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种族和民族差异是否导致疼痛治疗不足?是否有解决方案?

Do racial and ethnic disparities lead to the undertreatment of pain? Are there solutions?

机构信息

Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

出版信息

Curr Opin Anaesthesiol. 2022 Jun 1;35(3):273-277. doi: 10.1097/ACO.0000000000001139.

Abstract

PURPOSE OF REVIEW

The current review aims to empower anesthesiologists, specifically pain medicine specialists, to become leaders in ensuring equitable care.

RECENT FINDINGS

Disparities in both acute and chronic pain medicine lead to increased morbidity for patients of color. Gaps in care include misdiagnosis or under diagnosis of chronic pain disease states, undertreatment of sickle cell disease and other conditions that are common in minorities, under prescription of opioids, and lack of access to novel opioid sparing treatments. While the causes of these disparities are multifactorial, care team implicit bias and lack of representation are two of the major factors. Solutions are challenging, but the authors suggest an inside out solution. We believe that this practice will have far-reaching downstream effects, including improving diversity in our field and quality of care for our patients.

SUMMARY

The current article reviews disparities in both acute and chronic pain treatment for underrepresented racial and ethnic minorities in the United States. The authors examine whether implicit bias and lack of representation are a contributing factor for these disparities. Lastly, we will discuss potential solutions.

摘要

目的综述

本综述旨在使麻醉师(尤其是疼痛医学专家)能够成为确保公平医疗的领导者。

最新发现

急性和慢性疼痛医学中的差异导致有色人种患者的发病率增加。护理中的差距包括对慢性疼痛疾病状态的误诊或漏诊、镰状细胞病和少数民族常见疾病的治疗不足、阿片类药物处方不足以及缺乏新型阿片类药物节约治疗。尽管这些差异的原因是多方面的,但护理团队的内隐偏见和代表性不足是两个主要因素。解决方案具有挑战性,但作者提出了一种由内而外的解决方案。我们相信,这种做法将产生深远的下游影响,包括提高我们领域的多样性和患者的护理质量。

总结

本文综述了美国代表性不足的种族和少数民族在急性和慢性疼痛治疗方面的差异。作者检查了内隐偏见和代表性不足是否是造成这些差异的一个因素。最后,我们将讨论潜在的解决方案。

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