Exploring Racial Disparities in Chronic Pain Management.

Abstract

Introduction: Addressing racial disparities in chronic pain management referrals and prescribing is critical for ensuring equitable healthcare outcomes. Understanding these disparities is crucial for developing effective, patient-centered treatment strategies.

Patients and methods: A cross-sectional retrospective study of 19,919 patients diagnosed with chronic non-cancer pain between 7/1/2020 and 7/1/2022 was conducted at a major academic medical center. Patients' demographics, pain types, and treatment modalities were analyzed using chi-square tests and logistic regression models to evaluate racial differences in pain management referrals and opioid prescriptions.

Results: Non-Hispanic Black (NHB) and Hispanic patients had significantly lower odds of receiving interventional pain (Odds Ratio [OR] = 0.72 and 0.40, respectively) and neurosurgical referrals (OR = 0.66 and 0.49, respectively) compared to Non-Hispanic White (NHW) patients. Conversely, NHB patients were more likely to receive orthopedic surgery (OR = 1.40) and physical therapy referrals (OR = 1.16). Additionally, both NHB and Hispanic patients had lower odds of receiving opioid therapy (OR = 0.75 and 0.47, respectively) compared to NHW patients.

Conclusion: This study highlights significant racial disparities in chronic pain management, with NHB and Hispanic patients receiving fewer referrals to specialist care and lower opioid prescription rates compared to NHW patients. Strategies to address these disparities include provider education on implicit bias, cultural sensitivity training, and ensuring equitable access to healthcare resources. Further research is needed to explore the root causes of these disparities and develop targeted interventions to improve healthcare equity for all patients.