Racial and Ethnic Disparities in Acute Pain Control
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|ClinicalTrials.gov Identifier: NCT00115180|
Recruitment Status : Completed
First Posted : June 22, 2005
Last Update Posted : January 7, 2016
We aim to compare pain management among three groups of ethnic disparity (ED) patients, Hispanics, non-Hispanic Blacks, non-Hispanic Whites, and assess whether the observed association between pain management and race/ethnicity is independent of potentially important confounding variables (e.g., age, sex, insurance status, education). We also aim to assess whether the effect of race/ethnicity on adequacy of pain management is explained by patients' initial pain intensity or by discordance between patient and physician's: a) race/ethnicity; b) perception of patient's pain. To do this 285 patients with long-bone fractures will be recruited in the EDs of one municipal and one voluntary hospital serving an inner-city, disadvantaged population in the Bronx. Data will be collected on pain using self-reported pain and non-verbal pain expressions at baseline, one hour post-baseline, and discharge. Data on analgesics administered, patient and physician characteristics will also be collected.
We plan to conduct a chart review of long bone fractures in 2000 and 2001 so that we can analyze the association between race/ethnicity and pain management using the same design as published studies. Comparison of the retrospective and prospective studies will strengthen inferences that can be drawn.
We hypothesize that Black and Hispanic patients will be less likely to receive opioid analgesics than white patients.
|Condition or disease||Intervention/treatment|
|Fracture Pain||Other: No intervention|
Show Detailed Description
|Study Type :||Observational|
|Actual Enrollment :||285 participants|
|Official Title:||Racial and Ethnic Disparities in Acute Pain Control|
|Study Start Date :||September 2003|
|Actual Primary Completion Date :||November 2006|
|Actual Study Completion Date :||November 2006|
Hispanic patients with long bone fractures no intervention
Other: No intervention
White patients with long bone fractures no intervention
Other: No intervention
African-American patients with long bone fracture no intervention
Other: No intervention
- Receipt of any analgesics [ Time Frame: During Emergency Room visit ]The names of all medications, dose, route, and time administered were obtained in real time from the chart and ED staff. Patients were categorized as receiving: 1) no analgesics; 2) NSAIDS or acetaminophen; or 3) opioids. If both NSAIDS or acetaminophen and opioids were administered, patients were categorized as having received opioids. Analgesics given solely for fracture reduction were not used to categorize patients. Opioid analgesics were transformed into morphine equivalents as follows: 1 mg morphine = 3 mg of oxycodone; 0.15 mg of hydromorphone, and 13 mg of codeine. No other opioid analgesics were used with the exception of fentanyl, which was only used for fracture reduction.
- Receipt of opioid analgesics [ Time Frame: During Emergency Room visit ]Morphine, hydromorphone, oxycodone, codeine
- Time to first treatment with analgesic [ Time Frame: During Emergency Room visit ]Time from triage to first analgesic in minutes
- Receipt of parenteral analgesics [ Time Frame: During Emergency Room visit ]Analgesic administered parenterally
- Initial dose of opioid analgesic mg/kg [ Time Frame: During Emergency Room visit ]Initial dose of opioid analgesic converted to morphine equivalent units as follows: : 1 mg morphine = 3 mg of oxycodone; 0.15 mg of hydromorphone, and 13 mg of codeine.
- Pain at discharge from Emergency Department [ Time Frame: During Emergency Room visit ]Patients were asked to rate their pain intensity on a validated and reproducible 11-point numerical rating scale (NRS) ranging from 0 "no pain", to 10 "worst imaginable pain" at the time of discharge from the Emergency Department
- Difference in pain from baseline assessment to discharge from Emergency Department [ Time Frame: During Emergency Room visit ]Numerical Rating Scale (NRS) of pain at discharge subtracted from NRS of pain at baseline.
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Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00115180
|United States, New York|
|Jacobi Medical Center Emergency Department|
|Bronx, New York, United States, 10461|
|Montefiore Medical Center Emergency Department|
|Bronx, New York, United States, 10467|
|Study Chair:||E. John Gallagher, MD||Albert Einstein College of Medicine|