Document Type
Journal Article
Date of this Version
9-2015
Publication Source
The Journal of Pain
Volume
16
Issue
9
Start Page
825
Last Page
835
DOI
10.1016/j.jpain.2015.05.009
Abstract
Despite well-documented disparities in cancer pain outcomes among African Americans, surprisingly little research exists on adherence to analgesia for cancer pain in this group. We compared analgesic adherence for cancer-related pain over a 3-month period between African Americans and whites using the Medication Event Monitoring System (MEMS). Patients (N = 207) were recruited from outpatient medical oncology clinics of an academic medical center in Philadelphia (≥18 years of age, diagnosed with solid tumors or multiple myeloma, with cancer-related pain, and at least 1 prescription of oral around-the-clock analgesic). African Americans reported significantly greater cancer pain (P < .001), were less likely than whites to have a prescription of long-acting opioids (P < .001), and were more likely to have a negative Pain Management Index (P < .001). There were considerable differences between African Americans and whites in the overall MEMS dose adherence, ie, percentage of the total number of prescribed doses that were taken (53% vs 74%, P < .001). On subanalysis, analgesic adherence rates for African Americans ranged from 34% (for weak opioids) to 63% (for long-acting opioids). Unique predictors of analgesic adherence varied by race; income levels, analgesic side effects, and fear of distracting providers predicted analgesic adherence for African Americans but not for whites. Perspective: Despite evidence of disparities in cancer pain outcomes among African Americans, surprisingly little research exists on African Americans' adherence to analgesia for cancer pain. This prospective study uses objective measures to compare adherence to prescribed pain medications between African American and white patients with cancer pain.
Copyright/Permission Statement
© 2015 American Pain Society, published by Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords
Adult, African Americans, Analgesics, Electronics, European Continental Ancestry Group, Female, Humans, Male, Middle Aged, Neoplasms, Pain, Patient Compliance, Prospective Studies, Self Report, Sensitivity and Specificity
Recommended Citation
Meghani, S. H., Thompson, A. M., Chittams, J., Bruner, D. W., & Riegel, B. (2015). Adherence to Analgesics for Cancer Pain: A Comparative Study of African Americans and Whites Using an Electronic Monitoring Device. The Journal of Pain, 16 (9), 825-835. http://dx.doi.org/10.1016/j.jpain.2015.05.009
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Date Posted: 06 August 2018
This document has been peer reviewed.