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Are there differences in the process of pain assessment and management by race and ethnicity?

In the USA, there is evidence to suggest there are racial and ethnic disparities in process measures of pain management among children seeking care in emergency departments. Is this a major problem? Goyal MK et al [Pediatrics 2020;145(5):e20193370; DOI: https://doi.org/10.1542/peds.2019-3370] have tested the hypotheses that ‘minority children’ with long-bone fractures are less likely to receive analgesics, receive opioid analgesics, and achieve pain reduction. The Paediatric Emergency Care Applied Research Network (PECARN) used data from a registry from seven emergency departments and performed a 3 year retrospective cross-sectional study of children aged less than 18 years old with long-bone fractures. In 21 069 visits, children were judged to have moderate-to-severe pain and 86.1% received an analgesic and 45.4% received opioids. Of 8533 patients with reassessment of pain, 89.2% experienced ≥2-point reduction in pain score and 62.2% experienced optimal pain reduction. Comparewith non-Hispanic (NH) white children, NH African American and Hispanic children were less likely to receive opioids (NH African American: aOR 0.86 [0.77–0.95]; Hispanic: aOR 0.86 [0.76–0.96]) or achieve optimal pain reduction (NH African American: aOR 0.78 [0.67–0.90]; Hispanic: aOR 0.80 [0.67–0.95]) adjusted for pain severity. So although ‘minority children’ were more likely to receive …

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  • Provenance and peer review Commissioned; internally peer reviewed.

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