OBJECTIVES : This study assessed racial/ethnic differences in opioid prescribing practices among opioid-naïve patients who have undergone a simple mastectomy.

METHODS : Data from the TriNetX Electronic Medical Records (EMR), a federated global electronic network, from 2011-2018 were analyzed to examine opioid prescribing practices after simple mastectomy. TriNetX included patient level data such as demographics, diagnoses, procedures, labs, and medications. The study sample included patients aged >18 years who had undergone a simple mastectomy based on the ICD-9-CM and ICD-10-CM. Opioid prescribing practices within one month of mastectomy were examined based on RxNorm. Descriptive and chi-square analyses were conducted using the in-built analytics TriNetX platform.

RESULTS : Analyses of TriNetX revealed 7,429 patients who had undergone a simple mastectomy during 2011-2018. Hypertension (47%), joint disorders (46%), osteoarthritis (28%), thyroid disorders (28%), and diabetes (18%) were among the most frequent comorbidities. Opioid analgesics were prescribed to 76% of mastectomy patients (n=5,628). Approximately 82% of African Americans (n=946) were prescribed opioids within one month post-mastectomy compared to 77% of White non-Hispanics (n=4,234). Opioid analgesics were prescribed to 60% of White Hispanics (n=281) and 50% of Asians (n=167). Chi-square analyses revealed statistically significant differences in opioid prescribing practices by race/ethnicity after simple mastectomy. Bivariate analyses revealed that African Americans were 1.3 times (OR=1.32; 95% CI 1.12 - 1.56) more likely to receive prescription of opioids compared to White non-Hispanics counterparts. Compared to all other races/ethnicities, African Americans were 1.5 times (OR=1.54; 95% CI 1.32 - 1.82) more likely to receive prescription of opioids within one month post-mastectomy.

CONCLUSIONS : Racial/ethnic variability exists in opioid prescribing practices among patients who have undergone a simple mastectomy. Further research is needed to examine racial/ethnic disparities in both access to opioids and treatment.