Navigation Links
Use of opioids for pain in ERs on the rise, but racial differences in use still exist
Date:1/1/2008

In the last 15 years, use of opioid medications to treat patients with pain-related emergency department visits has improved although white patients were more likely to receive opioids than patients of a different race/ethnicity, according to a study in the January 2 issue of JAMA.

In the 1990s, national attention focused on increasing awareness of the problem of inadequately treated pain. Also, racial and ethnic minority groups appeared to be at higher risk of receiving inadequate treatment for pain in the emergency department, according to background information in the article. National quality improvement initiatives were implemented in the late 1990s, followed by substantial increases in opioid (narcotic agents used for pain relief) prescribing in the United States, but it is unknown whether opioid prescribing for treatment of pain in the emergency department has increased and whether differences in opioid prescribing by race/ethnicity have decreased.

Mark J. Pletcher, M.D., M.P.H., of the University of California, San Francisco, and colleagues examined whether opioid prescribing is increasing in U.S. emergency departments for patients presenting with pain and whether non-Hispanic white patients are more likely to receive an opioid than other racial/ethnic groups. Pain-related visits to U.S. emergency departments were identified using reason-for-visit and physician diagnosis codes from thirteen years (1993-2005) of The National Hospital Ambulatory Medical Care Survey.

During the survey years, pain-related visits accounted for 156,729 of 374,891 (42 percent) emergency department visits. An opioid analgesic was prescribed at 29 percent of pain-related visits. This proportion increased during the study period, from 23 percent in 1993 to 37 percent in 2005. Despite this time trend, the researchers found no evidence that the difference in opioid prescribing by race/ethnicity diminished over time. Averaged over the 13 survey years, opioid prescribing was more likely for pain-related visits made by whites (31 percent) than by blacks (23 percent), Hispanics (24 percent), or Asians/others (28 percent), and there was no evidence of an interaction between the time trend and race/ethnicity during the study period. In 2005, opioid prescribing rates were 40 percent in whites and 32 percent in all others.

Differential opioid prescribing was consistently present across different types of pain, across different levels of pain severity, for visits in which pain was the first or second/third reason for visit, and for two specific painful diagnoses, long-bone fracture and kidney stones. Differences in prescribing between whites and nonwhites were larger as pain severity increased and were particularly pronounced for patients with back pain (48 percent vs. 36 percent, respectively), headache (35 percent vs. 24 percent), abdominal pain (32 percent vs. 22 percent), and other pain (40 percent vs. 28 percent). Blacks were prescribed opioids at lower rates than any other race/ethnicity group for almost every type of pain visit.

Statistical adjustment for pain severity and other factors did not substantially change these differences. Compared with white patients, black patients were 34 percent less likely to receive an opioid prescription; Hispanic patients, 33 percent less likely; and Asian/other patients, 21 percent less likely.

Our results suggest that new strategies are needed to understand and improve the quality and equity of management of acute pain in the United States. Future initiatives should continue to monitor pain management quality indicators and processes of care that may contribute to inadequate care, to educate physicians about the importance of adequate pain control, and to promote cultural competence within individual physicians. It is likely, however, that eliminating disparities in pain control will also require nonphysician interventions such as patient-targeted self-efficacy education, nurse-initiated pain-treatment protocols, and other system-level changes to facilitate equitable, systematic, and consistent alleviation of pain in emergency department patients, the authors write.


'/>"/>

Contact: Wallace Ravven
415-476-2557
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Cancer Patients Hold Fast to Belief That Opioids Mean Death
2. With Obesity, Diabetes, and Cardiovascular Disease on the Rise, Physicians Need More Comprehensive Guidelines
3. Mailman School of Public Health study examines link between racial discrimination and substance use
4. Can racial health disparities be effectively reduced?
5. Racial and ethnic differences in colorectal cancer emphasize importance of screening
6. No racial differences seen in outcomes after liver transplantation
7. Genetic differences point to ethnic and racial disparities in colorectal cancer risk
8. Racial and ethnic differences in the biology of breast cancer tumors
9. Survival differences by race most apparent in advanced stages of breast cancer
10. Gene Studies of Male-Female Differences Often Flawed
11. Major differences revealed in how local authorities in the UK support disabled people
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/7/2016)... Orion, Clarkston, Metamora, Michigan (PRWEB) , ... February 07, 2016 , ... ... Friday in recognition of National Wear Red Day. National Wear Red Day is ... and stroke in women. Heart disease and stroke cause 1 in 3 deaths among ...
(Date:2/6/2016)... ... February 06, 2016 , ... ... ADVISORY: 5000 PERIOPERATIVE NURSES EXPECTED AT AORN SURGICAL CONFERENCE & EXPO , ... the world with an estimated 5000 perioperative nurses in attendance to study ...
(Date:2/6/2016)... ... February 06, 2016 , ... Shark Finds and Kevin ... of a new DRTV campaign with Belly Bands. , Having a dog is great—except ... to puppy pads and find nothing works, get Belly Bands, the easiest way ...
(Date:2/5/2016)... ... 05, 2016 , ... Love is in the air at King Kullen! The ... and packaging. This staple for Valentine’s Day is a must-have, and can be picked ... Day, not only are long-stem roses available, but also other flower bouquets, elegantly wrapped ...
(Date:2/5/2016)... , ... February 05, 2016 , ... ... setting the stage for new clinical and scientific initiatives have all marked the ... she was appointed President and CEO of the nation’s oldest cancer center, Candace ...
Breaking Medicine News(10 mins):
(Date:2/4/2016)... , Feb. 4, 2016 In response to the ... FDA,s Deputy Commissioner for Medical Products and Tobacco, along with ... reassess the agency,s approach to opioid medications. The plan will ... providing patients in pain access to effective relief. ... , Re-examine the risk-benefit paradigm for opioids and ...
(Date:2/4/2016)...  Blueprint Medicines Corporation (NASDAQ: BPMC ), ... investigational kinase medicines for patients with genomically defined ... of directors of Lonnel Coats , a ... industry-related experience. Jeffrey Albers , ... strategic experience developing and commercializing numerous oncology products ...
(Date:2/4/2016)... SIOUX FALLS, S.D. , Feb. 4, 2016 ... patient and guest technology solutions, today announced that ... SONIFI Health Senior Living Engagement System. The system ... information tool that residents access through a tablet ... --> The resident engagement system provides access ...
Breaking Medicine Technology: