• Ian Chen, James Kurz, Mark Pasanen, Charles Faselis, Mukta Panda, Lisa J Staton, Jane O'Rorke, Madhusudan Menon, Inginia Genao, JoAnn Wood, Alex J Mechaber, Eric Rosenberg, Tim Carey, Diane Calleson, and Sam Cykert.
• Eastern Virginia Medical School, Norfolk, USA. chenia@evms.edu
• J Gen Intern Med. 2005 Jul 1; 20 (7): 593598593-8.

BackgroundChronic pain is a frequent cause of suffering and disability that negatively affects patients' quality of life. There is growing evidence that disparities in the treatment of pain occur because of differences in race.ObjectiveTo determine whether race plays a role in treatment decisions involving patients with chronic nonmalignant pain in a primary care population.Design, Setting, And ParticipantsA cross-sectional survey was administered to patients with chronic nonmalignant pain and their treating physicians at 12 academic medical centers. We enrolled 463 patients with nonmalignant pain persisting for more than 3 consecutive months and the primary care physicians participating in their care.ResultsAnalysis of the 397 black and white patients showed that blacks had significantly higher pain scores (6.7 on a scale of 0 to 10, 95% confidence interval (CI) 6.4 to 7.0) compared with whites (5.6, 95% CI 5.3 to 5.9); however, white patients were more likely to be taking opioid analgesics compared with blacks (45.7% vs 32.2%, P<.006). Even after controlling for potentially confounding variables, white patients were significantly more likely (odds ratio (OR) 2.67, 95% CI 1.71 to 4.15) to be taking opioid analgesics than black patients. There were no differences by race in the use of other treatment modalities such as physical therapy and nonsteroidal anti-inflammatories or in the use of specialty referral.ConclusionEqual treatment by race occurs in nonopioid-related therapies, but white patients are more likely than black patients to be treated with opioids. Further studies are needed to better explain this racial difference and define its effect on patient outcomes.

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