TY - JOUR
T1 - Impact of physician and patient gender on pain management in the emergency department - A multicenter study
AU - Safdar, Basmah
AU - Heins, Alan
AU - Homel, Peter
AU - Miner, James
AU - Neighbor, Martha
AU - Desandre, Paul
AU - Todd, Knox H.
AU - Bartfield, Joel
AU - Ducharme, James
AU - Mader, Tim
AU - DeSandre, Paul
AU - Lock, Barbara
AU - Chang, Andrew
AU - Zun, Leslie
AU - Tanabe, Paula
AU - Vaillancourt, Christian
AU - Neighbor, Martha
AU - Cox, Robert
AU - Lee, Jacques
AU - Terndrup, Thomas
AU - Crandall, Cameron
AU - Heins, Alan
AU - Fosnocht, David
PY - 2009
Y1 - 2009
N2 - Objective. Pain is a complex experience influenced by factors such as age, race, and ethnicity. We conducted a multicenter study to better understand emergency department (ED) pain management practices and examined the influence of patient and provider gender on analgesic administration. Design: Prospective, multicenter, observational study. Setting. Consecutive patients, ≥8-years-old, presenting with complaints of moderate to severe pain (pain numerical rating scale [NRS]>3) at 16 U.S. and three Canadian hospitals. Outcomes Measures.Receipt of any ED analgesic, receipt of opioids, and adequate pain relief in the ED. Results. Eight hundred forty-two patients participated including 56% women. Baseline pain scores were similar in both genders. Analgesic administration rates were not significantly different for female and male patients (63% vs 57%, P = 0.08), although females presenting with severe pain (NRS≥8) were more likely to receive analgesics (74% vs 64%, P = 0.02). Female physicians were more likely to administer analgesics than male physicians (66% vs 57%, P = 0.009). In logistic regression models, predictors of ED analgesic administration were male physician (odds ratio [OR] = 0.7), arrival pain (OR=1.3), number of pain assessments (OR=1.83), and charted follow-up plans (OR=2.16). With regard to opioid administration, female physicians were more likely to prescribe opioids to females (P = 0.006) while male physicians were more likely to prescribe to males (P = 0.05). In logistic regression models, predictors of opioids administration included male patient gender (OR = 0.58), male patient-physician interaction (OR=2.58), arrival pain score (OR = 1.28), average pain score (OR = 1.10), and number of pain assessments (OR = 1.5). Pain relief was not impacted by gender. Conclusion. Provider gender as opposed to patient gender appears to influence pain management decisions in the ED.
AB - Objective. Pain is a complex experience influenced by factors such as age, race, and ethnicity. We conducted a multicenter study to better understand emergency department (ED) pain management practices and examined the influence of patient and provider gender on analgesic administration. Design: Prospective, multicenter, observational study. Setting. Consecutive patients, ≥8-years-old, presenting with complaints of moderate to severe pain (pain numerical rating scale [NRS]>3) at 16 U.S. and three Canadian hospitals. Outcomes Measures.Receipt of any ED analgesic, receipt of opioids, and adequate pain relief in the ED. Results. Eight hundred forty-two patients participated including 56% women. Baseline pain scores were similar in both genders. Analgesic administration rates were not significantly different for female and male patients (63% vs 57%, P = 0.08), although females presenting with severe pain (NRS≥8) were more likely to receive analgesics (74% vs 64%, P = 0.02). Female physicians were more likely to administer analgesics than male physicians (66% vs 57%, P = 0.009). In logistic regression models, predictors of ED analgesic administration were male physician (odds ratio [OR] = 0.7), arrival pain (OR=1.3), number of pain assessments (OR=1.83), and charted follow-up plans (OR=2.16). With regard to opioid administration, female physicians were more likely to prescribe opioids to females (P = 0.006) while male physicians were more likely to prescribe to males (P = 0.05). In logistic regression models, predictors of opioids administration included male patient gender (OR = 0.58), male patient-physician interaction (OR=2.58), arrival pain score (OR = 1.28), average pain score (OR = 1.10), and number of pain assessments (OR = 1.5). Pain relief was not impacted by gender. Conclusion. Provider gender as opposed to patient gender appears to influence pain management decisions in the ED.
KW - Analgesics
KW - Emergencies
KW - Emergency service, Hospital
KW - Pain management
KW - Patient gender
KW - Physician gender
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UR - http://www.scopus.com/inward/citedby.url?scp=62349141923&partnerID=8YFLogxK
U2 - 10.1111/j.1526-4637.2008.00524.x
DO - 10.1111/j.1526-4637.2008.00524.x
M3 - Article
C2 - 18992042
AN - SCOPUS:62349141923
SN - 1526-2375
VL - 10
SP - 364
EP - 372
JO - Pain Medicine
JF - Pain Medicine
IS - 2
ER -