title: No gender-related bias in acute musculoskeletal pain management in the emergency department.
abstract: BACKGROUND
  Patients' gender remains a contributor for bias in pain management. Implementation of standardised analgesic protocols has been shown to minimise bias in analgesic care. The purpose of this study was to assess whether gender-related bias in pain management exists in our emergency department (ED) setting, where a standardised pain management protocol based on patients' subjective pain rating is routinely used.
  
  
  METHODS
  Pain management measures (ie, analgesia administration, waiting time for analgesia, pain relief and patients' satisfaction) were prospectively assessed in 328 patients (150 women and 178 men, average age 36±18 years) who were treated in our ED for acute musculoskeletal pain.
  
  
  RESULTS
  Patients' subjective pain rating on arrival were similar for men and women (59±24 mm vs 61±26 mm, respectively; p=0.47). Interestingly, physicians using the same scale assessed the women's pain level to be higher than that of men (75±25 mm vs 63±22 mm, respectively; p<0.001) and higher than that of women's subjective pain rating (75±25 mm vs 61±26 mm respectively; p<0.001). Nevertheless, the rates of analgesia administration, waiting time for analgesia, pain relief and patient satisfaction were similar for both genders. Physicians' own gender did not affect analgesic care.
  
  
  CONCLUSIONS
  Our findings suggest that a standardised pain management protocol based on patients' subjective pain rating may reduce gender-related bias in acute musculoskeletal pain management.
authors.affiliation: Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ofir
authors.initials: O
authors.lastname: Uri
authors.affiliation: Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Elias
authors.affiliation: Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Behrbalk
authors.affiliation: Emergency Medicine, Tel Aviv Sourasky Medical Centre, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Pinchas
authors.initials: P
authors.lastname: Halpern
mesh_terms: D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods; D000700:Analgesics / Q000627:therapeutic use*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000188:drug therapy*; D059408:Pain Management / Q000706:statistics & numerical data*; D010147:Pain Measurement / Q000379:methods; D017060:Patient Satisfaction; D011446:Prospective Studies; D012737:Sex Factors; D063507:Sexism; D013997:Time Factors; D055815:Young Adult
chemical_list: D000700:Analgesics