{"pk":16237,"title":"Racial Disparities in Opioid Analgesia Administration Among Adult Emergency Department Patients with Abdominal Pain","subtitle":null,"abstract":"Introduction:\n Racial disparities in pain management have been reported among emergency department (ED) patients. In this study we evaluated the association between patients’ self-identified race/ethnicity and the administration of opioid analgesia among ED patients with abdominal pain, the most common chief complaint for ED presentations in the United States.\n \nMethods: \nThis was a retrospective cohort study of adult (age ≥18 years) patients who presented to the ED of a single center with abdominal pain from January 1, 2019–December 31, 2020. We collected demographic and clinical information, including patients’ race and ethnicity, from the electronic health record. The primary outcome was the ED administration of any opioid analgesic (binary). Secondary outcomes included the administration of non-opioid analgesia (binary) and administration of any analgesia (binary). We used logistic regression models to estimate odds ratios (OR) of the association between a patient’s race/ethnicity and analgesia administration. Covariates included age, sex, initial pain score, Emergency Severity Index, and ED visits in the prior 30 days. Subgroup analyses were performed in non-pregnant patients, those who underwent any imaging study, were admitted to the hospital, and who underwent surgery within 24 hours of ED arrival.\nResults:\n We studied 7,367 patients: 45% (3,314) were non-Hispanic (NH) White; 28% (2,092) were Hispanic/Latinx; 19% (1,384) were NH Black, and 8% (577) were Asian. Overall, 44% (3,207) of patients received opioid analgesia. In multivariable regression models, non-White patients were less likely to receive opioid analgesia compared with White patients (OR 0.73, 95% CI 0.65-0.83 for Hispanic/Latinx patients; OR 0.62, 95% CI 0.54-0.72 for Black patients; and OR 0.64, 95% CI 0.52-0.78 for Asian patients). Black patients were also less likely to receive non-opioid analgesia, and Black and Hispanic/Latinx patients were less likely than White patients to receive any analgesia. The associations were similar across subgroups; however, the association was attenuated among patients who underwent surgery within 24 hours of ED arrival. \nConclusion:\n Hispanic/Latinx, Black, and Asian patients were significantly less likely to receive opioid analgesia than White patients when presenting to the ED with abdominal pain. Black patients were also less likely than White patients to receive non-opioid analgesia.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Health Equity, Health Disparities, Oligoanalgesia, Racial Disparities, Abdominal Pain"}],"section":"Health Equity","is_remote":true,"remote_url":"https://escholarship.org/uc/item/72c6g150","frozenauthors":[{"first_name":"Angela","middle_name":"F.","last_name":"Jarman","name_suffix":"","institution":"University of California, Davis School of Medicine, Department of Emergency Medicine, Davis, California","department":"None"},{"first_name":"Alexander","middle_name":"C.","last_name":"Wang","name_suffix":"","institution":"University of California, Davis School of Medicine, Department of Emergency Medicine, Davis, California; David Grant Medical Center, Travis Air Force Base, Fairfield, California","department":"None"},{"first_name":"Julia","middle_name":"P.","last_name":"Schleimer","name_suffix":"","institution":"University of California, Davis School of Medicine, Violence Prevention Research Program, Department of Emergency Medicine, Davis, California; University of California, Davis, University of California Firearm Violence Research Center, Davis, California","department":"None"},{"first_name":"Roderick","middle_name":"W.","last_name":"Fontenette","name_suffix":"","institution":"University of California, Davis School of Medicine, Department of Emergency Medicine, Davis, California; David Grant Medical Center, Travis Air Force Base, Fairfield, California","department":"None"},{"first_name":"Bryn","middle_name":"E.","last_name":"Mumm","name_suffix":"","institution":"University of California, Davis School of Medicine, Department of Emergency Medicine, Davis, California","department":"None"}],"date_submitted":"2021-12-29T05:42:36Z","date_accepted":"2021-12-29T05:42:36Z","date_published":"2022-10-24T23:00:48Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/16237/galley/8148/download/"}]}