title: Pain treatment for older adults during prehospital emergency care: variations by patient gender and pain severity.
abstract: Older adults are less likely than younger adults to receive analgesic treatment during emergency department visits. Whether older adults are less likely to receive analgesics during protocolized prehospital care is unknown. We analyzed all ambulance transports in 2011 in the state of North Carolina and compared the administration of any analgesic or an opioid among older adults (aged 65 and older) versus adults aged 18 to 64. Complete data were available for 407,763 transports. Older men were less likely than younger men to receive an analgesic or an opioid regardless of pain severity. Among women with mild or moderate pain, older women were less likely than younger women to receive either form of pain treatment, but among women with more severe pain (pain score 8 or more), older women were more likely than younger women to receive pain treatment. Further, among women with mild or moderate pain, the oldest patients (aged 85 and older) were the least likely to receive any analgesic or an opioid, but among women with severe pain the oldest patients were the most likely to receive treatment. Further research is needed to assess the generalizability of this interaction between age, gender, and pain severity on pain treatment.
  
  
  CONCLUSIONS
  During prehospital care in North Carolina in 2011, older adults were generally less likely to receive pain treatment. However, older women with severe pain were more likely to receive treatment than younger women with severe pain. These results suggest an interaction between age, gender, and pain severity on pain treatment.
authors.affiliation: Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina, USA. tplattsm@med.unc.edu
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Platts-Mills
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Hunold
authors.forename: Mark A
authors.initials: MA
authors.lastname: Weaver
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Dickey
authors.forename: Antonio R
authors.initials: AR
authors.lastname: Fernandez
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
authors.forename: Charles B
authors.initials: CB
authors.lastname: Cairns
authors.forename: Samuel A
authors.initials: SA
authors.lastname: McLean
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010146:Pain / Q000503:physiopathology / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D012727:Sex Characteristics; D012737:Sex Factors; D055815:Young Adult
keywords: Pain; emergency treatment; geriatrics; prehospital