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:4/28/2017)... , ... April 28, 2017 , ... Horizon Blue Cross ... the company’s credit rating of “A” and its outlook as “stable.” At the same ... reserves, which have fallen in recent years, dip below “capital adequacy” thresholds required for ...
(Date:4/28/2017)... ... April 28, 2017 , ... Date aired: April ... “Computers are everywhere and they’re here to stay,” said Sharon Kleyne on her ... Your Health on Voice America sponsored by Nature’s Tears® EyeMist®. So she was ...
(Date:4/28/2017)... (PRWEB) , ... April 28, 2017 , ... ... announce that Aditya Patel M.D. has joined the revolutionary endoscopic practice under Dr. ... board certification in Interventional Pain Medicine. The patented, revolutionary eDiscSculpt Technique created and ...
(Date:4/28/2017)... Md. (PRWEB) , ... April 28, 2017 , ... ... Association of America (UCAOA) and College of Urgent Care Medicine will host industry ... workshops, sessions and speakers will help those in the industry adapt to the ...
(Date:4/28/2017)... ... ... Bill Howe started his sewer and drain company in 1980 focusing heavily ... team, the Bill Howe brand was born and they began cultivating their mission to ... the San Diego community in which they worked, lived and were raising their daughters. ...
Breaking Medicine News(10 mins):
(Date:4/19/2017)... 2017 /PRNewswire/ - CRH Medical Corporation (TSX: CRH) (NYSE MKT: CRHM) (the "Company"), ... Healthcare Investor Conference 2017 at the Sheraton Hotel in ... Executive Officer of the Company is scheduled to present on Tuesday, ... and the Chairman of the Board, Tony Holler ... ...
(Date:4/19/2017)... 19, 2017 Global Prostate Cancer Therapeutics ... the prostate cancer therapeutics market analyzes the current ... prevalence of prostate cancer, launch of promising emerging ... of new drugs & therapeutic biological products, and ... to lesser side effects are some of the ...
(Date:4/19/2017)... 19, 2017  New research provides evidence that an old ... to a study released today that will be presented at ... in Boston , April 22 to 28, ... of Parkinson,s disease, the oral drug levodopa has long been ... But as the disease progresses, the effects of the medication ...
Breaking Medicine Technology: