Affiliation:
1. 1Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, Florida.
2. 2Department of Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida.
3. 3Division of Hematology & Oncology, University of Florida College of Medicine, Gainesville, Florida.
4. 4Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida.
5. 5Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, Florida.
6. 6Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, Florida.
Abstract
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.
Funder
National Institutes of Health
Publisher
American Association for Cancer Research (AACR)