View in Browser

Sign up for Reuters newsletters

By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! Today we feature two studies that again shine a harsh light on racial disparities in U.S. healthcare. The first found that Black patients and other minorities are far less likely to get pain medications from ambulance crews. A second found the risk of death following surgery to be significantly higher among non-White Americans. On a more upbeat note, we cover a study showing that an inexpensive drug once used to treat depression can help patients suffering from irritable bowel syndrome.

In breaking news, see these stories from our Reuters journalists: Hundreds killed in Israeli air strike on Gaza Hospital; Gaza aid arrives at border crossing but no plan for delivery yet; U.S. removes coverage curb on PET scans for Alzheimer’s patients; four-day work week boosts Spanish workers’ health; and U.S. veterans targeted in scam following earplug litigation.

In a large U.S. study of seriously injured patients transported by ambulances, Blacks were  much less likely than whites to receive appropriate pain medications. REUTERS/Jonathan Ernst

Seriously injured patients from racial and ethnic minority groups do not have their pain treated equitably by U.S. ambulance services, researchers have found.

Black patients were nearly as likely as white patients to report pain levels of 7 or higher on a standard scale of 1-10, yet were “much less likely” to receive medication for it, researchers said. Among those with a high pain score, Black patients were 47% less likely to receive opioids or ketamine from the EMS team.

Patients from other racial and ethnic groups were between 7% and 20% less likely than white patients to receive pain medication, the researchers also found.

In the study of more than 4.7 million patients with acute traumatic injuries managed by emergency medical services (EMS) between 2019 and 2021, minority patients were significantly less likely to be asked by EMS workers to rate their pain, according to a report published on Tuesday in JAMA Network Open. That was particularly the case with Native American and Alaskan Native patients, researchers said.

They were able to conduct the study because the U.S. National Emergency Medical Services Information System (NEMSIS), which collects EMS data nationwide, recently added a “pain score” field to its database.

However, they noted, nearly 16% of entries during the study period lacked information about race and ethnicity.

National and state regulations to mandate inclusion of this information by EMS teams would aid efforts to identify causes for the racial and ethnic disparities and improve pre-hospital patient care, the researchers said.

The risk of death after surgery in the United States is much higher for nonwhite patients than for white patients, researchers reported on Sunday at a large meeting of anesthesiologists.

Their study of more than 1.5 million surgeries performed on hospitalized adults at 7,740 U.S. hospitals showed that between 2000 and 2020, rates of surgery-related deaths declined for patients of all races and ethnicities but remained higher for Blacks and Hispanics than for whites.

Disparity gaps remained constant over time, the researchers found. After accounting for individual risk factors, Black patients were 42% more likely than white patients to die within 30 days of surgery, and Hispanic patients were 21% more likely to die, they reported in San Francisco at Anesthesiology 2023.

Post-surgery death rates were particularly high for Black patients in the northeast, from Maine to New Jersey, and for Hispanic patients in western states, from Wyoming to Hawaii and Alaska.

“It’s important to note that disparities in these regions do not necessarily mean that the surgical care is inferior. It may reflect overall population health and socioeconomic conditions,” said study leader Dr. Christian Mpody from The Ohio State University College of Medicine in Columbus. “Our team is currently investigating the underlying causes of these regional variations.”

A cheap and widely available prescription drug can improve symptoms of irritable bowel syndrome (IBS), according to new research.

Data from a trial presented on Monday at the United European Gastroenterology meeting in Copenhagen showed that patients taking amitriptyline were almost twice as likely to report an overall improvement in symptoms as those taking a placebo.

IBS affects 5% to 10% of people worldwide, causing abdominal pain and changes to bowel movements that fluctuate in severity over time. There are treatments but no known cure.

“Patients with IBS can have impairments in quality of life of a similar magnitude to individuals with other chronic gastrointestinal conditions, such as Crohn’s disease, and worse quality of life than patients with other chronic non-gastrointestinal diseases,” researchers said in a report of the study published in The Lancet.

The 436 patients in the study had suffered with moderate to severe symptoms and an average duration of IBS of 10 years. They received either amitriptyline or a placebo along with instructions for increasing or decreasing the number of tablets they were taking depending on their symptoms.

Six months later, those taking amitriptyline reported a bigger improvement in their symptom scores and were almost twice as likely as those taking a placebo to report improvements in IBS symptoms.

Amitriptyline was originally used at high doses to treat depression but is rarely used for this purpose now because better treatments are available.

In the current study, anxiety or depression scores were not affected by the drug, suggesting that the beneficial effects of the medication took place in the gut, according to the researchers.

Doctors already prescribe the drug for chronic nerve and back pain, but they “haven’t often prescribed amitriptyline for IBS as the research evidence was uncertain,” study co-leader Hazel Everitt of the University of Southampton said in a statement. “Our new research provides good evidence of benefit.”

This newsletter was edited by Bill Berkrot. Additional reporting by Shawana Alleyne-Morris.

Sponsors are not involved in the creation of newsletters or other Reuters news content.

Reuters Health Rounds is sent twice a week. Think your friend or colleague should know about us? Forward this newsletter to them. They can also sign up here.

Want to stop receiving this newsletter? Unsubscribe here.
To manage which newsletters you’re signed up for, click here.

Reuters Terms & Conditions and Privacy Statement