Racial differences in opioid use for chronic nonmalignant pain.
Racial differences in opioid use for chronic nonmalignant pain.
复制标题
阿片类药物用于治疗慢性非恶性疼痛的种族差异。
DOI：
10.1111/j.1525-1497.2005.0106.x
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发表时间：
2005
影响因子：
5.7
通讯作者：
Cykert,Sam
中科院分区：
文献类型：
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作者：
Chen,Ian;Kurz,James;Pasanen,Mark;Faselis,Charles;Panda,Mukta;Staton,LisaJ;O'Rorke,Jane;Menon,Madhusudan;Genao,Inginia;Wood,JoAnn;Mechaber,AlexJ;Rosenberg,Eric;Carey,Tim;Calleson,Diane;Cykert,Sam
背景：慢性疼痛是痛苦和残疾的常见原因，对患者的生活质量产生负面影响。有越来越多的证据表明，在治疗疼痛的差异发生，因为在race.Objective的差异：以确定是否种族发挥作用，在初级保健population.Design，设置，和参与者的治疗决策涉及慢性非恶性疼痛患者：一个横截面调查管理的慢性非恶性疼痛患者和他们的治疗医生在12个学术医疗中心。我们招募了463名非恶性疼痛持续超过3个月的患者和参与其护理的初级保健医生。结果：对397名黑人和白色患者的分析表明，黑人的疼痛评分明显高于白人（0 ~ 10分，6.7分，95%可信区间（CI）6.4 ~ 7.0）与白人（5.6分，95%CI 5.3 ~ 5.9）相比;然而，与黑人相比，白色患者更有可能服用阿片类镇痛药（45.7%vs 32.2%，P <0.006）。即使在控制了潜在的混杂变量后，白色患者服用阿片类镇痛药的可能性也显著高于黑人患者（比值比（OR）2.67，95% CI 1.71 - 4.15）。在使用其他治疗方式，如物理治疗和非甾体类抗炎药或在使用专业referreration.Conclusion：种族平等治疗发生在非阿片类药物相关的治疗，但白色患者更有可能比黑人患者接受阿片类药物治疗的种族没有差异。需要进一步的研究来更好地解释这种种族差异，并确定其对患者结局的影响。
Background:Chronic pain is a frequent cause of suffering and disability that negatively affects patients' quality of life. There is growing evidence that disparities in the treatment of pain occur because of differences in race.Objective:To determine whether race plays a role in treatment decisions involving patients with chronic nonmalignant pain in a primary care population.Design, Setting, and Participants:A cross‐sectional survey was administered to patients with chronic nonmalignant pain and their treating physicians at 12 academic medical centers. We enrolled 463 patients with nonmalignant pain persisting for more than 3 consecutive months and the primary care physicians participating in their care.Results:Analysis of the 397 black and white patients showed that blacks had significantly higher pain scores (6.7 on a scale of 0 to 10, 95% confidence interval (CI) 6.4 to 7.0) compared with whites (5.6, 95% CI 5.3 to 5.9); however, white patients were more likely to be taking opioid analgesics compared with blacks (45.7% vs 32.2%,P<.006). Even after controlling for potentially confounding variables, white patients were significantly more likely (odds ratio (OR) 2.67, 95% CI 1.71 to 4.15) to be taking opioid analgesics than black patients. There were no differences by race in the use of other treatment modalities such as physical therapy and nonsteroidal anti‐inflammatories or in the use of specialty referral.Conclusion:Equal treatment by race occurs in nonopioid‐related therapies, but white patients are more likely than black patients to be treated with opioids. Further studies are needed to better explain this racial difference and define its effect on patient outcomes.