Is all pain is treated equally? A multicenter evaluation of acute pain care by age
Older patients receive less analgesics than younger patients, yet had greater reductions in acute pain scores. These differences may be driven by type of pain. Pain is highly prevalent in health care settings; however, disparities continue to exist in pain care treatment. Few studies have investigat...
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Veröffentlicht in: | Pain (Amsterdam) 2014-12, Vol.155 (12), p.2568-2574 |
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creator | Hwang, Ula Belland, Laura K. Handel, Daniel A. Yadav, Kabir Heard, Kennon Rivera-Reyes, Laura Eisenberg, Amanda Noble, Matthew J. Mekala, Sudha Valley, Morgan Winkel, Gary Todd, Knox H. Morrison, R. Sean |
description | Older patients receive less analgesics than younger patients, yet had greater reductions in acute pain scores. These differences may be driven by type of pain.
Pain is highly prevalent in health care settings; however, disparities continue to exist in pain care treatment. Few studies have investigated if differences exist based on patient-related characteristics associated with aging. The objective of this study was to determine if there are differences in acute pain care for older vs younger patients. This was a multicenter, retrospective, cross-sectional observation study of 5 emergency departments across the United States evaluating the 2 most commonly presenting pain conditions for older adults, abdominal and fracture pain. Multivariable adjusted hierarchical modeling was completed. A total of 6,948 visits were reviewed. Older (⩾65years) and oldest (⩾85years) were less likely to receive analgesics compared to younger patients ( |
doi_str_mv | 10.1016/j.pain.2014.09.017 |
format | Article |
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Pain is highly prevalent in health care settings; however, disparities continue to exist in pain care treatment. Few studies have investigated if differences exist based on patient-related characteristics associated with aging. The objective of this study was to determine if there are differences in acute pain care for older vs younger patients. This was a multicenter, retrospective, cross-sectional observation study of 5 emergency departments across the United States evaluating the 2 most commonly presenting pain conditions for older adults, abdominal and fracture pain. Multivariable adjusted hierarchical modeling was completed. A total of 6,948 visits were reviewed. Older (⩾65years) and oldest (⩾85years) were less likely to receive analgesics compared to younger patients (<65years), yet older patients had greater reductions in final pain scores. When evaluating pain treatment and final pain scores, differences appeared to be based on type of pain. Older patients with abdominal pain were less likely to receive pain medications, while older patients with fracture were more likely to receive analgesics and opioids compared to younger patients. Differences in pain care for older patients appear to be driven by the type of presenting pain.</description><identifier>ISSN: 0304-3959</identifier><identifier>EISSN: 1872-6623</identifier><identifier>DOI: 10.1016/j.pain.2014.09.017</identifier><identifier>PMID: 25244947</identifier><identifier>CODEN: PAINDB</identifier><language>eng</language><publisher>Philadelphia, PA: Elsevier B.V</publisher><subject>Acute Pain - therapy ; Acute pain care ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Aging ; Analgesics - therapeutic use ; Biological and medical sciences ; Cross-Sectional Studies ; Electronic Health Records - statistics & numerical data ; Emergency department ; Female ; Fundamental and applied biological sciences. Psychology ; Geriatrics ; Humans ; Male ; Middle Aged ; Observation ; Pain Measurement ; Retrospective Studies ; Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors ; Vertebrates: nervous system and sense organs ; Young Adult</subject><ispartof>Pain (Amsterdam), 2014-12, Vol.155 (12), p.2568-2574</ispartof><rights>2014</rights><rights>International Association for the Study of Pain</rights><rights>2015 INIST-CNRS</rights><rights>Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5639-ecb633607e3cb85fb27e1c47dc7450fbee6519b06a0ed5b7ff021865652819923</citedby><cites>FETCH-LOGICAL-c5639-ecb633607e3cb85fb27e1c47dc7450fbee6519b06a0ed5b7ff021865652819923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=29062958$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25244947$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hwang, Ula</creatorcontrib><creatorcontrib>Belland, Laura K.</creatorcontrib><creatorcontrib>Handel, Daniel A.</creatorcontrib><creatorcontrib>Yadav, Kabir</creatorcontrib><creatorcontrib>Heard, Kennon</creatorcontrib><creatorcontrib>Rivera-Reyes, Laura</creatorcontrib><creatorcontrib>Eisenberg, Amanda</creatorcontrib><creatorcontrib>Noble, Matthew J.</creatorcontrib><creatorcontrib>Mekala, Sudha</creatorcontrib><creatorcontrib>Valley, Morgan</creatorcontrib><creatorcontrib>Winkel, Gary</creatorcontrib><creatorcontrib>Todd, Knox H.</creatorcontrib><creatorcontrib>Morrison, R. Sean</creatorcontrib><title>Is all pain is treated equally? A multicenter evaluation of acute pain care by age</title><title>Pain (Amsterdam)</title><addtitle>Pain</addtitle><description>Older patients receive less analgesics than younger patients, yet had greater reductions in acute pain scores. These differences may be driven by type of pain.
