South Asians in US reluctant to seek medication for pain

South Asians living in the US are perceived to be more reluctant than other ethnicities to report pain and seek medications to treat the pain experienced near the end of their lives, researchers, including one of Indian-origin, have found.
When compared with other ethnicities, Asians are the most unsatisfied with the health care they received in the US, previous research has shown.
Among Asians, South Asians are a culturally similar group with origins in India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan and Maldives.
Now, researchers at the University of Missouri have found that health care providers perceive South Asians living in the US to be more reluctant than other ethnicities to report pain as well as seek medications to treat the pain they experience near the end of their lives.

"It is important to understand the cultural differences in medical practise 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 towards pain medicines," said co-author Karla Washington, assistant professor at the University of Missouri School of Medicine.
Researchers conducted focus groups and individual interviews with health care professionals who had experience providing care to seriously ill South Asian patients.

Health care providers told researchers that they perceived South Asian patients to have minimalistic attitudes toward medication in general.
"Doctors in South Asia do not routinely ask patients about their pain like they do here," said lead author Nidhi Khosla, assistant professor at the University of Missouri School of Health Professions.

"In South Asian culture, it is common for patients not to report their pain to avoid burdening others or being seen as weak," she said.
Khosla said in the US, health care providers typically ask patients to rank their pain from one to 10. Those pain scales are not used in South Asia, and people from that region may not be accustomed to discussing pain in that way.
In addition, Khosla said participants in the study showed that it is not uncommon for patients in South Asia to be given low-dose pain medications such as Tylenol after surgeries like Cesarean sections and gallbladder removals, which is a stark contrast to the narcotic medications typically prescribed here after similar procedures.

"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," she said.
Many South Asian patients and families in US spent a considerable amount of time living in South Asia, and their experiences with medicines there influence their attitudes about medicine in US, Washington said.
The study was published in the American Journal of Hospice and Palliative Medicine.