Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2004 Jul;96(7):928–932.

Racial differences in analgesic/anti-inflammatory medication use and perceptions of efficacy.

Kelli L Dominick 1, Hayden B Bosworth 1, Jason B Hsieh 1, Barry K Moser 1
PMCID: PMC2568439  PMID: 15253323

Abstract

BACKGROUND AND OBJECTIVE: Pharmacotherapy is a key component to osteoarthritis (OA) treatment. Research has shown important racial differences in pain thresholds and perceptions, but little is known about racial variations in responses to pain medications. The purpose of this study was to compare perceptions of efficacy of pain medications among African-American and Caucasian veterans with OA. METHODS: Participants (N = 202; 70% Caucasian, 30% African-American) were under care for OA within the VA healthcare system. Participants rated the helpfulness of current analgesic/anti-inflammatory medications (scale of 1--not at all helpful to 10--very helpful). RESULTS: The mean rating of medication helpfulness was 6.1. African-American participants reported significantly greater ratings of medication helpfulness than Caucasians (6.6 vs. 5.9), controlling for demographics, disease severity, total number of analgesic/anti-inflammatory medications being taken, and the class of the medication. CONCLUSION: African Americans had somewhat more favorable perceptions of medication helpfulness than Caucasians. However, overall ratings of medication helpfulness were relatively low. Further research is needed to examine whether modifiable factors (such as low dosing or patient nonadherence to prescription instructions) contribute to perceptions of poor efficacy.

