Treating Pain in South Asian Populations in the US

South Asians in the United States are more reluctant to seek pain medication compared to other ethnicities, according to findings published in the American Journal of Hospice & Palliative Medicine.

Researchers from the University of Missouri Columbia analyzed interviews and focus group interviews of 57 healthcare providers to South Asian patients in order to evaluate the reasons for this reluctance. The team was quick to point out that there is a lack of pain management research among seriously ill South Asian patients and this study would aid culturally responsible end of life care.

Additionally, prior research found that South Asians patients were the most unsatisfied with healthcare received in the United States when compared to other ethnicities, mostly due to the clashing practices of the United States compared to the healthcare the patients may receive overseas.

“In future years, health care workers in the US will provide care to an increasingly diverse group of patients that will include growing numbers of South Asians,” study co author Karla Washington, PhD, assistant professor in the Department of Family and Community Medicine at the MU School of Medicine explained in a press release. “It is important to understand the cultural differences in medical practice in South Asia, such as their low use of pain medication, so that health care providers here can better understand the factors that influence their patients’ attitudes toward pain medicines.”

The researchers found that doctors in South Asia do not routinely ask patients about their pain, nor are patients likely to report pain. Patients do not want to burden others or be seen as weak, the researchers added in the statement. While in the US, a doctor may ask a patient to rate their pain on a scale from 1 to 10, no system like that is present in South Asia. The patients may not be accustomed to describing their pain in those terms.

Other issues surrounding less frequent reports of pain include the generalized minimalistic attitude toward medication in general that exists in South Asia and the likelihood that patients have limited access to pain medication overseas, the authors continued.

In the focus group discussions, the researchers learned that low dose pain medications like Tylenol are often given in South Asia after procedures like Cesarean sections and gall bladder removals. This is in abundant contrast to practices in the US, which typically sees narcotics prescribed after similar operations.

“When treating patients from this region, doctors should consider asking about their unique values and preferences,” Washington concluded. “Chaplains and social workers also can help facilitate communication between patients and doctors about medications and alternative treatment options that could be more aligned with patients’ spiritual and cultural needs.”