Image Source: Cedar Sinai
July 9, 2024 Story by: Editor
Cedars-Sinai Investigators Find Racial and Ethnic Disparities in Postpartum Pain Management
A study conducted by Cedars-Sinai has revealed significant racial and ethnic disparities in pain management for women postpartum. The research, which included 18,000 women, found that these inequities persisted even among those reporting the highest levels of pain.
The study examined both opioid and non-opioid pain medications to determine if lower opioid doses, previously reported in some studies, could be attributed to patients receiving alternative drugs for their discomfort.
“Even after adjusting our analysis to include non-opioid medications, Black and Hispanic patients who reported the highest pain scores received lower doses of opioid-containing medication. The fact that they also received non-opioid drugs could not explain the lower opioid treatment they received when compared with white patients,” explained Naomi Greene, PhD, principal investigator of the study and an assistant professor of Research in Obstetrics and Gynecology.
The pain associated with labor and delivery can hinder women’s ability to care for themselves and their newborns. The investigators analyzed numerous variables from the electronic medical records of patients who delivered at Cedars-Sinai between 2019 and 2021. The cohort included White, Black, Asian, and Hispanic women.
“We attempted to identify factors that might have mitigated the apparent differences, such as the number of pain assessments, use of epidurals, the amount of non-opioid medication, maternal age, the number of pregnancies, and body mass index. But none of these factors could account for the racial and ethnic disparities in the amount of effective opioid pain management given to them,” said Sarah J. Kilpatrick, MD, PhD, the Helping Hand of Los Angeles Chair in Obstetrics and Gynecology and senior author of the paper.
The researchers stress the need for further studies to identify factors that might explain the persistent racial and ethnic disparities in pain management and to develop potential interventions to eliminate these inequities.
“This study adds to the growing body of literature on peripartum pain medication disparity. While confirming previous findings, we added to it by showing that the amount of non-opioid medication used could not explain those disparities in opiate-based therapy given to patients in pain,” Greene noted.
The study authors pointed out that pain perception and assessments are likely influenced by a complex set of factors.
“Healthcare provider beliefs, attitudes, and biases concerning pain rating in patients of different races and ethnicities are part of the challenge. Exploring this would necessitate a prospective intervention, such as a survey distributed to nurses and doctors to assess these beliefs and biases. Also, beyond recording a number for a pain score, we need to find ways to allow patients to directly assess their satisfaction with the pain management they are receiving,” Kilpatrick suggested. Source: Cedars Sinai
