Meghani, S. H, Thompson, A. M, Chitta, 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. Journal of Pain,16(9), 825-835. United States: Churchill Livingstone Inc.. Retrieved from https://doi.org/10.1016/j.jpain.2015.05.009
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.
Mary MacKillop Institute for Health Research
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