Inequity in outcomes from New Zealand chronic pain services

Making Education Easy

Authors:

Lewis GN et al.

July 28, 2021

Summary:

An analysis of 4876 patients who received treatment for chronic pain in New Zealand between 2014 and 2019 has highlighted ethnic disparities in outcomes. Clinical questionnaires used for patient assessment included the Brief Pain Inventory (BPI), the Depression, Anxiety and Stress Scale – 21 items (DASS-21), the Pain Catastrophising Scale (PCS); and the Pain Self-Efficacy Questionnaire (PSEQ). At treatment end, Pasifika patients had significantly poorer scores compared with Europeans on several DASS-21 and PCS subscales, while there were no differences between European, Māori and Asian ethnicities. At 3- to 6-month follow-up, Māori patients had poorer scores on almost all outcome measures compared with European patients, while Asian and Pasifika patients had poorer scores on several of the DASS-21 and PCS subscales. The authors suggest that the cultural safety of chronic pain clinics should be reviewed regarding both assessment and management procedures.

Comment:

Having identified inequities in outcomes following treatment in a chronic pain service, some would spend more time trying to better understand the potential patient, service and system factors. It’s refreshing to see that the authors have jumped right in to focus on what they know and can address – the efficacy, quality and cultural safety of the service itself.

Reference: N Z Med J. 2021;134(1533):11-20

Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.