No gender-related bias in acute musculoskeletal pain management in the emergency department

INTRODUCTION: Patients' gender remains a contributor for bias in pain management. Implementation of standardised analgesic protocols has been shown to minimise bias in analgesic care. The purpose of this study was to assess whether gender-related bias in pain management exists in our emergency department (ED) setting, where a standardised pain management protocol based on patients' subjective pain rating is routinely used. METHODS: Pain management measures (ie, analgesia administration, waiting time for analgesia, pain relief and patients' satisfaction) were prospectively assessed in 328 patients (150 women and 178 men, average age 36±18 years) who were treated in our ED for acute musculoskeletal pain. RESULTS: Patients' subjective pain rating on arrival were similar for men and women (59±24 mm vs 61±26 mm, respectively; p=0.47). Interestingly, physicians using the same scale assessed the women's pain level to be higher than that of men (75±25 mm vs 63±22 mm, respectively; p<0.001) and higher than that of women's subjective pain rating (75±25 mm vs 61±26 mm respectively; p<0.001). Nevertheless, the rates of analgesia administration, waiting time for analgesia, pain relief and patient satisfaction were similar for both genders. Physicians' own gender did not affect analgesic care. CONCLUSIONS: Our findings suggest that a standardised pain management protocol based on patients' subjective pain rating may reduce gender-related bias in acute musculoskeletal pain management.