Management of pain based on ethnicity
| First author, Publication Year, and Location | Type of Study | Total Number and Definition of Subjects | Definition of Outcome | Comparison of Outcome Based on Management of Different Ethnicities/Groups |
|---|---|---|---|---|
| Goyal et al., 2020; National Database, United States | 3 yr Retrospective Cross-Sectional Study | 7 pediatrics EDs; 21,069 patient visits | 1) Administration of any analgesic or opioids and 2) Reduction of moderate to severe pain related to long bone fractures | Compared to NH whites, minority children more likely to receive any analgesics (NH African American: aOR 1.72 [95% CI 1.51–1.95]; Hispanic: aOR 1.32 [95% CI 1.16–1.51]); but less likely to receive opioids: NH African American: aOR 0.86, Hispanics: aOR 0.86. Minority children achieved less optimal pain reduction (NH African American: aOR 0.78 [95% CI 0.67–0.90]; Hispanic: aOR 0.80 [95% CI 0.67–0.95) |
| Goyal et al., 2015; National Database, United States | Cross- Sectional Study, National Survey of Different EDs | 0.94 million ED visits | Receipt of pain medication for children diagnosed with appendicitis | Black patients with moderate pain were less likely to receive any analgesia than whites: 15.7% (95% CI, 0.1%-39.5%) vs 58.5% (95% CI, 45.8%-71.1%), adjusted OR=0.1 (95% CI, 0.02–0.8). For severe pain, blacks were less likely to receive opioids than whites: 24.5% (95% CI, 1.1%-48%) vs 58.3% (46.1%-70.4%), adjusted OR=0.2 (95% CI, 0.06–0.9) |
| Ortega et al., 2013; Minnesota, United States | Retrospective, Cohort | 878 patients | Receipt of opioid pain medication at ED discharge for long bone fractures | Whites as reference: Biracial (RR, 0.45; 95% CI, 0.27–0.75), NH black (RR, 0.59; 95% CI, 0.42–0.75), and Hispanic/Latino (RR, 0.61; 95% CI, 0.42–0.89). Non-whites less likely to receive opioids upon discharge. |
| Johnson et al., 2013; Philadelphia, United States | Retrospective, Cohort | 2,298 ED visits | Receipt of pain medications for abdominal pain | NH black patients had a significantly less likelihood to be administered any analgesic (OR 0.61; CI 0.43–0.87) or a narcotic analgesic (OR 0.38; 95% CI 0.18–0.81) compared to NH whites. |
| Kipping et al., 2018; Washington DC, United States | Retrospective, Cross-sectional | 24,733 ED visits | 1) Receipt of pain medication for abdominal pain, and 2) Pain reduction | Black children compared to white children were at greater likelihood to receive analgesia (aOR 1.94; 95% confidence interval, 1.71–2.21). Blacks (aOR 0.66; 0.51–0.85) and Hispanics (aOR 0.56; 0.39–0.80) were less likely to receive opioids. Black children were more likely to report reduced pain score (aOR, 1.42; 1.13–1.79). |
| Hambrook et al., 2010; United States (National) | Retrospective | 818 ED visits | Receipt of pain medication for chest pain | Receiving at least one pain medication: Caucasian 79%, African American 77%, ‘other’ 65%, P=NS. Children living in metropolitan areas were more likely to receive pain medication than those from non-metropolitan areas (p<0.01). |
| Caperall et al., 2013; Pittsburgh, PA, United States | Retrospective | 9,424 ED visits | Receipt of pain medication for abdominal pain | Narcotics for abdominal pain related to different causes: White 17.8%, African American 10.4% (p value <0.001). Racial differences for receiving pain medication for pain related to appendicitis was not statistically significant. |
NH: Non-Hispanic, aOR: Adjusted odds ratio