Race/Ethnicity and Sex and Opioid Administration in the Emergency Room

Rosenbloom, Julia M.; Burns, Stacey; Kim, Eugene; August, David A.; Ortiz, Vilma E.; Houle, Timothy T.

doi:10.1213/ane.0000000000003517

Cited by 22 publications

(17 citation statements)

References 14 publications

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“…19 Additionally, no statistically significant interactions were discovered between race or ethnicity and opioid administration for individuals presenting to the ED with definitive pain confirmed to originate from the appendix or gallbladder. 20 Moreover, two studies confirmed the frequency of opioids prescribed at discharge was similar between racial and ethnic groups for patients presenting to the ED for long bone fracture. 19,21 In contrast, racial and ethnic disparities were established for non-definitive and more subjectively painful conditions such as back and abdominal pain where a distinct source of pain was not always clearly identifiable.…”

Section: Data Synthesis Summarymentioning

confidence: 84%

“…A total of six articles remained from which data was extracted and summarized into findings. [17][18][19][20][21][22]…”

Section: Search Results and Study Inclusionmentioning

confidence: 99%

“…Likewise, one study 22 failed to clearly define independent variables. Two studies 20,21 failed to assess exposure(s) more than once over time and examine different levels of exposure as related to the outcome. One study 21 did not adjust for key confounding variables, while all studies failed to blind the exposure status of the participants.…”

Section: Methodological Quality Resultsmentioning

confidence: 99%

“…One study 21 did not adjust for key confounding variables, while all studies failed to blind the exposure status of the participants. [17][18][19][20][21][22]…”

Section: Methodological Quality Resultsmentioning

confidence: 99%

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Racial and Ethnic Disparities in Pain Management

Harris¹,

Long

2021

Clin Prac Athl Train

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Pain is subjective, which makes its management a complicated task. The challenge of medical decisionmaking associated with pain often requires health care providers to rely heavily on their individual discretion and experience. This often creates an avenue for biases to play a role in the selection of the best available and most appropriate pain management interventions. Therefore, the overall purpose of this review is to summarize the current literature related to racial and ethnic disparities in pain management. Electronic searches of four databases revealed 2,112 articles; however, only six studies met criteria for inclusion in this review. Even when the source of pain is the same, research indicates management may differ between racial or ethnic groups. While the treatment of objectively painful conditions remains relatively constant among races and ethnicities, inequities in pain management become more apparent in the treatment of conditions characterized by only subjective pain indicators. Further disparities were identified in the dosage, dosage reduction, and oversight of opioid analgesics between groups. Inequities in prescribing patterns widen existing healthcare disparities by contributing to undertreatment of pain in ethnic minorities and overtreatment of pain and subsequent risk of opioid abuse in Whites. Health care providers must use a patient-centered and evidence-based approach to combat the ambiguity of clinical decisionmaking regarding pain. When knowledgeable of appropriate standard of care for pain management, athletic trainers can identify when a patient's pain needs are unmet or when substance abuse interventions may be necessary.

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Section: Data Synthesis Summarymentioning

confidence: 84%

“…A total of six articles remained from which data was extracted and summarized into findings. [17][18][19][20][21][22]…”

Section: Search Results and Study Inclusionmentioning

confidence: 99%

Section: Methodological Quality Resultsmentioning

confidence: 99%

“…One study 21 did not adjust for key confounding variables, while all studies failed to blind the exposure status of the participants. [17][18][19][20][21][22]…”

Section: Methodological Quality Resultsmentioning

confidence: 99%

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Racial and Ethnic Disparities in Pain Management

Harris¹,

Long

2021

Clin Prac Athl Train

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“…1,7 Studies have examined patient factors associated with receipt of opioids for chronic pain in outpatient settings and postsurgical opioid use; however, to our knowledge, none have examined the patient characteristics associated with the expectation of provision of opioids for acute pain control in outpatient settings. [8][9][10][11] Several studies on postsurgical acute and chronic pain showed that increased anxiety and depression are associated with increased opioid requirement and patients who were anxious had significantly higher pain scores compared with less anxious patients. [12][13][14][15][16][17] Pain catastrophizing, a cascade of negative thoughts and emotions in response to actual or anticipated pain, 18 is shown to predict delayed opioid cessation after surgery 19 as well as predict acute postoperative pain and chronic postsurgical pain.…”

Section: Introductionmentioning

confidence: 99%

Patient “Catastrophizing” Associated with Expectations of Opioid Prescriptions for Acute Pain Control

et al. 2020

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Background: The prescription of opioids for acute pain may be a driving factor in chronic opioid abuse. We examined patients' characteristics associated with the expectation of the receipt of opioid prescriptions for acute pain control. Methods: A 1-time survey was administered to adult patients at family medicine clinics in the Pacific Northwest between November 2018 and January 2019. Logistic regression modeled adjusted odds of expecting an opioid prescription in ≥ 3 of the 4 dispositional acute pain scenarios by patient demographics, opioid use, past-week pain intensity and duration, past-week anxiety, and pain catastrophizing. Results: The survey was completed by 108 patients (62% female, 48% between 30 and 49 years of age, 75% non-Hispanic Whites). Most patients (71%) expected an opioid prescription in ≥ 1 of the 4 scenarios; 26% expected a prescription in ≥ 3 scenarios. Patients with higher levels of pain catastrophizing had more than 3 times greater odds of expecting opioids than those with lower pain catastrophizing (OR, 3.73; P = .032; 95% CI, 1.12-12.46); no other characteristics were statistically significant. Conclusion: Higher pain catastrophizing was associated with increased odds of expecting opioids in dispositional acute pain scenarios in outpatient settings. Future studies can determine whether addressing pain catastrophizing reduces expectations of opioid prescribing for acute pain control. The finding that most patients expected opioid prescriptions in acute pain scenarios needs further exploration into other potential factors associated with these expectations. Evidence-based guidelines for condition-specific acute pain management are warranted for appropriate opioid prescribing and to guide treatment expectations.

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Dementia and Cognitive Disorders in Geriatric Hispanic/Latinos

Colimon-Ardila

2022

Mental Health for Hispanic Communities

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Race/Ethnicity and Sex and Opioid Administration in the Emergency Room

Cited by 22 publications

References 14 publications

Racial and Ethnic Disparities in Pain Management

Racial and Ethnic Disparities in Pain Management

Patient “Catastrophizing” Associated with Expectations of Opioid Prescriptions for Acute Pain Control

Dementia and Cognitive Disorders in Geriatric Hispanic/Latinos

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