Gender-Associated Differences in Emergency Department Pain Management

• Published in: Annals of emergency medicine Vol. 26; no. 4; pp. 414 - 421
• Main Authors: Raftery, Kathleen A, Smith-Coggins, Rebecca, Chen ‡, Alice HM
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Mosby, Inc 01-10-1995; Elsevier
• Subjects: Adult; Analgesics; Analgesics - administration & dosage; Analgesics - classification; Back Pain - drug therapy; Biological and medical sciences; Cohort Studies; Emergency Service, Hospital; Female; Headache - drug therapy; Humans; Male; Medical sciences; Middle Aged; Neck; Neuropharmacology; Pain - drug therapy; Pharmacology. Drug treatments; Prospective Studies; Sex Factors; Human; Chemotherapy; Correlation; Pain; Treatment; Health staff; Sex; Patient; Perception; Comparative study
• ISSN: 0196-0644; 1097-6760
• DOI: 10.1016/S0196-0644(95)70107-9

Study objective: To determine whether patient or provider gender is associated with the number, type, and strength of medications received by emergency department patients with headache, neck pain, or back pain.
Design: Prospective cohort study.
Setting: Stanford University Hospital ED.
Participants: Patients 18 years and older who arrived at the ED with a chief complaint of headache, neck pain, or back pain between February 1, 1993, and September 30, 1993. Provider participants included medical students, interns, residents, nurse practitioners, and attending physicians.
Results: ED administration of analgesic versus no analgesic, strength of analgesic administered, and administration of multiple medications. The study group consisted of 190 patients, 110 of them female. The patients were evaluated by 84 providers, 60 of them male. According to the providers surveyed, female patients described more pain than did male patients (
P<.01) and were perceived by providers to experience more pain (
P =.03). Female patients received more medications (
P<.01) and were less likely to receive no medication (
P =.01). Female patients also received more potent analgesics (
P =.03). Linear and logistic regression analysis showed that patient perception of pain was the strongest predictor of the number and strength of medications given; patient gender was not a predictor.
Conclusion: Female patients with headache, neck pain, or back pain describe more pain and are perceived by providers to have more pain than male patients in the ED. Female patients also receive more medications and stronger analgesics. In this study, severity of patient pain rather than gender stereotyping appeared to correlate most with pain-management practices. [Raftery KA, Smith-Coggins R, Chen AHM: Gender-associated differences in emergency department pain management.
Ann Emerg Med October 1995;26:414-421.]