914 - Disparities in the Management of Spine Pain

Objectives: To summarize the current literature on disparities in the management of spine pain. To identify methods for improvement of care in spine pain patients who are from underrepresented and marginalized groups.

Design: We focused on chronic pain studies in adults conducted in the United States and published between January 2000 and June 2020. Studies included cross-sectional, longitudinal, and interventional designs that explored racial or ethnic differences in the treatment of pain or pain-related outcomes.

Results: Review of the current literature reveals racial and ethnic disparities in pain care across clinical settings, with marginalized minorities receiving less quality pain care than non-Hispanic whites. Studies found that factors that contribute to disparities include management and long-term monitoring of opioid misuse among Black/minority patients, pain severity, imaging disparities, surgical management, perceived discrimination amongst healthcare professionals, and patients’ psychosocial and sociodemographic profile all played a role in disparities in chronic spine pain, patient outcomes, and quality of life. Continuing medical education certified activities focused on disparities in pain management, addressing language barriers with interpreting services and Electronic Health Toolkits, and advocating for systems-level changes are promising interventions.

Conclusions: Disparities exist in the management of chronic spine pain. Identifying causes of racial and ethnic disparities in the evaluation and treatment of pain in adults will help provide insight to clinicians and guide the development and implementation of effective interventions to improve health outcomes for patients. Additional work is needed to better understand why disparities exist and which contributing factors are the most influential.