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Table 2 Unadjusted and adjusted OR with 95% CI for receipt of opioid, by chronic pain typea,b,c,d

From: The association between cognitive ability and opioid prescribing in vulnerable older adults with chronic pain in ambulatory care: a secondary data analysis using the Medical Expenditure Panel Survey

 

Any chronic pain (n = 60,594), odds ratio (95% CI)

Severe chronic pain (n = 36,996), odds ratio (95% CI)

Chronic pain ICD 9/10 diagnosese (n = 48,273), odds ratio (95% CI)

Unadjusted

 Cognitive status

  No cognitive impairment (NCI)

1 [reference]

1 [reference]

1 [reference]

  Cognitive impairment (CI)

1.876 (1.756–2.005)

1.392 (1.294–1.498)

1.987 (1.845–2.139)

  AD/ADRD

1.160 (0.991–1.358)

0.890 (0.748–1.059)

1.482 (1.251–1.757)

Adjusted

 Cognitive status

  No cognitive impairment (NCI)

1 [reference]

1 [reference]

1 [reference]

  Cognitive impairment (CI)

1.409 (1.306–1.519)

1.167 (1.074–1.269)

1.453 (1.336–1.580)

  AD/ADRD

1.229 (1.039–1.454)

1.132 (0.937–1.367)

1.477 (1.229–1.776)

  Age

0.978 (0.976–0.981)

0.973 (0.970–0.976)

0.980 (0.977–0.982)

 Race/ethnicity

  White

1 [reference]

1 [reference]

1 [reference]

  Asian

0.383 (0.328–0.447)

0.341 (0.278–0.417)

0.378 (0.316–0.453)

  Black

0.896 (0.840–0.955)

0.831 (0.770–0.898)

0.944 (0.879–1.013)

  Latine

0.651 (0.602–0.703)

0.601 (0.547–0.659)

0.658 (0.603–0.717)

  Others

1.267 (1.094–1.468)

1.135 (0.954–1.350)

1.124 (0.958–1.319)

 Sex

  Female

1 [reference]

1 [reference]

1 [reference]

  Male

0.948 (0.901–0.998)

0.896 (0.840–0.955)

1.061 (1.002–1.123)

 Marital status

  Married

1 [reference]

1 [reference]

1 [reference]

  Divorced/widowed

1.095 (1.036–1.157)

0.992 (0.928–1.061)

1.053 (0.991–1.118)

  Never married

0.918 (0.831–1.015)

0.871 (0.769–0.987)

0.893 (0.800–0.998)

  Income

0.942 (0.920–0.965)

0.973 (0.943–1.003)

0.904 (0.881–0.927)

 Education

  Less or equal to high school

1 [reference]

1 [reference]

1 [reference]

  College/bachelor

0.883 (0.829–0.941)

0.948 (0.874–1.029)

0.921 (0.860–0.987)

  Masters/doctorate

0.805 (0.727–0.893)

0.888 (0.770–1.025)

0.747 (0.669–0.834)

 Insurance

  Private

1 [reference]

1 [reference]

1 [reference]

  Public

1.295 (1.221–1.374)

1.188 (1.107–1.274)

1.310 (1.228–1.398)

  Uninsured

0.743 (0.663–0.833)

0.691 (0.602–0.793)

0.775 (0.680–0.884)

  Depression

1.503 (1.415–1.596)

1.432 (1.333–1.539)

1.518 (1.421–1.622)

 Elixhauser Comorbidity Index

  0

1 [reference]

1 [reference]

1 [reference]

  1

1.218 (1.146–1.294)

1.158 (1.072–1.250)

1.396 (1.305–1.493)

  2

1.635 (1.523–1.756)

1.495 (1.369–1.632)

1.814 (1.678–1.962)

   ≥ 3

2.339 (2.123–2.577)

2.060 (1.839–2.308)

2.574 (2.318–2.858)

 Rurality

  Urban

1 [reference]

1 [reference]

1 [reference]

  Rural

1.030 (0.966–1.098)

1.002 (0.927–1.082)

1.070 (0.997–1.149)

Region

  Northeast

1 [reference]

1 [reference]

1 [reference]

  Midwest

1.396 (1.281–1.521)

1.427 (1.284–1.587)

1.309 (1.194–1.435)

  South

1.470 (1.357–1.593)

1.456 (1.321–1.605)

1.481 (1.359–1.614)

  West

1.517 (1.389–1.656)

1.527 (1.371–1.700)

1.479 (1.347–1.625)

  1. aAnalyses applied survey weights to adjust for MEPS complex survey design
  2. bIn addition to the variables indicated above, models included region and survey year
  3. cIndividuals with diagnoses of cancer or opioid use disorder, prescriptions for methadone or buprenorphine, presence of proxy responses, or missing values for cognitive status or pain variables were excluded
  4. dOpioids included prescriptions for codeine, hydrocodone, hydromorphone, levorphanol, meperidine, morphine, opium, oxycodone, oxymorphone, pentazocine, propoxyphene, tapentadol, butorphanol, fentanyl, nalbuphine, sufentanil, tramadol, and dihydrocodeine
  5. eChronic pain conditions were identified based on International Classification of Disease (ICD) 9/10 codes following the approach outlined by Mikoz and colleagues [20]
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BMC Medicine

ISSN: 1741-7015

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