Racial disparities in analgesic use amongst patients presenting to the emergency department for kidney stones in the United States

Berger, Alexandra; Wang, Ye; Rowe, Courtney K.; Chung, Benjamin I.; Haleblian, George E.

doi:10.1016/j.ajem.2020.01.017

Cited by 31 publications

(27 citation statements)

References 12 publications

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“…patient harm, such as less adequately controlled pain among Black patients. 1,3 Undertreated pain has negative health and social consequences and further contributes to substance-use stigma within minority communities. 38 Moreover, Black people who describe more discrimination in medical settings were more likely to report subsequent opioid misuse.…”

Section: Discussionmentioning

confidence: 99%

“…Researchers also have documented racial and ethnic disparities in analgesia for cancer pain and chronic noncancer pain. [1][2][3][4][5][6][7][8][9][10][11] Studies have demonstrated that White patients are more likely to receive opioid prescriptions compared with Black patients. Even with similar documented pain scores, there is evidence that Black patients receive fewer analgesics com-pared with White patients.…”

mentioning

confidence: 99%

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Racial and Ethnic Disparities in Discharge Opioid Prescribing From a Hospital Medicine Service

Rambachan

Fang

Prasad

et al. 2021

Journal of Hospital Medicine

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BACKGROUND: Differential opioid prescribing patterns have been reported in non-White patient populations. However, these disparities have not been well described among hospitalized medical inpatients. OBJECTIVE: To describe differences in opioid prescribing patterns among inpatients discharged from the general medicine service based on race/ethnicity. DESIGN, SETTING, AND PARTICIPANTS: For this retrospective study, we performed a multivariable logistic regression for patient race/ethnicity and whether patients received an opioid prescription at discharge and a negative binomial regression for days of opioids prescribed at discharge. The study included all 10,953 inpatients discharged from the general medicine service from June 2012 to November 2018 at University of California San Francisco Medical Center who received opioids during the last 24 hours of their hospitalization. MAIN OUTCOMES AND MEASURES: We examined two primary outcomes: whether a patient received an opioid prescription at discharge, and, for patients prescribed opioids, the number of days dispensed. RESULTS: Compared with White patients, Black patients were less likely to receive an opioid prescription at discharge (predicted population rate of 47.6% vs 50.7%; average marginal effect [AME], −3.1%; 95% CI, −5.5% to −0.8%). Asian patients were more likely to receive an opioid prescription on discharge (predicted population rate, 55.6% vs 50.7%; AME, +4.9; 95% CI, 1.5%-8.3%). We also found that Black patients received a shorter duration of opioid days compared with White patients (predicted days of opioids on discharge, 15.7 days vs 17.8 days; AME, −2.1 days; 95% CI, −3.3 to −0.9). CONCLUSION: Black patients were less likely to receive opioids and received shorter courses at discharge compared with White patients, adjusting for covariates. Asian patients were the most likely to receive an opioid prescription.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Racial and Ethnic Disparities in Discharge Opioid Prescribing From a Hospital Medicine Service

Rambachan

Fang

Prasad

et al. 2021

Journal of Hospital Medicine

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“…25 NonHispanic White patients presenting to the ED with suspected kidney/ureteral stones received opioids more frequently and in greater quantity than Hispanics. 26,27 Black patients with renal colic received opioids less frequently than Whites; they were also less likely to receive ketorolac. 27 In addition, patients with higher education and health insurance coverage were more likely to receive opioids.…”

