(P65) Effectiveness Perception and Preferred Route of Administration Pain Controlamong a Hispanic Population in Southern Puerto Rico

Objectives: To evaluate the preferred route of pain medication administration by the Puerto Rican population; To compare preferred route of pain medication administration with demographics, to identify possible trends such as educational level.

Background: It has been known that pain are amongst the most common causes of ED visits yearly and that it associated with decreased quality of life, medications dependence, and a great burden of cost to the healthcare system. Factors such as race, ethnicity, social and economic conditions influence illness and health seeking behavior. Multiple studies demonstrate equal effectiveness of different route of administration for pain management in the ED. Despite this, there is a popular belief among Hispanic population that pain medications administered via IM or IV route are more effective than PO counterpart which becomes obvious at some medico-patient interactions.

Methods: Data gathering was made through a survey conducted from October 2016 thru June 2017 on Hispanics 21 years or older visiting Sant Lukes Hospital, Ponce Puerto Rico. Participation in this survey was made voluntarily after consent was obtained and no compensation was given of any type. In the survey, participants were questioned about what they believed was the best option for pain control for a specific intensity of pain (mild, moderate, or severe pain). The acceptable responses for these questions were the PO, IM or IV, route. The questionnaire administered contained the following information provided in table 1. Responses from patients were tabulated, and quantitative descriptive data was analyzed. Percentages were obtained after data analysis and graphical representations were made.

Results: For mild pain, those who preferred PO route 91.7% had an educational level of college or more (Level 3), 77% had a high school level of education (Level 2) and 79% an elementary level of education (Level 1). For moderate pain, 32.3% (Level 3), 38.8% (Level 2) and 35% (Level 1). For severe pain, 6.4% (Level 3), 11.6% (Level 2) and 16.4% (Level 1).

Similarly, data was organized to evaluate for patients who preferred the parenteral route. Those who preferred IM route for mild, 5.8% (Level 3), 19.4% (Level 2) and 13% a (Level 1). For moderate, 49.1% (Level 3), 40.5% (Level 2) and 45.8% (Level 1). For severe, 42.6% (Level 3), 44.2% (Level 2) and 38.4% (Level 1).

Those who preferred IV route for mild 2.5% (Level 3), 3.4% (Level 2) and 7.3% (Level 1). For moderate, 18.7% (Level 3) 20.4% (Level 2) and 19.2% (Level1). For severe, 51% (Level 3), 44.2% (Level 2) and 45.8% (Level 1).

Overall, 78% of participants responded that the preferred route was IV, 15% responded IM and 7% selected the oral route as the preferred. Males in general selected IV route in 80% versus females who preferred this route by a 20%.

Conclusions: For the studied population, southern Puerto Ricans, the preferred route for pain medication administration is the intravenous over the oral route. Nonetheless, there were changes in preference depending on the type of pain that was questioned, with the trend increasing towards more invasive routes as pain level increased. Educational level may have an impact on the selection of medication route as well since we observed that in mild pain, the group of college educational level or more were more prone to select an oral route than other participants while this pattern was not present in the severe pain answers.

References (Optional): American Pain Society, (2022). Study Shows Chronic Pain Costs United States Up to $635 Billion. [online] Socialworktoday.com.

Brigham and Women's Hospital. (2021). One in five American adults experience chronic pain. ScienceDaily.

Im, E. O., Guevara, E., & Chee, W. (2007). The pain experience of Hispanic patients with cancer in the US. In Oncology Nursing Forum (Vol. 34, No. 4, p. 861). NIH Public Access.

Peacock, S., & Patel, S. (2008). Cultural influences on pain. Reviews in pain, 1(2), 6-9.

Pergolizzi J, Raffa R. The WHO Pain Ladder: Do We Need Another Step?. Practical Pain Management. 2014;14(1).

U.S. Department of Health and Human Services (2019). Pain Management Best Practices Inter-Agency Task Force Report: Updates, Gaps, Inconsistencies, and Recommendations. Retrieved from U. S. Department of Health and Human

Wyatt, R. (2013). Pain and ethnicity. AMA Journal of Ethics, 15(5), 449-454.

Zelaya, C. E., Dahlhamer, J. M., Lucas, J. W., & Connor, E. M. (2020). Chronic pain and high-impact chronic pain among US adults, 2019.

Funding (Optional): Ponce Health Sciences University