# Racial Disparities in Analgesic Prescribing for Post-Surgical Pain Management among Older Americans following Hip and Knee Replacement Surgeries

> **NIH NIH R21** · UNIVERSITY OF ROCHESTER · 2022 · $205,042

## Abstract

ABSTRACT
 Black patients are less likely to be prescribed opioid or non-opioid analgesics for pain relief than White
patients who present with similar pain intensities, especially in the emergency room. Many of these disparities
are attributed to physician prescribing practices. However, whether similar disparities exist in opioid and non-
opioid analgesic prescribing for post-operative pain for older Americans following one of the most common
elective surgeries for their age – hip and knee replacements (“joint replacements”) – is unknown. Joint
replacements are highly successful surgeries for older Medicare beneficiaries with advanced osteoarthritis.
The ability of these surgeries to provide relief from pain, and improve functionality and health-related quality of
life has placed them among the highest-volume surgeries for older Medicare beneficiaries. Opioid and non-
opioid analgesics are the two groups of drugs commonly used to relieve surgical pain following joint
replacements. Opioids were previously the first choice of drugs for short-term post-operative pain control.
However, with the devastating implications of the opioid crisis, there is a growing recognition of the importance
of minimizing the duration of post-operative opioid prescribing and increasing the use of non-opioid analgesics.
Importantly, there is considerable variation in the prescribing amounts and duration of these drugs. This
variability when coupled with prescriber biases, may create barriers for Black Medicare beneficiaries while
accessing much-needed care for post-operative pain, and represents substantial unmet pain management
needs for these patients. These unmet needs further exacerbate the disparities in post-operative recovery and
contribute to the inequity in joint replacement care. Furthermore, state laws that restrict the prescribing of
opioids for acute pain have the potential to exacerbate these disparities if the decline in opioid prescribing is
not accompanied by a commensurate increase in non-opioid analgesic prescribing. The goal of our proposal is
to generate rigorous empirical evidence to support equitable post-operative analgesic prescribing. We achieve
this goal by examining whether a patient’s race influences opioid and non-opioid analgesic prescribing
following joint replacement surgeries (Aim 1), and whether state opioid prescribing restrictions are likely to
influence these disparities (Aim 2). We focus our analysis on Medicare beneficiaries in New York undergoing
joint replacements from 2014-2019. We will use Medicare datasets and sophisticated empirical methods to
address the proposed Aims. The findings from our proposal will generate evidence for improving equity in post-
operative analgesic prescribing for joint replacement patients across the country and for the design of
interventions that can attenuate racial disparities in surgical pain management.

## Key facts

- **NIH application ID:** 10508187
- **Project number:** 1R21AG078552-01
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Caroline Pinto Thirukumaran
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $205,042
- **Award type:** 1
- **Project period:** 2022-09-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10508187

## Citation

> US National Institutes of Health, RePORTER application 10508187, Racial Disparities in Analgesic Prescribing for Post-Surgical Pain Management among Older Americans following Hip and Knee Replacement Surgeries (1R21AG078552-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10508187. Licensed CC0.

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