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Minorities Less Likely Than Whites to Receive Good Pain Care

Minorities Less Likely Than Whites to Receive Good Pain Care

NEW YORK—Blacks,
Hispanics, and other minorities are less likely than whites to receive
appropriate analgesia, as illustrated in the cancer literature and anecdotal
reports from those who work with minority populations, said Stacie T.
Pinderhughes, MD. "This is a high-risk group with regard to adequate and
appropriate treatment of pain," said Dr. Pinderhughes, assistant professor of
geriatrics and internal medicine, Mount Sinai School of Medicine, New York.

Studies show that physicians will evaluate pain equally,
regardless of the patient’s pain or ethnicity, Dr. Pinder-hughes said at an
American Medical Association media briefing on pain management. However, when
it comes to treatment, there appears to be a significant disparity in
prescribing practices.

In one study of cancer patients, 65% of minority patients
did not receive guideline-recommended analgesic prescriptions. By contrast, 50%
of nonminority patients received appropriate pain therapy (Ann Intern Med
127:813-816, 1997).

A variety of factors may influence whether or not minorities
receive appropriate prescriptions. One major barrier to treatment is limited
access to opioids in neighborhood pharmacies. A colleague of Dr. Pinderhughes
at Mount Sinai found that pharmacies in predominantly minority neighborhoods
were less likely to stock opioid pain medications than pharmacies in
predominantly nonmi-nority neighborhoods (N Engl J Med 342:1023-1026,
2000).

Dr. Pinderhughes told the story of a Puerto Rican-American
assistant who 2 years ago brought her best friend home to die of metastatic
cancer. She went to a local pharmacy in Spanish Harlem, which could not fill
her friend’s morphine prescription—nor could four other pharmacies in the
neighborhood.

"She had to go back to Mount Sinai, ultimately, to get her
prescription filled, so her best friend could die 2 days later at home in
relative comfort," Dr. Pinder-hughes recalled.

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