An Examination of Cultural Values and Pain Management in Foreign-Born Spanish-Speaking Hispanics Seeking Care at a Federally Qualified Health Center

Torres, Calia A.; Thorn, Beverly E.; Kapoor, Shweta; DeMonte, C.

doi:10.1093/pm/pnw315

Cited by 35 publications

(30 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly to black Americans, Hispanic-Americans express hesitance to take pain medications [59,76,[100][101][102][103]. Instead, they prefer pain self-management and other noninvasive medical treatments including creams and ointments, electric blankets, folk remedies (i.e., teas or natural healers), practicing yoga and visiting a chiropractor [104]. Further, they are more likely than white and black patients to choose over the counter medications for pain [90].…”

Section: Patient Preferencesmentioning

confidence: 99%

See 1 more Smart Citation

Racial and Ethnic Differences in the Experience and Treatment of Noncancer Pain

et al. 2019

View full text Add to dashboard Cite

The burden of pain is unequal across racial and ethnic groups. In addition to racial and ethnic differences in the experience of pain, there are racial and ethnic disparities in the assessment and treatment of pain. In this article, we provide a nonexhaustive review of the biopsychosocial mechanistic factors contributing to racial and ethnic differences in both the experience and treatment of pain. Using a modified version of the Socioecological Model, we focus on patient-, provider- and system-level factors including coping, perceived bias and discrimination, patient preferences, expectations, patient/provider communication, treatment outcomes and healthcare access. In conclusion, we provide psychosocial factors influencing racial and ethnic differences in pain and highlight future research targets and possible solutions to reduce these disparities.

show abstract

Section: Patient Preferencesmentioning

confidence: 99%

“…Further, they are more likely than white and black patients to choose over the counter medications for pain [90]. It is important to note, however, that while Hispanic patients prefer to avoid taking pain medications, they still express a desire to have it available to them should they need it [104].…”

Section: Patient Preferencesmentioning

confidence: 99%

Racial and Ethnic Differences in the Experience and Treatment of Noncancer Pain

et al. 2019

View full text Add to dashboard Cite

show abstract

“…For example, qualitative research and case studies suggest that Latinx-Americans may define and experience pain as transcending personal physical experiences and including interpersonal dimensions 41,42. Latinx-Americans are also more likely to report cultural values of acceptance of pain as a necessary part of life34,43 (including fatalistic beliefs that one should not attempt to change one’s pain,44 as well as stoicism [e.g., refraining from expressing pain] so as not to burden close others36,41,45).…”

Section: Introductionmentioning

confidence: 99%

<p>The influence of Latinx American identity on pain perception and treatment seeking</p>

Ng¹,

Nanavaty²,

Mathur³

2019

JPR

View full text Add to dashboard Cite

IntroductionLatinx-Americans are underserved across healthcare contexts, and racial disparities in pain management are pervasive. One potential contributor is racial bias in pain perception – including low-level implicit biases and explicitly held lay-beliefs. Delays in seeking pain treatment may compound these disparities. However, experiments testing these factors in the context of Latinx-American pain are limited, and mechanisms by which Latinx-American group-membership influences pain perception and treatment are not understood.MethodsHere, Latinx-American and White-American participants read vignettes including a Latinx or White patient’s pain description and numerical pain rating. Participants then rated how much pain they thought each patient was in using the same numerical scale. Participants also reported how much pain they themselves would need to experience to prompt treatment-seeking.ResultsIn contrast to prior work identifying lay beliefs that Latinx-Americans feel less pain than White-Americans, participants in the current study revealed a bias in the opposite direction. This was largely driven, however, by Latinx-American participants, who have been under-represented in previous studies of empathy and pain perception. Latinx-Americans ascribed more pain to patients overall – irrespective of patient race – relative to White-Americans. Latinx-American participants also reported that their own pain would need to be significantly more intense before seeing a doctor.ConclusionThese results suggest that, relative to White-Americans, Latinx-Americans may be more likely to believe people are in more pain than they report – or may be more perceptive of others’ pain – and that they may be in more pain upon presenting to medical settings.

show abstract

“…Some of these pain-management differences have been explained by cultural pref-erences. 37 Finally, after accounting for COT status and neoplasm status, the association of patient age with HCP probability differed across rescheduling periods. The probability of a HCP was lower as age increased in the prerescheduling period and greater after rescheduling.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Increased Hydrocodone Regulation on Opioid Prescribing in an Urban Safety-Net Health Care System

et al. 2019

View full text Add to dashboard Cite

Background: Hydrocodone-combination analgesics were changed from Schedule III to Schedule II to discourage the prescribing of these analgesics. Our primary aim was to explore the effect of hydrocodone rescheduling on opioid prescribing within an urban safety-net health care system.Methods and Design: Data were extracted from electronic records of ambulatory patients (N ‫؍‬ 82,432 patients) prescribed hydrocodone-combination, codeine-combination, or tramadol opioid analgesics (N ‫؍‬ 200,675 prescriptions) between October 6, 2013 and October 6, 2015. Data analyses modeled predicted probabilities of hydrocodone-combination prescriptions (HCPs). Chronic opioid therapy (COT) for chronic pain (ie, >3 opioid prescriptions/12 months) and morphine milligram equivalency (MME) levels were also examined.Results: The probability of providers writing HCPs decreased significantly from pre-to postrescheduling (0.525 vs 0.158, respectively, P < .0001). However, this coincided with large probability increases in codeine-combination (0.064 vs 0.269) and tramadol prescriptions (0.412 vs 0.573). The probability of HCPs varied across physician specialty (P < .0001), patient diagnoses (P < .0001), COT versus non-COT patients (P < .0001), and patient characteristics (sex, race/ethnicity, and age; P < .05). COT patients received significantly more opioid prescriptions in the postrescheduling period (M ‫؍‬ 4.81 vs M ‫؍‬ 4.27; P < .0001). Patients on <20 MME/day increased slightly from pre-to postrescheduling (P < .0001).Discussion: Significant declines in HCPs occurred after rescheduling; however, one third of patients prescribed opioids remained on doses >20 MME/day. Codeine-and tramadol-prescription probabilities increased significantly and providers may have an increased perception of safety about these medications. Physicians and health care systems must reduce their overreliance on opioids in treating pain, especially chronic pain, as all opioids incur some level of risk.(J Am Board Fam Med 2019;32: 362-374.)

show abstract

An Examination of Cultural Values and Pain Management in Foreign-Born Spanish-Speaking Hispanics Seeking Care at a Federally Qualified Health Center

Cited by 35 publications

References 34 publications

Racial and Ethnic Differences in the Experience and Treatment of Noncancer Pain

Racial and Ethnic Differences in the Experience and Treatment of Noncancer Pain

<p>The influence of Latinx American identity on pain perception and treatment seeking</p>

The Impact of Increased Hydrocodone Regulation on Opioid Prescribing in an Urban Safety-Net Health Care System

Contact Info

Product

Resources

About