Pediatric Appendicitis Study: Black children less likely to get pain medication

Source: UPI Health
Previous studies have shown that black patients receive pain medication less often than whites for many conditions. None of those studies, researchers said, specifically has looked at children, and in relation to a condition known for being painful.
Just over half, 56.8 percent, of all children were found to be treated for appendicitis with any kind of painkiller at the emergency room, and only 41.3 percent received at least one dose of an opioid, according to the study.

Of black children who were treated, only 12.2 percent received an opioid — 20 percent less than white children.

“Although there is limited research that identifies subtle genetic variability in pain perception, the likelihood that physiological differences explain these phenomena is negligible,” researchers wrote in a commentary also published alongside the study, which is published in Pediatrics. “If there is no physiological explanation for differing treatment of the same phenomena, we are left with the notion that subtle biases, implicit and explicit, conscious and unconscious, influence the clinician’s judgment.”
Researchers reviewed data collected between 2003 and 2010 as part of the National Hospital Ambulatory Medical Care Survey on roughly 1 million children diagnosed with appendicitis during the time.
The researchers considered demographic, ethnic and pain level scores for the children, finding significant differences in the rates that black children receive pain medication when compared with white children — although they note that the overall number of children receiving is concerning as well.

Doctors often underestimate patient levels of pain, a bias they said can be exacerbated by age and race of patients, according to the data.

“Appendicitis pain is under-treated in pediatrics, and racial disparities with respect to analgesia administration exist,” the researchers wrote in the study. “Black children are less likely to receive any pain medication for moderate pain and less likely to receive opioids for severe pain, suggesting a different threshold for treatment.”

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