Pain is highly prevalent in health care settings; however, disparities continue to exist in pain care treatment. Few studies have investigated if differences exist based on patient-related characteristics associated with aging. The objective of this study was to determine if there are differences in acute pain care for older vs younger patients. This was a multicenter, retrospective, cross-sectional observation study of 5 emergency departments across the United States evaluating the 2 most commonly presenting pain conditions for older adults, abdominal and fracture pain. Multivariable adjusted hierarchical modeling was completed. A total of 6,948 visits were reviewed. Older (⩾65years) and oldest (⩾85years) were less likely to receive analgesics compared to younger patients (<65years), yet older patients had greater reductions in final pain scores. When evaluating pain treatment and final pain scores, differences appeared to be based on type of pain. Older patients with abdominal pain were less likely to receive pain medications, while older patients with fracture were more likely to receive analgesics and opioids compared to younger patients. Differences in pain care for older patients appear to be driven by the type of presenting pain.</description><subject>Acute Pain - therapy</subject><subject>Acute pain care</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging</subject><subject>Analgesics - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cross-Sectional Studies</subject><subject>Electronic Health Records - statistics & numerical data</subject><subject>Emergency department</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observation</subject><subject>Pain Measurement</subject><subject>Retrospective Studies</subject><subject>Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors</subject><subject>Vertebrates: nervous system and sense organs</subject><subject>Young Adult</subject><issn>0304-3959</issn><issn>1872-6623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl-P1CAUxYnRuOPqF_DB8GLiS-uFFhgSo9ls_LPJJiZGnwmltzuMTDsL7Wzm20vtuOqLPhAC_M7hcg-EPGdQMmDy9bbcW9-XHFhdgi6BqQdkxdaKF1Ly6iFZQQV1UWmhz8iTlLYAwDnXj8kZF7yuda1W5MtVojYEOjtRn-gY0Y7YUryd8vbxHb2guymM3mE_YqR4sGGyox96OnTUumnERepsRNocqb3Bp-RRZ0PCZ6f5nHz78P7r5afi-vPHq8uL68IJWekCXSOrSoLCyjVr0TVcIXO1ap2qBXQNohRMNyAtYCsa1XXA2VoKKfiaac2rc_J28d1PzQ7bucJog9lHv7PxaAbrzd8nvd-Ym-Fgai6gUiobvDoZxOF2wjSanU8OQ7A9DlMyTDHFa85B_B-VXIu1AgYZ5Qvq4pBSxO6-IgZmzs1szdwyM-dmQJucWxa9-PMt95JfQWXg5QmwydnQRds7n35zGn5WkLl64e6GkANL38N0h9Fs0IZxY_IPgNx7Wcx3M55XRR5MZ9mbRYY5sIPPiuQ89g5bH9GNph38v8r_ARH4xV4</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Hwang, Ula</creator><creator>Belland, Laura K.</creator><creator>Handel, Daniel A.</creator><creator>Yadav, Kabir</creator><creator>Heard, Kennon</creator><creator>Rivera-Reyes, Laura</creator><creator>Eisenberg, Amanda</creator><creator>Noble, Matthew J.</creator><creator>Mekala, Sudha</creator><creator>Valley, Morgan</creator><creator>Winkel, Gary</creator><creator>Todd, Knox H.</creator><creator>Morrison, R. Sean</creator><general>Elsevier B.V</general><general>International Association for the Study of Pain</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20141201</creationdate><title>Is all pain is treated equally? A multicenter evaluation of acute pain care by age</title><author>Hwang, Ula ; Belland, Laura K. ; Handel, Daniel A. ; Yadav, Kabir ; Heard, Kennon ; Rivera-Reyes, Laura ; Eisenberg, Amanda ; Noble, Matthew J. ; Mekala, Sudha ; Valley, Morgan ; Winkel, Gary ; Todd, Knox H. ; Morrison, R. Sean</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5639-ecb633607e3cb85fb27e1c47dc7450fbee6519b06a0ed5b7ff021865652819923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acute Pain - therapy</topic><topic>Acute pain care</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging</topic><topic>Analgesics - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cross-Sectional Studies</topic><topic>Electronic Health Records - statistics & numerical data</topic><topic>Emergency department</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Geriatrics</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observation</topic><topic>Pain Measurement</topic><topic>Retrospective Studies</topic><topic>Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors</topic><topic>Vertebrates: nervous system and sense organs</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hwang, Ula</creatorcontrib><creatorcontrib>Belland, Laura K.