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Abstract
The Pain Management Index (PMI) is used to assess pain medication adequacy in black
and white chronic pain patients (18-50 years) at referral to tertiary pain care. Using
WHO guidelines for pain treatment, PMI was calculated from pain severity and drug
analgesic potency. From 183 patients recruited, 128 provided treatment information
for analyses (53% white, 60% female). Most (51.6%) had adequate PMI. Blacks were prescribed
fewer pain medications (P = .03); fewer women had adequate medication strength (P
= .04). In hierarchical regression, PMI was predicted at entry by female gender, lower
MPI, higher affective MPQ, and a gender X age interaction. Younger men experienced
better pain management, reducing toward the PMI level of women by age 50. In the final
block, black race, being married, affective pain, and gender X age were associated
with higher PMI, female gender and being employed were associated with lower PMI.
Women, particularly younger women, were at higher risk for inadequate pain management
in a primary care environment. These results support variability in chronic pain care
and the need for research focusing on whether these disparities persist with specialized
pain care.