A Systematic Review of Racial Disparities in Emergency Department Pain Evaluation and Treatment in the United States

Abstract

Background: Providers working in emergency departments (ED) must balance the need to relieve patients’ pain with the dangers of overprescribing opioids. Lack of standardization of pain evaluation and treatment may contribute to inequities in the management of pain in emergency departments. Evaluating differences in how different populations receive care in emergency departments can help to identify problems and areas where improvements need to occur. Purpose: The purpose of this literature review is to evaluate what current research states about the prevalence and causes of racial disparities in pain evaluation and treatment in United States emergency departments and determine what gaps in knowledge are a priority for future research. Methods: A literature review was conducted using the Augsburg University library search engine and PubMed. Exclusion criteria were any articles published prior to 2020, any articles discussing hospitals outside the United States, systematic reviews, and articles which did not discuss racial disparities in pain evaluation or treatment. Conclusions: Many patient populations, such as Black, Hispanic and Native American patients, experience lowered rates of opioid prescription for pain in emergency departments across the United States. Racial disparities in the evaluation and treatment of chest pain are also widespread. Pediatric patients presenting with pain also experience racial disparities in rates of opioid prescription and imaging studies ordered. More research needs to be done into the efficacy of trainings and policy implementation to reduce these inequities