Socioeconomic Disadvantage Linked With Potentially Inappropriate Opioid Prescriptions


Patients who lived in socioeconomically disadvantaged areas were more likely to have potentially inappropriate opioid prescriptions, compared with other types of potentially inappropriate medications.

Older adults with rheumatic disease who live in socioeconomically disadvantaged areas are more likely to have a potentially inappropriate opioid prescription, according to research presented at ACR Convergence 2021, the annual meeting of the American College of Rheumatology.

Investigators studied a population-based sample of older adults seen by rheumatologists to assess both potentially inappropriate medication use and to identify risk factors. The study cohort included adults 65 years of age or older with 2 or more visits at a clinical rheumatology practice during 2018 and 1 of 6. rheumatic diseases associated with pain, (osteoarthritis, gout, rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, and systemic sclerosis). Diagnosis was defined by 2 or more ICD-10CM codes more than 30 days apart.

A total of 178,833 older adults (mean age, 75 years) from 217 practices were included in the study. Forty percent of older adults potentially inappropriate medication on their medication list, with rates that differed slightly among diseases. Patients were most likely to have a prescription for opioids (17%), nonsteroidal anti-inflammatory drugs (12%), benzodiazepines, or anticholinergics (4%).

Those who lived in more socioeconomically disadvantaged neighborhoods were more likely to have an opioid prescription, according to researchers. Other factors associated with higher odds of opioid prescriptions included being a woman, osteoarthritis, gout or psoriatic arthritis diagnosis; Medicaid insurance; and American Indian or Alaskan Natives race/ethnicity. Lower odds of opioid prescription were associated with older age and Asian race/ethnicity.

“Older adults with rheumatic disease were more likely to have an opioid prescription if they lived in a socioeconomically disadvantaged area,” the researchers concluded. “In contrast, other [potentially inappropriate medication] prescriptions assessed did not vary based on the level of disadvantage in the area of residence. Future research should evaluate ways to reduce potentially harmful medications.”


1. Anastasiou C, Evans M, Schmajuk G, Yazdany J. Older patients with rheumatic disease are commonly prescribed potentially inappropriate medications. Presented at: ACR Convergence 2021; November 3-9, 2021. Abstract 1044.

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