Breakout session: Gender and ethnic disparities in pain management.

BACKGROUND: Pain management is a complex and evolving topic. Treatment of pain must account for biochemical as well as social and economic factors. Sex, gender, and ethnic differences exist in the pathophysiology, diagnosis, and provision of care for patients with pain. QUESTIONS/PURPOSES: We sought to identify the sex, gender, and ethnic disparities leading to care inequalities with respect to pain management. Our purposes were to (1) clarify the state of where we are now, (2) outline ways to approach where we need to go, and (3) generate solutions for how we get there. WHERE ARE WE NOW?: Studies are beginning to uncover the biologic mechanisms underlying the pain response in sex, gender, and ethnic subgroups. Patient characteristics that increase the risk of postoperative pain are being identified. WHERE DO WE NEED TO GO?: Much work needs to be done in medical education with respect to sex, gender, and ethnic disparities in pain management. Research efforts must better describe differences in physiology of pain, incidence of pain, coping strategies, patient-doctor relationships, and gender/ethnic-specific modes of care for the patient with pain. HOW DO WE GET THERE?: Future work will involve combined efforts with pain/anesthesia specialty societies, developing a disparities and pain management curriculum for medical providers, endorsing health literacy, performing high-quality Level I/II research, and exploring systems processes in pain management in the acute hospital setting.