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 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 one prescription of oral around-the-clock analgesic (ATC)]. 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 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, i.e., percentage of the total number of prescribed doses that were actually taken (53% vs. 74%, P<.001). On sub-analysis, 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.

The introduction of a transfusion guideline was independently associated with increased intraoperative pretransfusion hematocrit assessment and restrictive transfusion. The use of a software tool did not further influence either behavior.

requiring further intervention, which may help to identify which patients need more aggressive monitoring for potential failures.