Disparities in pain management among patients with life-limiting illnesses in Latin America: a scoping review

Patients with life limiting illnesses frequently experience moderate to severe pain, and many do not receive adequate analgesic control. In Latin America, palliative care coverage remains limited and access to essential opioids is often restricted, contributing to important inequities in pain management. To map and characterize the available evidence on disparities in pain management among patients receiving palliative care in Latin America, with particular attention to structural, cultural, and educational determinants associated with unequal access and treatment. A scoping review was conducted in three indexed databases, PubMed, Scopus, and Web of Science, and supplemented by snowball searching. Articles published between January 2019 and June 2025 were screened, yielding 511 records in total. After removal of duplicates and application of predefined inclusion and exclusion criteria, 19 studies were included in a thematic synthesis. The evidence was organized into seven thematic categories: identified disparities; access to and availability of analgesic treatments; training of healthcare professionals; pain perception and patient and family satisfaction; clinical consequences associated with inadequate pain management; recommendations reported in the literature; and knowledge gaps and areas for future research. The findings suggest that disparities are associated with limited service distribution, regulatory and administrative barriers affecting opioid access, insufficient professional training, and sociocultural influences shaping pain perception and treatment decisions. The available evidence indicates that important inequities in pain management persist across Latin America. These disparities appear to be linked to structural constraints within health systems, uneven service distribution, regulatory challenges in opioid access, and gaps in professional education. Coordinated regional efforts, including strengthened training, improved access to essential medicines, and culturally responsive care strategies, may contribute to advancing more equitable palliative care delivery. Further context specific research is needed to inform policy development and implementation.