Abstract 129 Table 1

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