Abstract
Objective
This review aims to quantify the effect of minority status on analgesia use for acute
pain management in US Emergency Department (ED) settings.
Methods
We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)
methodology to perform a review of studies from 1990 to 2018 comparing racial and
ethnic differences in the administration of analgesia for acute pain. Studies were
included if they measured analgesia use in white patients compared to a racial minority
in the ED and studies were excluded if they focused primarily on chronic pain, case
reports and survey studies. Following data abstraction, a meta-analysis was performed
using fixed and random-effect models to determine primary outcome of analgesia administration
stratified by racial and ethnic classification.
Results
763 articles were screened for eligibility and fourteen studies met inclusion criteria
for qualitative synthesis. The total study population included 7070 non-Hispanic White
patients, 1538 Hispanic, 3125 Black, and 50.3% female. Black patients were less likely
than white to receive analgesia for acute pain: OR 0.60 [95%-CI, 0.43–0.83, random
effects model]. Hispanics were also less likely to receive analgesia: OR 0.75 [95%-CI,
0.52–1.09].
Conclusion
This study demonstrates the presence of racial disparities in analgesia use for the
management of acute pain in US EDs. Further research is needed to examine patient
reported outcomes in addition to the presence of disparities in other groups besides
Black and Hispanic. Trial registration: Registration number CRD42018104697 in PROSPERO.
Keywords
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Article Info
Publication History
Published online: June 05, 2019
Accepted:
June 4,
2019
Received in revised form:
June 4,
2019
Received:
May 6,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
