Disparities in Pain Care

Discussion in 'Chit Chat' started by JLH, Apr 30, 2007.

  1. JLH

    JLH New Member

    Disparities in Pain Care

    African Americans and Hispanics are affected by racial profiling for diversion and under-treatment by some physicians. This is compounded by a lack of research on pain across racial and ethnic differences, as well as cultural attitudes toward pain care.

    In one study, more than 80% of African American patients and 80% of Hispanic patients waited until their pain severity was a 10 on a 10-point scale before calling their health care provider or oncology clinic for assistance with pain management.

    Elders are among the most undertreated for pain. Of the community-dwelling elder population, 25-50% can expect to suffer pain. Among institutionalized elders, 71-83% report at least one pain problem.

    Unfortunately, under-treatment of pain in the pediatric population is worse than that for adults, including elders.

    Only recently has the FDA required new medications be evaluated for efficacy and safety in the pediatric population. In one study, 65% of children younger than 2 years old went without pain medications compared to 48% of older children up to 10 years.

    Gender is also a bias in pain assessment and treatment. Women seek help for pain more frequently than men, but are less likely to receive treatment. Physicians often assume either that women can handle more pain or that they are exaggerating the level of pain they experience.

    Women are more likely to be given sedatives for their pain while men are more likely to be given analgesics.

    Historically, the medical literature has portrayed women as hysterical and oversensitive. By extension, physicians often view women’s statements as emotional, rather than objective. In one study of patients with chronic pain, female patients were more likely than their male counterparts to be diagnosed with histrionic disorder, excessive emotionality, and attention-seeking behavior.

    Studies of VA patients show that the pain of veterans is significantly worse than that of the general public. A higher incidence of pain in veterans was anticipated compared with the general public because of the greater exposure to trauma and psychological stress, both of which increase pain and compound therapy.

    ref: painfoundation.org
  2. JLH

    JLH New Member

    This article states that elders are among the most undertreated for pain.

    Well, my 88 year old MIL is not! She has many spinal fractures due to osteoporosis which cause her a lot of pain. She is under Hospice Care right now and they have her on MS-Cotin and Percocet. They are very concerned about keeping her comfortable and pain free. I know this has only been possible because Hospice is taking care of her.

    Had a regular doctor been treating her, I doubt if she would get the amount of pain killers that she is getting now.