Association of Race, Ethnicity, and Language in the Administration of Multimodal Pain Medications in Elective Surgeries.

In 30 seconds

This secondary analysis of a randomized controlled trial examined whether race, ethnicity, and language preference were associated with postoperative administration of scheduled nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (APAP) among adults undergoing elective surgery at one academic center. Among 29,016 patients with one of these medications ordered, Asian race and non-English language preference (NELP) were associated with lower adjusted odds of NSAID administration (aOR 0.67 and 0.69, respectively). For APAP, adjusted odds were lower for Asian and African American patients and for those with NELP (aOR 0.70, 0.77, and 0.68, respectively).

Key findings

• Asian race (aOR 0.67, 95% CI [0.49, 0.91]) and NELP (aOR 0.69, 95% CI [0.49, 0.98]) were associated with lower adjusted odds of NSAID administration.
• Lower adjusted odds of APAP administration were associated with Asian race (aOR 0.70, 95% CI [0.59, 0.84]), African American race (aOR 0.77, 95% CI [0.61, 0.97]), and NELP (aOR 0.68, 95% CI [0.56, 0.82]).
• Nonadministration occurred in 4.0% of encounters with NSAIDs ordered and 4.2% of encounters with APAP ordered.

Why it matters

The findings identify differences in whether ordered postoperative nonopioid analgesics were administered across racial and language groups. Because these medications are part of multimodal pain management, disparities between ordering and administration may contribute to unequal delivery of postoperative care. The results also highlight administration—not only prescribing—as a relevant point for evaluating equity in hospital pain management.

What to keep in mind

This was a secondary analysis at a single academic center, and the observational comparisons do not establish that race or language preference caused differences in medication administration.