Impact of Race/Ethnicity on Pain Management Outcomes in a Community-Based Teaching Hospital Following Inpatient Palliative Care Consultation

Objective: To examine race/ethnicity differences in pain management outcomes following inpatient palliative care consultation.

Methods: We conducted a retrospective study based on data from a community-based teaching hospital in Fresno, CA, USA, from April 2014 to July 2015. One hundred sixty-one patients with life-limiting diagnoses and palliative care pain-related consultations were included. The patients were categorized into four racial groups: Caucasians, African-Americans, Hispanics, and Asians/Others. Demographics and baseline pain scores using the Visual Analogue Scale (VAS) were obtained. The outcome measures included the length of stay, time to consult, and pain scores at admission, 24 hours before the consultation, 24-48 hours after consultation, and at discharge.

Results: The initial median pain scores were not significantly different between the groups, however, the Asians had slightly higher pain scores compared to the other groups. African-Americans, Caucasians, and Hispanics had significant differences in pain outcomes after consultation compared to 24 hours prior to consultation (p = 0.01, p < 0.01 and p = 0.02, respectively). Caucasians and Hispanics had significant differences in pain outcomes after palliative consultation compared to initial admission assessment (p < 0.01). The differences between discharge and admission pain scores were significant only for Asians, Caucasians, and Hispanics (p = 0.04, p < 0.01, p < 0.01, respectively) but not African-Americans. There were no significant pain score differences across the racial groups following consultations.

Conclusion: There were no significant differences in pain reduction amongst the racial groups, suggesting that pain can adequately be managed in individual racial groups after inpatient palliative care consultations.