</creatorcontrib><creatorcontrib>Handel, Daniel A.</creatorcontrib><creatorcontrib>Yadav, Kabir</creatorcontrib><creatorcontrib>Heard, Kennon</creatorcontrib><creatorcontrib>Rivera-Reyes, Laura</creatorcontrib><creatorcontrib>Eisenberg, Amanda</creatorcontrib><creatorcontrib>Noble, Matthew J.</creatorcontrib><creatorcontrib>Mekala, Sudha</creatorcontrib><creatorcontrib>Valley, Morgan</creatorcontrib><creatorcontrib>Winkel, Gary</creatorcontrib><creatorcontrib>Todd, Knox H.</creatorcontrib><creatorcontrib>Morrison, R. Sean</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pain (Amsterdam)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hwang, Ula</au><au>Belland, Laura K.</au><au>Handel, Daniel A.</au><au>Yadav, Kabir</au><au>Heard, Kennon</au><au>Rivera-Reyes, Laura</au><au>Eisenberg, Amanda</au><au>Noble, Matthew J.</au><au>Mekala, Sudha</au><au>Valley, Morgan</au><au>Winkel, Gary</au><au>Todd, Knox H.</au><au>Morrison, R. Sean</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is all pain is treated equally? A multicenter evaluation of acute pain care by age</atitle><jtitle>Pain (Amsterdam)</jtitle><addtitle>Pain</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>155</volume><issue>12</issue><spage>2568</spage><epage>2574</epage><pages>2568-2574</pages><issn>0304-3959</issn><eissn>1872-6623</eissn><coden>PAINDB</coden><abstract>Older patients receive less analgesics than younger patients, yet had greater reductions in acute pain scores. These differences may be driven by type of pain.
Pain is highly prevalent in health care settings; however, disparities continue to exist in pain care treatment. Few studies have investigated if differences exist based on patient-related characteristics associated with aging. The objective of this study was to determine if there are differences in acute pain care for older vs younger patients. This was a multicenter, retrospective, cross-sectional observation study of 5 emergency departments across the United States evaluating the 2 most commonly presenting pain conditions for older adults, abdominal and fracture pain. Multivariable adjusted hierarchical modeling was completed. A total of 6,948 visits were reviewed. Older (⩾65years) and oldest (⩾85years) were less likely to receive analgesics compared to younger patients (<65years), yet older patients had greater reductions in final pain scores. When evaluating pain treatment and final pain scores, differences appeared to be based on type of pain. Older patients with abdominal pain were less likely to receive pain medications, while older patients with fracture were more likely to receive analgesics and opioids compared to younger patients. Differences in pain care for older patients appear to be driven by the type of presenting pain.</abstract><cop>Philadelphia, PA</cop><pub>Elsevier B.V</pub><pmid>25244947</pmid><doi>10.1016/j.pain.2014.09.017</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Acute Pain - therapy Acute pain care Adolescent Adult Age Factors Aged Aged, 80 and over Aging Analgesics - therapeutic use Biological and medical sciences Cross-Sectional Studies Electronic Health Records - statistics & numerical data Emergency department Female Fundamental and applied biological sciences. Psychology Geriatrics Humans Male Middle Aged Observation Pain Measurement Retrospective Studies Somesthesis and somesthetic pathways (proprioception, exteroception, nociception) interoception electrolocation. Sensory receptors Vertebrates: nervous system and sense organs Young Adult |
title | Is all pain is treated equally? A multicenter evaluation of acute pain care by age |
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