Students Research in Progress
Sunday, October 13, 2024
12:45 PM–02:15 PM
Abstract
Introduction: The role of race in nociplastic (centralized) pain has been insufficiently explored. There is a critical need to assess access to diagnosis and pharmacoequity for older adults with centralized pain from diverse racial backgrounds.
Research Question or Hypothesis: (Aim 1) How is race associated with the diagnosis and (Aim 2) management of those with a centralized pain syndrome among older adults?
Study Design: This was a retrospective cohort study of Medicare beneficiaries (=66) with an outpatient claim for a centralized pain diagnosis from 01/01/2019-12/31/2019.
Methods: Medicare beneficiaries (non-HMO and >66 in 2019) with at least 9 months of continuous A/B/D coverage and no centralized pain diagnosis in 2018 were included. Patients with a centralized pain diagnosis in 2019 were captured. Mechanistic-based pain therapy (MBPT) was analyzed for patients with a matching diagnosis/medication pairing within 60 days of diagnosis. R was used for data management and analysis. The Aim 1 logistic regression analysis considered race, sex, and the Van Walraven Elixhauser comorbidity index, and their association with at least one pain diagnosis.
Results: 1,881,778 patients were included in the analysis. Eight percent (n=50,136) of older adults had at least one centralized pain diagnosis. White patients comprised the majority of the dataset (87%), followed by Black (6%), and Asian (1.7%). Black (p<0.001; OR 0.88, 95% CI 0.86-0.90) and Asian (p<0.001; OR 0.75, 95% CI 0.72-0.79) patients were less likely to be diagnosed with a centralized pain syndrome. Preliminary results indicate only 22% of patients received MBPT (n=31,865). More Black (26%) and Asian (25.7%) of patients received MBPT compared to White patients (21.7%).
Conclusion: Centralized pain conservatively affects 8% of the older adult population. Diagnostic differences by race exist and need to be addressed. MBPT appears to have low uptake with racial differences present.
Presenting Author
Teresa Knecht BAUniversity of Michigan
Authors
Vincent Marshall M.S.
University of Michigan
Michael Smith PharmD, BCPS
University of Michigan