JAMA Study Shows Racial Disparities In Emergency Department Pain Relief Prescriptions

Main Category: Pain / Anesthetics
Also Included In: Public Health
Article Date: 03 Jan 2008 - 11:00 PDT

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Emergency department physicians are prescribing more narcotics to patients who say they have pain, but minority patients are less likely than whites to receive such drugs, according to a study published on Wednesday in the Journal of the American Medical Association, the AP/Houston Chronicle reports. The government-funded study, which was conducted by researchers at the University of California-San Francisco, used data from a federal survey to analyze more than 150,000 ED visits for all types of pain at 500 city and rural U.S. hospitals from 1993 to 2005.

According to the study, narcotic prescriptions by ED physicians increased from 23% in 1993 to 37% in 2005. The study found that opioid narcotics were prescribed in 31% of pain-related visits involving whites, 28% involving Asians, 24% involving Hispanics and 23% involving blacks. In addition, the study found that in more than 2,000 visits for kidney stones, whites received narcotics 72% of the time, Hispanic patients received the drugs 68% of the time, and Asian and black patients received the drugs 67% and 56% of the time, respectively. Minorities were slightly more likely than whites to receive aspirin, ibuprofen and similar pain medications, according to the study. The study found racial disparities in ED narcotic prescriptions in both urban and rural hospitals.

Study co-author Mark Pletcher said that the "gaps between whites and nonwhites have not appeared to close at all." According to the study's authors, physicians might be less likely to see signs of pain medication abuse among white patients or might be undertreating pain in minorities. Pletcher said that patient behavior also might play a role, adding that minorities "may be less likely to keep complaining about their pain or feel they deserve good pain control" (Johnson, AP/Houston Chronicle, 1/2).

An abstract of the study is available online.

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