Race Affects Opioid Selection for Cancer Pain
African-American patients are less likely to receive oxycodone, even among patients with CKD
THURSDAY, July 24, 2014 (HealthDay News) -- Racial disparities exist in the type of opioid prescribed for cancer pain, according to a study published online July 21 in the Journal of Clinical Oncology.
Salimah H. Meghani, Ph.D., R.N., from the University of Pennsylvania in Philadelphia, and colleagues recruited 182 patients from clinics within a single health system. All participants reported the presence of cancer-related pain plus a prescription for morphine or oxycodone. The abbreviated Modification of Diet in Renal Disease formula was used to estimate kidney function.
The researchers found that the severity of analgesic-related adverse effects was greater for patients with chronic kidney disease (CKD) who received morphine versus oxycodone (P = 0.010). Compared with white patients, African-American patients had 71 percent lower odds of receiving a prescription of oxycodone (P < 0.001), when controlling for health insurance type. The effect of private insurance was no longer significant on limiting the analysis to patients with CKD, but race remained a significant predictor of the prescribed opioid selection. In the presence of CKD, race was a strong predictor for adverse effect severity, and this association was partially mediated by the type of opioid selection.
"Reducing racial disparities in the type of opioid prescription and understanding mechanisms of disproportionate opioid-related adverse effects in African-American patients might decrease the clinical disparities in cancer pain outcomes," the authors write.
One author disclosed financial ties to the pharmaceutical industry.