Inequity in outcomes from New Zealand chronic pain services

To evaluate outcomes from chronic pain services in New Zealand based on patient ethnicity.

Clinical and demographic data were obtained from 4,876 patients from the Electronic Persistent Pain Outcomes Collaboration (ePPOC) database, a database of standardised assessments from chronic pain services across New Zealand. Clinical questionnaires included the Brief Pain Inventory (BPI); Depression, Anxiety and Stress Scale - 21 items (DASS-21); Pain Catastrophising Scale (PCS); and the Pain Self-Efficacy Questionnaire (PSEQ). Regression analysis (adjusting for age, body mass index, and baseline values) was used to determine whether patient ethnicity was associated with clinical questionnaire data at treatment end and at 3-6-month follow-up.

At treatment end, there were significantly poorer scores for Pacific people compared to Europeans for several of the DASS-21 and PCS subscales, while there were no differences between European and Māori and Asian ethnicities. At follow-up, almost all outcome measures were poorer for Māori compared to European, and several of the DASS-21 and PCS subscales were poorer for Asian and Pacific people compared to Europeans.

There are ethnic inequalities in the efficacy of treatment for chronic pain services in New Zealand. The cultural safety of the chronic pain clinics should be reviewed regarding both assessment and management procedures.