Both Race and Insurance Type Independently Predict the Selection of Oral Opioids Prescribed to Cancer Outpatients.
Salimah H Meghani, William E Rosa, Jesse Chittams and 3 others
PMID 31501079WHAT IT FOUND
African American cancer outpatients were more often prescribed morphine and less often oxycodone than White patients.
Private insurance also predicted opioid choice, while kidney disease did not. This is an association, not proof of bias or harm.
Key findings
01African American patients were more likely to be prescribed morphine and less likely to be prescribed oxycodone than White patients.
02In adjusted analysis, African American patients had 2.573 times the estimated odds of receiving morphine compared with White patients.
03Private insurance had 78% lower odds of morphine and 8.437 times higher estimated odds of oxycodone than Medicaid, while kidney disease did not predict opioid type after controlling for race and insurance.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The supplied text does not report the number of patients analysed, and the authors describe the sample as small, so some results may be unstable. This was an observational secondary analysis, not a trial; it cannot show that race or insurance caused the prescribing difference. The authors say unmeasured socioeconomic factors may still explain the race effect, and they could not assign moral value or prove bias. Immediate-release and extended-release opioids were combined, and cost differences between generic morphine and brand-name oxycodone may relate to the insurance finding. The analysis focused on oral morphine or oxycodone and excluded patients using only non-oral opioids; the other prescription category was small and mixed. The study reports prescription associations, not patient outcomes such as pain control, side effects, adherence, or mortality.
Declared interests
No author conflict-of-interest statement is included in the supplied text. The article metadata lists NIH extramural research support.
The easy way to misread this
Do not conclude that prescribers were racially biased or that morphine harmed patients. The study found associations in a small observational sample and could not prove causation, bias, or clinical harm.