjusted odds ratios (aORs) for opioid use by race/ethnicity, adjusting for various covariates, e.g., comorbidity and preoperative opioid use.
RESULTS: The final cohort included 8,887 patients (mean age 62.6 years; 58.9% female). Overall, 83.0% received opioid therapy, and 17.0% received non-opioid therapy within 30 days post-surgery. Hispanic patients had significantly lower odds of receiving opioids compared with non-Hispanic White patients (aOR 0.46; 95% CI, 0.36-0.60). Odds of opioid use did not differ significantly between non-Hispanic Black and White patients (aOR 1.24; 95% CI, 0.95-1.63). Preoperative opioid use was the strongest predictor of postoperative opioid use (aOR 4.82; 95% CI, 4.05-5.75). Increasing age was associated with higher odds of opioid use, while gender was not significantly associated.
CONCLUSIONS: Racial and ethnic differences in postoperative opioid use existed following common orthopedic surgeries, particularly among Hispanic patients. These findings underscore the need for equitable, evidence-based pain management strategies for patients undergoing orthopedic surgery.
METHODS: We conducted a retrospective cohort study using data from the NIH All of Us Research Program. Adults aged ≥18 years undergoing total knee arthroplasty, total hip arthroplasty, or rotator cuff repair were included if they had at least one postoperative analgesic prescription within 30 days of surgery and continuous electronic health record data for ≥180 days prior to surgery. Postoperative pain management was classified as opioid versus non-opioid therapy within 30 days after the index procedure. Multiple logistic regression was used to estimate adjusted odds ratios (aORs) for opioid use by race/ethnicity, adjusting for various covariates, e.g., comorbidity and preoperative opioid use.
RESULTS: The final cohort included 8,887 patients (mean age 62.6 years; 58.9% female). Overall, 83.0% received opioid therapy, and 17.0% received non-opioid therapy within 30 days post-surgery. Hispanic patients had significantly lower odds of receiving opioids compared with non-Hispanic White patients (aOR 0.46; 95% CI, 0.36-0.60). Odds of opioid use did not differ significantly between non-Hispanic Black and White patients (aOR 1.24; 95% CI, 0.95-1.63). Preoperative opioid use was the strongest predictor of postoperative opioid use (aOR 4.82; 95% CI, 4.05-5.75). Increasing age was associated with higher odds of opioid use, while gender was not significantly associated.
CONCLUSIONS: Racial and ethnic differences in postoperative opioid use existed following common orthopedic surgeries, particularly among Hispanic patients. These findings underscore the need for equitable, evidence-based pain management strategies for patients undergoing orthopedic surgery.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH80
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), STA: Surgery