Evidence map›Paper›PMID 34535520›Full record

Trial reportJournal of the American Board of Family Medicine : JABFM

Patient, Provider, and Clinic Characteristics Associated with Opioid and Non-Opioid Pain Prescriptions for Patients Receiving Low Back Imaging in Primary Care.

Laura S Gold, Zachary A Marcum, Eric N Meier, Judith A Turner, Kathryn T James, David F Kallmes, Patrick H Luetmer, Brent Griffith, Karen J Sherman, Janna L Friedly and 6 more

Open access · diamondAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 1 institution in 1 country.

Laura S GoldFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA). goldl@uw.edu.
Zachary A MarcumFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Eric N MeierFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Judith A TurnerFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Kathryn T JamesFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
David F KallmesFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Patrick H LuetmerFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Brent GriffithFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Karen J ShermanFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Janna L FriedlyFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Pradeep SuriFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Richard A DeyoFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Sandra K JohnstonFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Andrew L AvinsFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Patrick J HeagertyFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
Jeffrey G JarvikFrom the Department of Radiology, School of Medicine, University of Washington, Seattle, WA (LSG, KTJ, SKJ, JGJ); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA (LSG, ENM, JAT, KTJ, JLF, PS, SKJ, PJH, JGJ); Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA (ZAM); Department of Biostatistics, University of Washington, Seattle, WA (ENM, PJH); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (JAT); Department of Rehabilitation Medicine, University of Washington, Seattle, WA (JAT, JLF); Department of Radiology Mayo Clinic, Rochester, MN (DFK, PHL); Department of Radiology, Henry Ford Hospital, Detroit, MI, (BG); Kaiser Permanente Washington, Seattle, WA (KJS); Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA (PS); Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, OR (RAD); Division of Research, Kaiser Permanente Northern California, Oakland, CA (ALA).
University of Washington · US

Funding

NIH Health Care Systems Research Collaboratory-Coordinating Center (U24)U24AT009676 · NCCIH · DUKE UNIVERSITY · PI LESLEY H CURTIS, Adrian Hernandez · 2017 to 2026
$21.5M
UW Core Center for Clinical Research of Musculoskeletal ConditionsP30AR072572 · NIAMS · UNIVERSITY OF WASHINGTON · PI JEFFREY G JARVIK, Pradeep Suri · 2017 to 2026
$8.3M
A Pragmatic Trial of Lumbar Image Reporting with Epidemiology (LIRE)UH3AR066795 · NIAMS · UNIVERSITY OF WASHINGTON · PI JARVIK, JEFFREY G · 2014 to 2017
$6.0M
A Pragmatic Trial of Lumbar Image Reporting with Epidemiology (LIRE)UH2AT007766 · NCCIH · UNIVERSITY OF WASHINGTON · PI JARVIK, JEFFREY G · 2012 to 2012
$838k
NCCIH NIH HHS U24 AT009676NCCIH NIH HHS UH2 AT007766NIAMS NIH HHS P30 AR072572NIAMS NIH HHS UH3 AR066795
6 · The paper itself

Abstract

backgroundTo describe characteristics of patients, providers, and clinics associated with opioid or non-opioid pain medication prescribing patterns for patients who received lower spine imaging in primary care clinics.

methodsIn these secondary analyses of the Lumbar Imaging with Reporting of Epidemiology (LIRE) study, a randomized controlled trial conducted in 4 health systems in the United States, we evaluated characteristics associated with receipt of pain medication prescriptions. The outcomes were receipt of prescriptions for opioid or, separately, non-opioid pain medications within 90 days after imaging. Among patients who received opioid or non-opioid prescriptions, we evaluated receipt of multiple prescriptions in the year following imaging. Mixed models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).

resultsCompared with whites, patients identified as Asian (OR, 0.53; 95% CI, 0.51-0.56), Native Hawaiian/Pacific Islander (OR, 0.73; 95% CI, 0.64-0.83), multiracial (OR, 0.84; 95% CI, 0.71-0.98) or Black (OR, 0.92; 95% CI, 0.89-0.96) had significantly reduced odds for receiving prescriptions for opioids within 90 days. Patients identified as Native American/Alaska Native had greater odds for receiving prescriptions for non-opioid pain medications within 90 days (OR, 1.12; 95% CI, 1.01-1.24). Receipt of pain prescriptions 120 days before imaging was strongly predictive of subsequent receipt of pain prescriptions across all categories.

conclusionsAfter adjusting for factors that could affect prescribing, the strongest differences observed in pain-medication prescribing were across racial categories and for patients with previous pain prescriptions. Further research is needed to understand these differences and to optimize prescribing.

Indexed as

Analgesics, OpioidPractice Patterns, Physicians'Drug PrescriptionsHumansPainPrimary Health CareUnited StatesAnalgesics, OpioidBack PainDiagnostic ImagingDrug PrescriptionsNon-Opioid AnalgesicsOpioid AnalgesicsPrimary Health CareRace Factors

Identifiers

PMID34535520
PMCPMC9746536
OpenAlexW3200195270

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.