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{
    "pk": 18531,
    "title": "Equity in the Early Pain Management of Long Bone Fractures in Black vs White Patients: We Have Closed the Gap",
    "subtitle": null,
    "abstract": "<p><strong>Introduction: </strong>Patients with long bone fractures often present to the emergency department (ED) with severe pain and are typically treated with opioid and non-opioid analgesics. Historical data reveals racial disparities in analgesic administration, with White patients more likely to receive analgesics. With the diversifying US population, health equity is increasingly crucial. In this study we aimed to evaluate the early administration of opioid and non-opioid analgesia among Black and White patients with long bone and femur fractures in EDs over different time frames using a substantial database.</p>\n<p><strong>Methods: </strong>We retrospectively extracted Information from 57 US healthcare organizations within the TriNetX database, encompassing 95 million patients. The ED records from 2003–2023 were subjected to propensity score matching for age and gender. We focused on four cohorts: two comprising Black and White patients diagnosed with long bone fractures, and another two with Black and White patients diagnosed solely with femur fractures. We examined analgesic administration rates over 20 years (2003–2023) at five-year intervals (2003–2008; 2008–2013; 2013–2018; 2018–2023), and further analyzed the rates for the most recent two-year period (2021–2023).</p>\n<p><strong>Results: </strong>Disparities in analgesic administration significantly diminished over the study period. For patients with long bone fractures (1,095,052), the opioid administration gap narrowed from 6.3% to 1.1%, while non-opioid administration disparities reduced from 4.4% to 0.3%. Similar trends were noted for femur fractures (265,181). By 2021–2023, no significant differences in analgesic administration were observed between racial groups.</p>\n<p><strong>Conclusion: </strong>Over the past 20 years, the gap in early administration of opioid and non-opioid analgesics for Black and White patients presenting with long bone fractures or femur fractures has been disappearing.</p>",
    "language": null,
    "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": "Equity"
        },
        {
            "word": "Opioid analgesia"
        },
        {
            "word": "non-opioid analgesia"
        },
        {
            "word": "Long bone fracture"
        },
        {
            "word": "pain management"
        }
    ],
    "section": "Health Equity",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/6p69m38v",
    "frozenauthors": [
        {
            "first_name": "Dietrich",
            "middle_name": "",
            "last_name": "Jehle",
            "name_suffix": "",
            "institution": "University of Texas Medical Branch, Department of Emergency Medicine, Galveston, Texas",
            "department": ""
        },
        {
            "first_name": "Krishna",
            "middle_name": "K.",
            "last_name": "Paul",
            "name_suffix": "",
            "institution": "University of Texas Medical Branch, Department of Emergency Medicine, Galveston, Texas",
            "department": ""
        },
        {
            "first_name": "Stanley",
            "middle_name": "",
            "last_name": "Troung",
            "name_suffix": "",
            "institution": "University of Texas Medical Branch, Department of Emergency Medicine, Galveston, Texas",
            "department": ""
        },
        {
            "first_name": "Jackson",
            "middle_name": "M.",
            "last_name": "Rogers",
            "name_suffix": "",
            "institution": "University of Texas Medical Branch, Department of Emergency Medicine, Galveston, Texas",
            "department": ""
        },
        {
            "first_name": "Blake",
            "middle_name": "",
            "last_name": "Mireles",
            "name_suffix": "",
            "institution": "University of Texas Medical Branch, Department of Emergency Medicine, Galveston, Texas",
            "department": ""
        },
        {
            "first_name": "John",
            "middle_name": "J.",
            "last_name": "Straub",
            "name_suffix": "",
            "institution": "University of Texas Medical Branch, Department of Emergency Medicine, Galveston, Texas",
            "department": ""
        },
        {
            "first_name": "Georgiy",
            "middle_name": "",
            "last_name": "Golovko",
            "name_suffix": "",
            "institution": "University of Texas Medical Branch, Department of Pharmacology and Toxicology, Galveston, Texas",
            "department": ""
        },
        {
            "first_name": "Matthew",
            "middle_name": "M.",
            "last_name": "Talbott",
            "name_suffix": "",
            "institution": "University of Texas Medical Branch, Department of Emergency Medicine, Galveston, Texas",
            "department": ""
        },
        {
            "first_name": "Ronald",
            "middle_name": "W.",
            "last_name": "Lindsey",
            "name_suffix": "",
            "institution": "University of Texas Medical Branch, Department of Orthopaedic Surgery and Rehabilitation, Galveston, Texas",
            "department": ""
        },
        {
            "first_name": "Charles",
            "middle_name": "P.",
            "last_name": "Mouton",
            "name_suffix": "",
            "institution": "University of Texas Medical Branch, Department of Family Medicine, Galveston, Texas",
            "department": ""
        }
    ],
    "date_submitted": "2023-10-28T05:22:13+02:00",
    "date_accepted": "2024-04-15T19:05:23.599000+02:00",
    "date_published": "2024-08-01T15:00:00+02:00",
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        "path": "https://journalpub.escholarship.org/westjem/article/18531/galley/24590/download/"
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            "label": "Layout",
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            "label": "Final Article",
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            "path": "https://journalpub.escholarship.org/westjem/article/18531/galley/24590/download/"
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}