Pain management disparities in kidney stones point to need for guidelines, experts say

Recent study findings pointing to disparities in receipt of pain management for nephrolithiasis have led researchers to propose collaboration with emergency medicine colleagues and endourologists to develop pain management guidelines.¹

In an interview with Urology Times®, study author Hailey Frye explained, “Making sure that all parties involved, whether it was the urologist, the residents, but also our colleagues down in the emergency department, were included in these conversations was an important priority for us moving forward, and so we discussed and learned from our emergency department colleagues some of the different factors that go into managing pain in the acute care setting…Additionally, we talked about staffing and the ability to provide the check in on these patients, and so being able to balance some of these external factors and external limitations that come into play in the emergency department was something that we wanted to consider and wanted to help our emergency department colleagues consider and work with when developing these guidelines for pain management,” said Frye, a medical student at the University of Minnesota, Minneapolis.

Frye was also asked about steps to take for advocating for change within health care systems.

“For other health care professionals aiming to advocate for equitable changes within their system, it's really important to just start conversations about what you're noticing, whether it is pain management or whether it's waiting time or access to care or access to the physical clinic itself, initiating conversations with colleagues and really prioritizing those values within the system I think is the first start,” Frye said.

She added, “We had a lot of data to drive this discovery and this finding, as far as readmission rates or who received these different prescriptions, but the 1 area that we wanted to expand further on and hope to is really the patient experience; what is it like to have to go to the emergency department with a kidney stone? And so thinking about all of those factors prior to implementing a framework is important in order to make sure that you give yourself and your hospital group the best shot to be able to make changes and minimize those disparities.”

REFERENCE

1. Frye HH, Ganesan V, Agarwal D, Patterson B, Herman A, Borofsky MS. Need for pain management policies: Uncovering hidden biases in pain management of nephrolithiasis. Presented at: American Urological Association Annual Urology Advocacy Summit. March 3-5, 2025. Washington. https://www.auasummit.org/virtual-poster-session