Researchers from Oregon Health and Science University Report New Studies and Findings in the Area of Anesthesiology (Education Program Regarding Labor Epidurals Increases Utilization by Hispanic Medicaid Beneficiaries)

2019 OCT 31 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Researchers detail new data in Pain Medicine - Anesthesiology. According to news reporting originating in Portland, Oregon, by NewsRx journalists, research stated, “Hispanic women choose epidural labor analgesia less commonly than non-Hispanic women. This may represent a healthcare disparity related to a language barrier and inadequate opportunities for labor analgesia education.”

The news reporters obtained a quote from the research from Oregon Health and Science University, “It was hypothesized that a language-concordant, educational program regarding labor epidurals would improve epidural utilization in two independent cohorts of Hispanic and non-Hispanic women. A randomized controlled trial, blinded to anesthesia, nursing, and obstetric providers, was completed at an academic hospital (February 2015 to February 2017). Two cohorts of Medicaid beneficiaries of Hispanic (English- and/or Spanish-speaking) and non-Hispanic ethnicity were enrolled concurrently. The patients were randomized to routine care alone or routine care and an additional educational program comprised of three components: a video show, corresponding pamphlet, and in-person counseling. The primary endpoint was use of epidural labor analgesia. The secondary endpoint was change in response before and after delivery on common misconceptions based on a 12-point epidural questionnaire. Hispanic women randomized to the intervention group were 33% more likely to choose epidural analgesia compared to the routine care group (40 of 50 [80%] vs. 30 of 50 [60%]; risk ratio, 1.33 [95% CI, 1.02 to 1.74]; P = 0.029). For the non-Hispanic cohort, no difference was detected in epidural use between the intervention and routine care groups (41 of 50 [82%] vs. 42 of 49 [86%]; risk ratio, 0.96 [95% CI, 0.80 to 1.14]; P = 0.62), but the study was underpowered to determine a result of no difference. Patients assigned to the intervention had a greater improvement in epidural understanding compared with routine care, among both Hispanic (2.26 vs. 0.74, respectively; difference in change from baseline, 1.52 [95% CI, 0.77 to 2.27]; P< 0.001) and non-Hispanic (1.36 vs. 0.33, respectively; difference in change from baseline, 1.03 [95% CI, 0.23 to 1.75]; P = 0.005) cohorts. There were no adverse events during the trial. The educational program increased epidural use among Hispanic women.”

According to the news reporters, the research concluded: “The educational program reduced misconceptions regarding epidural analgesia in both Hispanic and non-Hispanic cohorts.”

For more information on this research see: Education Program Regarding Labor Epidurals Increases Utilization by Hispanic Medicaid Beneficiaries. Anesthesiology, 2019;131(4):840-849. Anesthesiology can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Anesthesiology - http://journals.lww.com/anesthesiology/pages/default.aspx)

Our news correspondents report that additional information may be obtained by contacting B.M. Togioka, Oregon Health and Science University, Dept. of Anesthesiology & Perioperative Medicine, Portland, OR 97239, United States. Additional authors for this research include L.M. Noles, M.M. Treggiari, K.M. Seligman, M.K. Werntz and N.D. Yanez.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/aln.0000000000002868. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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