<p></p><p> Compared
to White and high socioeconomic (SES) patients, Black and low SES patients are
less likely to receive adequate pain care, including receiving fewer analgesic
medications. Providers may, inadvertently or not, contribute to these
disparities in pain care via biased decision-making. Prior work suggests there
is a complex relationship in which race and SES uniquely and interactively affect
providers’ clinical decisions, but few studies have examined the influence of
patient race and SES simultaneously on providers’ pain-related decisions.
Furthermore, previous studies suggest that providers’ attitudes about race and
SES influence their clinical decisions. The present study examined the
influence of patient race and SES and providers’ implicit and explicit
attitudes about race and SES on providers' pain-related decisions. Four hundred
and seven medical residents and fellows made pain assessment (interference and
distress) and treatment (opioids, opioid contracts, and workplace
accommodations) decisions for 12 computer-simulated patients with chronic back
pain that varied by race (Black/White) and SES (low/high). Subjects completed
Implicit Association Tests to assess implicit attitudes and feeling
thermometers to assess explicit attitudes about race and SES. Repeated measures
ANOVAs indicated that patient race and/or SES had main effects on all
pain-related decisions and had interaction effects on providers’ ratings for
interference, distress, and workplace accommodations. Providers’ implicit
attitudes about race and explicit attitudes about race and SES predicted their
pain-related decisions, but these effects were not consistent across all
decisions. The current study highlights the need to examine the effects of
patient race and SES together, along with providers’ implicit and explicit attitudes,
in the context of pain care. Results inform future work that can lead to the
development of evidence-based interventions to reduce disparities in pain care.</p><br><p></p>
| Identifer | oai:union.ndltd.org:purdue.edu/oai:figshare.com:article/7977581 |
| Date | 10 June 2019 |
| Creators | Tracy Marie Anastas (6576719) |
| Source Sets | Purdue University |
| Detected Language | English |
| Type | Text, Thesis |
| Rights | CC BY 4.0 |
| Relation | https://figshare.com/articles/The_Influence_of_Patient_Race_and_Socioeconomic_Status_on_Providers_Assessment_and_Treatment_Recommendations_for_Chronic_Pain/7977581 |
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