Knoebel Randall W, Starck Janet V, Miller Pringl
Department of Pharmacy, University of Chicago Medicine, Chicago, Illinois, USA.
Department of Palliative Care, University of Illinois Hospital, Chicago, Illinois, USA.
Health Equity. 2021 Sep 14;5(1):596-605. doi: 10.1089/heq.2020.0062. eCollection 2021.
Growing evidence suggests disparities in the prevalence, management, progression, and outcomes of chronic, nonmalignant pain-related conditions, especially for African American patients. The purpose of this review is to explore studied causative factors that influence the management of chronic pain among African Americans, including factors that result in disparate care that may contribute to unfavorable outcomes. This narrative review is based on available literature published on this topic published within the last 10 years. Assessment of chronic pain is multifaceted, often complicated by patient medical comorbidities and a complex set of biopsychosocial/spiritual/financial and legal determinants. These complexities are further exacerbated by a patient's race, by provider bias, and by structural barriers-all intersecting and culminating in disparate outcomes. A comprehensive analysis is needed to identify quality improvement interventions and to mitigate major barriers contributing to disparities in the management of chronic pain in the African American population.
越来越多的证据表明，慢性非恶性疼痛相关疾病在患病率、管理、进展和治疗结果方面存在差异，尤其是非裔美国患者。本综述的目的是探讨影响非裔美国人慢性疼痛管理的已研究致病因素，包括导致可能造成不良后果的差异护理的因素。本叙述性综述基于过去10年内发表的关于该主题的现有文献。慢性疼痛的评估是多方面的，常常因患者的合并症以及一系列复杂的生物心理社会/精神/财务和法律决定因素而变得复杂。患者的种族、医疗服务提供者的偏见和结构性障碍进一步加剧了这些复杂性，所有这些相互交织，最终导致不同的结果。需要进行全面分析，以确定质量改进干预措施，并减轻导致非裔美国人慢性疼痛管理差异的主要障碍。