Full text

PDF
928

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bates M. S., Edwards W. T., Anderson K. O. Ethnocultural influences on variation in chronic pain perception. Pain. 1993 Jan;52(1):101–112. doi: 10.1016/0304-3959(93)90120-E. [DOI] [PubMed] [Google Scholar]
  2. Bellamy N., Buchanan W. W., Goldsmith C. H., Campbell J., Stitt L. W. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988 Dec;15(12):1833–1840. [PubMed] [Google Scholar]
  3. Case John P., Baliunas Algis J., Block Joel A. Lack of efficacy of acetaminophen in treating symptomatic knee osteoarthritis: a randomized, double-blind, placebo-controlled comparison trial with diclofenac sodium. Arch Intern Med. 2003 Jan 27;163(2):169–178. doi: 10.1001/archinte.163.2.169. [DOI] [PubMed] [Google Scholar]
  4. Centers for Disease Control and Prevention (CDC) Prevalence of disabilities and associated health conditions among adults--United States, 1999. MMWR Morb Mortal Wkly Rep. 2001 Feb 23;50(7):120–125. [PubMed] [Google Scholar]
  5. Centers for Disease Control and Prevention (CDC) Prevalence of self-reported arthritis or chronic joint symptoms among adults--United States, 2001. MMWR Morb Mortal Wkly Rep. 2002 Oct 25;51(42):948–950. [PubMed] [Google Scholar]
  6. Day R., Morrison B., Luza A., Castaneda O., Strusberg A., Nahir M., Helgetveit K. B., Kress B., Daniels B., Bolognese J. A randomized trial of the efficacy and tolerability of the COX-2 inhibitor rofecoxib vs ibuprofen in patients with osteoarthritis. Rofecoxib/Ibuprofen Comparator Study Group. Arch Intern Med. 2000 Jun 26;160(12):1781–1787. doi: 10.1001/archinte.160.12.1781. [DOI] [PubMed] [Google Scholar]
  7. Detora L. M., Krupa D., Bolognese J., Sperling R. S., Ehrich E. W. Rofecoxib shows consistent efficacy in osteoarthritis clinical trials, regardless of specific patient demographic and disease factors. J Rheumatol. 2001 Nov;28(11):2494–2503. [PubMed] [Google Scholar]
  8. Edwards R. R., Doleys D. M., Fillingim R. B., Lowery D. Ethnic differences in pain tolerance: clinical implications in a chronic pain population. Psychosom Med. 2001 Mar-Apr;63(2):316–323. doi: 10.1097/00006842-200103000-00018. [DOI] [PubMed] [Google Scholar]
  9. Elders M. J. The increasing impact of arthritis on public health. J Rheumatol Suppl. 2000 Oct;60:6–8. [PubMed] [Google Scholar]
  10. Helmick C. G., Lawrence R. C., Pollard R. A., Lloyd E., Heyse S. P. Arthritis and other rheumatic conditions: who is affected now, who will be affected later? National Arthritis Data Workgroup. Arthritis Care Res. 1995 Dec;8(4):203–211. doi: 10.1002/art.1790080403. [DOI] [PubMed] [Google Scholar]
  11. Ibrahim S. A., Siminoff L. A., Burant C. J., Kwoh C. K. Variation in perceptions of treatment and self-care practices in elderly with osteoarthritis: a comparison between African American and white patients. Arthritis Rheum. 2001 Aug;45(4):340–345. doi: 10.1002/1529-0131(200108)45:4<340::AID-ART346>3.0.CO;2-5. [DOI] [PubMed] [Google Scholar]
  12. Ibrahim Said A., Burant Christopher J., Mercer Mary Beth, Siminoff Laura A., Kwoh C. Kent. Older patients' perceptions of quality of chronic knee or hip pain: differences by ethnicity and relationship to clinical variables. J Gerontol A Biol Sci Med Sci. 2003 May;58(5):M472–M477. doi: 10.1093/gerona/58.5.m472. [DOI] [PubMed] [Google Scholar]
  13. Lawrence R. C., Helmick C. G., Arnett F. C., Deyo R. A., Felson D. T., Giannini E. H., Heyse S. P., Hirsch R., Hochberg M. C., Hunder G. G. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998 May;41(5):778–799. doi: 10.1002/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-V. [DOI] [PubMed] [Google Scholar]
  14. McConnell S., Kolopack P., Davis A. M. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): a review of its utility and measurement properties. Arthritis Rheum. 2001 Oct;45(5):453–461. doi: 10.1002/1529-0131(200110)45:5<453::aid-art365>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
  15. Mintzes Barbara, Barer Morris L., Kravitz Richard L., Kazanjian Arminée, Bassett Ken, Lexchin Joel, Evans Robert G., Pan Richard, Marion Stephen A. Influence of direct to consumer pharmaceutical advertising and patients' requests on prescribing decisions: two site cross sectional survey. BMJ. 2002 Feb 2;324(7332):278–279. doi: 10.1136/bmj.324.7332.278. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum. 2000 Sep;43(9):1905–1915. doi: 10.1002/1529-0131(200009)43:9<1905::AID-ANR1>3.0.CO;2-P. [DOI] [PubMed] [Google Scholar]
  17. Roberts M. S., Owen S. G., Friesen W. T., Francis H., Flux W. Community Surveillance Study--perceived response of rheumatoid arthritis patients to NSAIDs. Agents Actions Suppl. 1985;17:41–54. doi: 10.1007/978-3-0348-7720-6_5. [DOI] [PubMed] [Google Scholar]
  18. Scholes D., Stergachis A., Penna P. M., Normand E. H., Hansten P. D. Nonsteroidal antiinflammatory drug discontinuation in patients with osteoarthritis. J Rheumatol. 1995 Apr;22(4):708–712. [PubMed] [Google Scholar]
  19. Walker A. M., Chan K. W., Yood R. A. Patterns of interchange in the dispensing of non-steroidal anti-inflammatory drugs. J Clin Epidemiol. 1992 Feb;45(2):187–195. doi: 10.1016/0895-4356(92)90015-f. [DOI] [PubMed] [Google Scholar]
  20. Yelin E., Callahan L. F. The economic cost and social and psychological impact of musculoskeletal conditions. National Arthritis Data Work Groups. Arthritis Rheum. 1995 Oct;38(10):1351–1362. doi: 10.1002/art.1780381002. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES