{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T02:30:23Z","timestamp":1783823423269,"version":"3.55.0"},"reference-count":61,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R21 AG078552"],"award-info":[{"award-number":["R21 AG078552"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Profound racial and ethnic disparities exist in the use and outcomes of total hip\/knee replacements (total joint replacements [TJR]). Whether similar disparities extend to post\u2010TJR pain management remains unknown. Our objective is to examine the association of race and ethnicity with opioid fills following elective TJRs for White, Black, and Hispanic Medicare beneficiaries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used the 2019 national Medicare data to identify beneficiaries who underwent total hip\/knee replacements. Primary outcomes were at least one opioid fill in the period from discharge to 30\u2009days post\u2010discharge, and 31\u201390\u2009days following discharge. Secondary outcomes were morphine milligram equivalent per day and number of opioid fills. Key independent variable was patient race\u2010ethnicity (non\u2010Hispanic White, non\u2010Hispanic Black, Hispanic). We estimated multivariable hierarchical logistic regressions and two\u2010part models with state\u2010level clustering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 67,550 patients, 93.36% were White, 3.69% were Black, and 2.95% were Hispanic. Compared to White patients, more Black patients and fewer Hispanic patients filled an opioid script (84.10% [Black] and 80.11% [Hispanic] vs. 80.33% [White],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) in the 30\u2010day period. On multivariable analysis, Black patients had 18% higher odds of filling an opioid script in the 30\u2010day period (odds ratio [OR]: 1.18, 95% confidence interval [CI]: 1.05\u20131.33,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), and 39% higher odds in the 31\u201390\u2010day period (OR: 1.39, 95% CI: 1.26\u20131.54,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). There were no significant differences in the endpoints between Hispanic and White patients in the 30\u2010day period. However, Hispanic patients had 20% higher odds of filling an opioid script in the 31\u2010 to 90\u2010day period (OR: 1.20, 95% CI: 1.07\u20131.34,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Important race\u2010 and ethnicity\u2010based differences exist in post\u2010TJR pain management with opioids. The mechanisms leading to the higher use of opioids by racial\/ethnic minority patients need to be carefully examined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18605","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T05:29:17Z","timestamp":1695965357000},"page":"102-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Association of race and ethnicity with opioid prescribing for\n                    <scp>M<\/scp>\n                    edicare beneficiaries following total joint replacements"],"prefix":"10.1111","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3316-0951","authenticated-orcid":false,"given":"Caroline P.","family":"Thirukumaran","sequence":"first","affiliation":[{"name":"Department of Orthopaedics University of Rochester  Rochester New York USA"},{"name":"Department of Public Health Sciences University of Rochester  Rochester New York USA"},{"name":"Center for Musculoskeletal Research University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Fiscella","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences University of Rochester  Rochester New York USA"},{"name":"Department of Family Medicine University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith B.","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Harvard T. H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jalpa A.","family":"Doshi","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2142-2109","authenticated-orcid":false,"given":"Derek T.","family":"Schloemann","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Rochester  Rochester New York USA"},{"name":"Center for Musculoskeletal Research University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin F.","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Rochester  Rochester New York USA"},{"name":"Center for Musculoskeletal Research University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200405000-00012"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.01617"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.20.00246"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.00884"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000177"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.12.008"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B7.BJJ-2018-1518.R1"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.20.01401"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa2034159"},{"key":"e_1_2_12_11_1","volume-title":"Framing Opioid Prescribing Guidelines for Acute Pain: Developing the Evidence","author":"National Academies of Sciences, Engineering, and Medicine","year":"2020"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2007.64"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.93.12.2067"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2006.9.1454"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2011.01310.x"},{"key":"e_1_2_12_16_1","unstructured":"Substance Abuse and Mental Health Services Administration.The opioid crisis and the Black\/African American population: an urgent issue. 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