Section: Disparities In Management Pain Controlmentioning

confidence: 99%

Disparities in Kidney Stone Disease: A Scoping Review

et al. 2021

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Purpose: We reviewed the available evidence regarding health disparities in kidney stone disease to identify knowledge gaps in this area. Materials and Methods: A literature search was conducted using PubMed Ò , Embase Ò and Scopus Ò limited to articles published in English from 1971 to 2020. Articles were selected based on their relevance to disparities in kidney stone disease among adults in the United States. Results: Several large epidemiological studies suggest disproportionate increases in incidence and prevalence of kidney stone disease among women as well as Black and Hispanic individuals in the United States, whereas other studies of comparable size do not report racial and ethnic demographics. Numerous articles describe disparities in imaging utilization, metabolic workup completion, analgesia, surgical intervention, stone burden at presentation, surgical complications, followup, and quality of life based on race, ethnicity, socioeconomic status and place of residence. Differences in urinary parameters based on race, ethnicity and socioeconomic status may be explained by both dietary and physiological factors. All articles assessed had substantial risk of selection bias and confounding. Conclusions: Health disparities are present in many aspects of kidney stone disease. Further research should focus not only on characterization of these disparities but also on interventions to reduce or eliminate them.

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“…Gjennom en systematisk innhenting av artikler fant vi at afroamerikanere scorer høyere på smerteintensitet sammenlignet med hvite; likevel har afroamerikanere min dre sannsynlighet til å motta opioider for smertene (15,19,20,2224,26,27,30). Det samme gjelder latinamerikanere sammenlignet med hvite amerikanere (19,20,23,24,27).…”

Section: Drøftingunclassified

Etniske ulikheter i håndteringen av akutte smerter på akuttmottak eller postoperativ avdeling: En systematisk oversikt, med narrativ syntese

Samsonsen

Moi

Mortensen

2021

inspira

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Bakgrunn: Smerter er et hyppig fenomen i akuttavdelinger og kan ubehandlet føre til stress, søvnmangel og kroniske smertetilstander for pasientene. Sykepleieres smertehåndtering, inkludert observasjoner og tiltak, kompliseres av variasjonen i smerteuttrykk og reaksjoner på behandlingen hos pasientene. Med større etnisk mangfold i norske sykehus, kan kulturelle forskjeller være til hinder for adekvat smertelindring. Hensikt: Å oppsummere kunnskap om betydningen av etnisitet for smerteopplevelse og smertehåndteringen hos voksne akutt og/eller kritisk syke pasienter. Metode: Systematisk oversikt med narrativ syntese. Søket ble utført i Embase, Medline, Cochrane og Cinahl. Det ble søkt etter engelske eller norske/danske/svenske artikler publisert mellom 1980–2021 som omhandlet etnisitet og smertehåndtering i akutt-, postoperative- eller intensivavdelinger på sykehus. Det ble utført en blindet screening av artiklene i henhold til inklusjons- og eksklusjonskriterier. Critical Appraisal Skills Programme (CASP) ble brukt for å kvalitetsvurdere inkluderte studier. Resultater: Av i alt 1605 studier ble 22 studier inkludert. Studiene omhandlet pasientgrupper på akuttmottak eller postoperativ avdeling. Hyppigst forekom studier av etniske- og raseforskjeller av smerter etter benbrudd, etterfulgt av studier av etniske- og raseforskjeller ved forskjellige akutte smerter; dislokasjon av ledd, akutt koronarsyndrom, traume, magesmerter og postoperative smerter. De fleste studiene (16 av 22) rapporterte etniske forskjeller enten i smerteintensitet og/eller valg av analgetika, dose og/eller ventetid for analgetika. Konklusjon: Basert på funnene i denne systematiske oversikten har etnisitet stor betydning for smerteopplevelse og utført smertebehandling på akuttmottak og postoperative avdelinger. Åpenhet for ulike kulturelle smerteuttrykk, samt bevissthet rundt mulige fordommer, er viktig for god smertehåndtering i akuttavdelinger.

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Racial disparities in analgesic use amongst patients presenting to the emergency department for kidney stones in the United States

Cited by 31 publications

References 12 publications

Racial and Ethnic Disparities in Discharge Opioid Prescribing From a Hospital Medicine Service

Racial and Ethnic Disparities in Discharge Opioid Prescribing From a Hospital Medicine Service

Disparities in Kidney Stone Disease: A Scoping Review

Etniske ulikheter i håndteringen av akutte smerter på akuttmottak eller postoperativ avdeling: En systematisk oversikt, med narrativ syntese

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