Impact of physician and patient gender on pain management in the emergency department - A multicenter study

Basmah Safdar, Alan Heins, Peter Homel, James Miner, Martha Neighbor, Paul Desandre, Knox H. Todd, Joel Bartfield, James Ducharme, Tim Mader, Paul DeSandre, Barbara Lock, James Miner, Andrew Chang, Leslie Zun, Paula Tanabe, Christian Vaillancourt, Martha Neighbor, Robert Cox, Jacques Lee & 4 others Thomas Terndrup, Cameron Crandall, Alan Heins, David Fosnocht

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)364-372
Number of pages9
JournalPain Medicine
Volume10
Issue number2
DOIs
StatePublished - 2009

Fingerprint

Pain Management
Multicenter Studies
Hospital Emergency Service
Odds Ratio
Physicians
Pain
Analgesics
Opioid Analgesics
Logistic Models
Pain Measurement
Observational Studies
Outcome Assessment (Health Care)

Keywords

  • Analgesics
  • Emergencies
  • Emergency service, Hospital
  • Pain management
  • Patient gender
  • Physician gender

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine
  • Medicine(all)

Cite this

Safdar, B., Heins, A., Homel, P., Miner, J., Neighbor, M., Desandre, P., ... Fosnocht, D. (2009). Impact of physician and patient gender on pain management in the emergency department - A multicenter study. Pain Medicine, 10(2), 364-372. https://doi.org/10.1111/j.1526-4637.2008.00524.x

Impact of physician and patient gender on pain management in the emergency department - A multicenter study. / Safdar, Basmah; Heins, Alan; Homel, Peter; Miner, James; Neighbor, Martha; Desandre, Paul; Todd, Knox H.; Bartfield, Joel; Ducharme, James; Mader, Tim; DeSandre, Paul; Lock, Barbara; Miner, James; Chang, Andrew; Zun, Leslie; Tanabe, Paula; Vaillancourt, Christian; Neighbor, Martha; Cox, Robert; Lee, Jacques; Terndrup, Thomas; Crandall, Cameron; Heins, Alan; Fosnocht, David.

In: Pain Medicine, Vol. 10, No. 2, 2009, p. 364-372.

Research output: Contribution to journalArticle

Safdar, B, Heins, A, Homel, P, Miner, J, Neighbor, M, Desandre, P, Todd, KH, Bartfield, J, Ducharme, J, Mader, T, DeSandre, P, Lock, B, Miner, J, Chang, A, Zun, L, Tanabe, P, Vaillancourt, C, Neighbor, M, Cox, R, Lee, J, Terndrup, T, Crandall, C, Heins, A & Fosnocht, D 2009, 'Impact of physician and patient gender on pain management in the emergency department - A multicenter study', Pain Medicine, vol. 10, no. 2, pp. 364-372. https://doi.org/10.1111/j.1526-4637.2008.00524.x
Safdar, Basmah ; Heins, Alan ; Homel, Peter ; Miner, James ; Neighbor, Martha ; Desandre, Paul ; Todd, Knox H. ; Bartfield, Joel ; Ducharme, James ; Mader, Tim ; DeSandre, Paul ; Lock, Barbara ; Miner, James ; Chang, Andrew ; Zun, Leslie ; Tanabe, Paula ; Vaillancourt, Christian ; Neighbor, Martha ; Cox, Robert ; Lee, Jacques ; Terndrup, Thomas ; Crandall, Cameron ; Heins, Alan ; Fosnocht, David. / Impact of physician and patient gender on pain management in the emergency department - A multicenter study. In: Pain Medicine. 2009 ; Vol. 10, No. 2. pp. 364-372.
@article{1d880d75f2ca4959b1fed4cfb96f9b19,
title = "Impact of physician and patient gender on pain management in the emergency department - A multicenter study",
abstract = "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.",
keywords = "Analgesics, Emergencies, Emergency service, Hospital, Pain management, Patient gender, Physician gender",
author = "Basmah Safdar and Alan Heins and Peter Homel and James Miner and Martha Neighbor and Paul Desandre and Todd, {Knox H.} and Joel Bartfield and James Ducharme and Tim Mader and Paul DeSandre and Barbara Lock and James Miner and Andrew Chang and Leslie Zun and Paula Tanabe and Christian Vaillancourt and Martha Neighbor and Robert Cox and Jacques Lee and Thomas Terndrup and Cameron Crandall and Alan Heins and David Fosnocht",
year = "2009",
doi = "10.1111/j.1526-4637.2008.00524.x",
language = "English (US)",
volume = "10",
pages = "364--372",
journal = "Pain Medicine",
issn = "1526-2375",
publisher = "Wiley-Blackwell",
number = "2",

}

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 - Miner, James

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

UR - http://www.scopus.com/inward/record.url?scp=62349141923&partnerID=8YFLogxK

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

VL - 10

SP - 364

EP - 372

JO - Pain Medicine

JF - Pain Medicine

SN - 1526-2375

IS - 2

ER -