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. 2015 Jan;16(1):99-111.
doi: 10.1111/pme.12591. Epub 2014 Oct 23.

The influence of health care professional characteristics on pain management decisions

Emily J Bartley  1 , Jeff Boissoneault, Alison M Vargovich, Laura D Wandner, Adam T Hirsh, Benjamin C Lok, Marc W Heft, Michael E Robinson
Affiliations

The influence of health care professional characteristics on pain management decisions

Emily J Bartley et al. Pain Med. 2015 Jan.

Abstract

Objective: Evidence suggests that patient characteristics such as sex, race, and age influence the pain management decisions of health care providers. Although this signifies that patient demographics may be important determinants of health care decisions, pain-related care also may be impacted by the personal characteristics of the health care practitioner. However, the extent to which health care provider characteristics affect pain management decisions is unclear, underscoring the need for further research in this area.

Methods: A total of 154 health care providers (77 physicians, 77 dentists) viewed video vignettes of virtual human (VH) patients varying in sex, race, and age. Practitioners provided computerized ratings of VH patients' pain intensity and unpleasantness, and also reported their willingness to prescribe non-opioid and opioid analgesics for each patient. Practitioner sex, race, age, and duration of professional experience were included as predictors to determine their impact on pain management decisions.

Results: When assessing and treating pain, practitioner sex, race, age, and duration of experience were all significantly associated with pain management decisions. Further, the role of these characteristics differed across VH patient sex, race, and age.

Conclusions: These findings suggest that pain assessment and treatment decisions may be impacted by the health care providers' demographic characteristics, effects which may contribute to pain management disparities. Future research is warranted to determine whether findings replicate in other health care disciplines and medical conditions, and identify other practitioner characteristics (e.g., culture) that may affect pain management decisions.

Keywords: Age; Experience; Gender; Pain Management Disparities; Pain Treatment; Provider Characteristics; Race.

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Figures

Figure 1
Figure 1
Still-frame of virtual human cues. Male sex, white race, older age (A); female sex, black race, younger age (B). [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
Figure 2
Figure 2
Ratings of pain assessment. (A) Caucasian practitioners rated pain intensity higher in younger virtual human (VH) adults, while non-Caucasian providers rated pain intensity higher in older VH adults. (B) Caucasian practitioners rated pain unpleasantness higher in younger VH adults. (C) Younger and middle-aged practitioners rated VH females as having higher pain unpleasantness.
Figure 3
Figure 3
Ratings of pain treatment. (A) Female practitioners were more likely to recommend treatment with non-opioid analgesics; however, this effect was stronger for black virtual human (VH) patients. (B) Caucasian practitioners were more willing to prescribe opioid analgesics to younger VH adults. (C) Younger practitioners were more willing to prescribe opioid analgesics to female VH patients. (D) Practitioners with moderate and high years of professional experience were more willing to prescribe opioid analgesics to black VH patients. Exp = experience.
See this image and copyright information in PMC

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