title: Is all pain is treated equally? A multicenter evaluation of acute pain care by age.
abstract: Pain is highly prevalent in health care settings; however, disparities continue to exist in pain care treatment. Few studies have investigated if differences exist based on patient-related characteristics associated with aging. The objective of this study was to determine if there are differences in acute pain care for older vs younger patients. This was a multicenter, retrospective, cross-sectional observation study of 5 emergency departments across the United States evaluating the 2 most commonly presenting pain conditions for older adults, abdominal and fracture pain. Multivariable adjusted hierarchical modeling was completed. A total of 6,948 visits were reviewed. Older (⩾ 65 years) and oldest (⩾ 85 years) were less likely to receive analgesics compared to younger patients (<65 years), yet older patients had greater reductions in final pain scores. When evaluating pain treatment and final pain scores, differences appeared to be based on type of pain. Older patients with abdominal pain were less likely to receive pain medications, while older patients with fracture were more likely to receive analgesics and opioids compared to younger patients. Differences in pain care for older patients appear to be driven by the type of presenting pain.
authors.affiliation: Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA Geriatric Research, Education and Clinical Center, James J. Peters VAMC, Bronx, NY, USA Medical University of South Carolina, Charleston, SC, USA Department of Emergency Medicine, Oregon Health & Science University, Portland, SC, USA Department of Emergency Medicine, George Washington University Medical Center, Washington, DC, USA Department of Emergency Medicine, University of Colorado, Aurora, CO, USA Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Ula
authors.initials: U
authors.lastname: Hwang
authors.forename: Laura K
authors.initials: LK
authors.lastname: Belland
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Handel
authors.forename: Kabir
authors.initials: K
authors.lastname: Yadav
authors.forename: Kennon
authors.initials: K
authors.lastname: Heard
authors.forename: Laura
authors.initials: L
authors.lastname: Rivera-Reyes
authors.forename: Amanda
authors.initials: A
authors.lastname: Eisenberg
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Noble
authors.forename: Sudha
authors.initials: S
authors.lastname: Mekala
authors.forename: Morgan
authors.initials: M
authors.lastname: Valley
authors.forename: Gary
authors.initials: G
authors.lastname: Winkel
authors.forename: Knox H
authors.initials: KH
authors.lastname: Todd
authors.forename: Sean R
authors.initials: SR
authors.lastname: Morrison
mesh_terms: D059787:Acute Pain / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000700:Analgesics / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D010147:Pain Measurement; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000700:Analgesics
keywords: Acute pain care; Emergency department; Geriatrics