Unraveling Racial Disparities in Supportive Care Medication Use Among End-of-Life Pancreatic Cancer Patients: Focus on Pain Management and Psychiatric Therapies

Overview

Journal Cancer Epidemiol Biomarkers Prev

Specialties Biochemistry
Oncology
Public Health

Date 2023 Oct 3

PMID 37788369

Authors

John M Allen

MegCholack Awunti

Yi Guo

Jiang Bian

Sherise C Rogers

Lisa Scarton

David L DeRemer

Diana J Wilkie

Affiliations

Soon will be listed here.

Abstract

Background: Supportive care medication use differences may contribute to racial disparities observed in health-related quality of life in patients with pancreatic cancer.

Methods: In this observation study using the Surveillance, Epidemiology, and End Results-Medicare linked database, we sought to examine supportive care medication use disparities in patients with pancreatic cancer from 2005 to 2017 by race and ethnicity.

Results: Among 74,309 patients included in the final analysis, racial and ethnic disparities in the use of supportive care medications were identified. After adjustment for confounding factors and compared with non-Hispanic Whites, minorities had significantly less use of opioids [Black: adjusted OR (aOR), 0.84; 95% confidence interval (CI), 0.79-0.88; Asian: aOR, 0.84; 95% CI, 0.79-0.90), and skeletomuscular relaxants (Black: aOR, 0.90; 95% CI, 0.82-0.99; Hispanic: aOR, 0.82; 95% CI, 0.74-0.91; Asian: aOR, 0.59; 95% CI, 0.51-0.68), and increased use of non-opioid analgesics (Hispanic: aOR, 1.16; 95% CI, 1.01-1.14; Asian: aOR, 1.37; 95% CI, 1.26-1.49). Racial and ethnic minorities had less use of antidepressants (Black: aOR, 0.56; 95% CI, 0.53-0.59; Hispanic: aOR, 0.77; 95% CI, 0.73-0.82; Asian: aOR, 0.47; 95% CI, 0.44-0.51), anxiolytics (Black: aOR, 0.78; 95% CI, 0.74-0.82; Hispanic: aOR, 0.66; 95% CI, 0.62-0.71; Asian: aOR, 0.52; 95% CI, 0.48-0.57), and antipsychotics (Hispanic: aOR, 0.90; 95% CI, 0.82-0.99; Asian: aOR, 0.84; 95% CI, 0.74-0.95).

Conclusions: Racial and ethnic disparities in the use of supportive care medications among patients with pancreatic cancer were observed, with the differences unexplained by sociodemographic factors.

Impact: Future studies should identify strategies to promote equitable use of supportive care medications among racial minorities and explore factors that may influence their use in these populations.

Citing Articles

A Systematic Review of the Influence of Social Determinants of Health on Mental Health Service Utilization and Outcomes Among Asian American Cancer Survivors.

Wen Y, Brauer E, Choi K J Racial Ethn Health Disparities. 2025; .

PMID: 39752074 DOI: 10.1007/s40615-024-02275-8.

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