Confronting Racism in All Forms of Pain Research: A Shared Commitment for Engagement, Diversity, and Dissemination

Hood, Anna; Booker, Staja Q.; Moraís, Calia A.; Goodin, Burel R.; Letzen, Janelle E.; Campbell, Lisa C.; Merriwether, Ericka N.; Aroke, Edwin N.; Campbell, Claudia M.; Mathur, Vani A.; Janevic, Mary R.

doi:10.1016/j.jpain.2022.01.008

Cited by 41 publications

(35 citation statements)

References 106 publications

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“…Patient groups that have been historically marginalized and victims of systemic and structural racism and discrimination could receive more inclusive and respectful care if RHM is implemented well. For example, it is well documented that patients with cancer from underrepresented groups experience inadequate pain management ( 27–29 ) . Imagine a scenario where robust RHM systems track and record the patient’s experience with pain, and longitudinal data are presented to the outpatient clinician in such a way that reduces bias and the risk of undertreatment of pain.…”

Section: Discussionmentioning

confidence: 99%

Challenges and Opportunities in Designing and Deploying Remote Health Monitoring Technology for Older Adults With Cancer

LeBaron

2022

Innovation in Aging

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Remote health monitoring (RHM) technologies (e.g., wearables, smart phones, embedded sensors, telehealth platforms) offer significant opportunities to improve health and wellness for older adults facing serious illness. This paper highlights key challenges and opportunities for designing and deploying RHM systems in the context of caring for older adults with cancer, with an emphasis on the key role nurses can play in this work. Focal topics include user-centered design; interdisciplinary collaboration; addressing health inequities and disparities; privacy and data security; participant recruitment and burden; personalized and tailored care; rapid technological change; family caregiver perspectives; and naturalistic data collection. It is critical for nurses to be aware of both challenges and opportunities within each of these areas in order to develop RHM systems that are optimally beneficial for patients, family caregivers, clinicians, and organizations. By leveraging their unique knowledge of the illness experience from the patient, family, and healthcare provider perspective, nurses can make essential clinical and scientific contributions to advance the field of RHM.

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Section: Discussionmentioning

confidence: 99%

Challenges and Opportunities in Designing and Deploying Remote Health Monitoring Technology for Older Adults With Cancer

LeBaron

2022

Innovation in Aging

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“…Further understanding of the reasons for which ethnicity data are not provided or recorded for a large proportion of patients within our hospital is needed. Consultation with patients, particularly those from ethnically minoritized groups, 24 is needed to understand how to optimize collection and use of these data. When investigating potential disparities in access to pain management services, it is crucial to understand how data can be ‘weaponised against the minoritized’ (p. 2, 25 ) such that the data further disadvantage or marginalize certain groups.…”

Section: Discussionmentioning

confidence: 99%

An updated audit of the patient selection process for pain management programmes in a speciality care service before and during the COVID-19 pandemic

Buscemi

Chicken

Mahy

et al. 2022

British Journal of Pain

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Background The provision of pain management programmes (PMPs) changed substantially in response to the COVID-19 pandemic with virtual delivery implemented in many services. Little is known about patient selection processes for virtual PMPs and how this might differ from in-person programmes. The aim of this audit was to document the patient selection process for PMPs at a speciality pain service prior to and during the pandemic. Methods This retrospective audit used data from consecutive patients attending a multidisciplinary assessment to determine the suitability of a PMP. Anonymized data were extracted from assessment letters and hospital records in the months prior to the pandemic (n =168) and during the start of the pandemic once the service began delivering virtual PMPs (n =171). Results For the standard pain management pathway, most patients were offered a PMP option within the service before and during the pandemic, although a greater proportion of patients were offered treatment during the pandemic. For the neuromodulation pathway, most patients were offered a pre-neuromodulation PMP option, and this was similar before and during the pandemic. Psychosocial complexities and unwillingness to engage in a pain management approach that does not principally focus on pain reduction were the most common reasons that patients were not offered a programme. Discussion This audit points to a pattern of more inclusive assessment outcomes within our service over time and particularly during the pandemic. Offering a range of in-person and virtual PMPs can meet a wider range of patient need. Research is needed to understand how to best assess and match patients with the breadth of treatment delivery formats now available.

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“…This approach was intentional and is responsive to recent calls for anti-racism research, which argue that comparing groups has limited value, effective for highlighting where differences exist, but falling short of enhancing our understanding of why and how differences emerge and shape the experiences of Black individuals with pain. [39][40][41] In contrast, centering the voices of racialized individuals living with pain serves to focus attention on the experiences and needs of these individuals and, as such, h a s t h e p o t e n t i a l t o m o v e a n t i -r a c i s m e f f o r t s forward-ultimately helping to facilitate "more effective and relevant pain interventions for racialized groups." 40 The COVID-19 pandemic led to extraordinary shifts in the way in which care is provided.…”

Section: Discussionmentioning

confidence: 99%

Healthcare Access and Delivery During the COVID-19 Pandemic for Black Veterans with Chronic Pain: a Qualitative Study

2022

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BACKGROUND:The COVID-19 pandemic led to significant disruptions in healthcare and rapid increases in virtual healthcare delivery. The full effects of these shifts remain unknown. Understanding effects of these disruptions is particularly relevant for patients with chronic pain, which typically requires consistent engagement in treatment to maximize benefit, and for Black patients, given documented racial disparities in pain treatment and telehealth delivery. OBJECTIVE: To understand how Black patients with chronic pain experienced pandemic-related changes in healthcare delivery. DESIGN: In-depth, semi-structured qualitative interviews PARTICIPANTS: Black veterans with chronic pain. KEY RESULTS: Participants described decreased ability to self-manage their chronic pain, obtain nonpharmacological services such as physical therapy, see their primary care providers, and schedule surgery. Most did not believe telehealth met their needs, describing feeling inadequately assessed for their pain and noting that beyond renewing prescriptions, telehealth visits were not that useful. Some believed their communication with their providers suffered from a lack of in-person contact. Others, however, were willing to accept this tradeoff to prevent possible exposure to COVID-19, and some appreciated the convenience of being able to access healthcare from home. CONCLUSIONS: Black patients with chronic pain described mostly negative effects from the shift to telecare after the pandemic's onset. Given existing disparities and likely persistence of virtual care, research on the longerterm effects of virtual pain care for Black patients is needed.

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Confronting Racism in All Forms of Pain Research: A Shared Commitment for Engagement, Diversity, and Dissemination

Cited by 41 publications

References 106 publications

Challenges and Opportunities in Designing and Deploying Remote Health Monitoring Technology for Older Adults With Cancer

Challenges and Opportunities in Designing and Deploying Remote Health Monitoring Technology for Older Adults With Cancer

An updated audit of the patient selection process for pain management programmes in a speciality care service before and during the COVID-19 pandemic

Healthcare Access and Delivery During the COVID-19 Pandemic for Black Veterans with Chronic Pain: a Qualitative Study

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