Racial and Socioeconomic Factors Associated with the Use of Complementary and Alternative Modalities for Pain in Cancer Outpatients: An Integrative Review

Ludwick, Allison; Corey, Kristin L.; Meghani, Salimah H.

doi:10.1016/j.pmn.2019.08.005

Cited by 22 publications

(12 citation statements)

References 40 publications

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“…Future studies are needed to evaluate these relationships in more diverse, lower income, and community settings. Race and socioeconomic status are known to influence pain management in patients with cancer, 8,[46][47][48][49][50][51] underscoring the importance of understanding whether race moderates the relationship of psychosocial factors to worse pain outcomes. 6,39 Finally, some patients were recruited during the time of the COVID-19 pandemic, although recruitment was paused during the months of heaviest COVID-related hospitalizations, which may have influenced whether some patients delayed presenting to the ED.…”

Section: Discussionmentioning

confidence: 99%

Psychological Evaluation of Patients With Cancer Presenting to the Emergency Department With Pain: Independent Predictors of Worse Pain Severity, Interference, and Higher Hourly Opioid Administration

Azizoddin

Beck

Flowers

et al. 2022

JCO Oncology Practice

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PURPOSE: Pain is a common complaint in patients with cancer presenting to the emergency department (ED). This prospective study evaluated whether biopsychosocial factors could help predict cancer patients with risk of higher pain severity, pain interference, and opioid consumption. METHODS: Patients with cancer presenting to the ED with a complaint of moderate-severe pain (≥ 4/10-numeric rating scale) completed validated self-report measures assessing sociodemographics, cancer-related treatments, pain severity and interference, medication use, and psychological symptoms (depression, anxiety, pain catastrophizing, and sleep disturbance). Opioids administered and subsequent hospitalization were abstracted. Univariable and multivariable regression analyses assessed factors associated with pain-related outcomes. RESULTS: Participants (n = 175) presented with a variety of cancer types, with 76% having metastatic disease and 42% reporting current outpatient opioid use. Higher pain catastrophizing, lower depressive symptoms, lower income, outpatient opioid use, and historical chronic pain were independently associated with worse pain ( P ≤ .05). Higher pain catastrophizing, anxiety, sleep disturbance, outpatient opioid use, and education were independently associated with worse pain interference ( P ≤ .05). The sole independent predictor of ED opioid administration was outpatient opioid use. Patients taking outpatient opioids were younger, had lower health literacy, worse pain catastrophizing, sleep disturbance, depression/anxiety, and greater rates of metastatic cancer and cancer-related surgery ( P ≤ .05). CONCLUSION: Biopsychosocial factors, particularly pain catastrophizing, remained significantly associated with worse pain outcomes for patients with cancer in the ED even after controlling for demographic and clinical variables. Patient outpatient opioid use was independently associated with worse pain, interference, and greater opioid administration, identifying this as a marker for who may benefit most from adjuvant pharmacologic and behavioral interventions.

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Section: Discussionmentioning

confidence: 99%

Psychological Evaluation of Patients With Cancer Presenting to the Emergency Department With Pain: Independent Predictors of Worse Pain Severity, Interference, and Higher Hourly Opioid Administration

Azizoddin

Beck

Flowers

et al. 2022

JCO Oncology Practice

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“…Prior research suggests that the relationship between low socioeconomic status and pain may be mediated by psychological factors including lower perceived control ( 26‐28 ). Second, low-income individuals may be more likely to use opioids chronically due to lack of access to nonpharmacological pain management interventions ( 29 , 30 ). Based on the results of our study and others, a multidisciplinary approach to pain management—particularly one that addresses psychological factors that contribute to pain—may be particularly important for low-income cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Chronic Opioid Use: A Population-Level Analysis of North Carolina Cancer Survivors Using Multi-Payer Claims

Check

Baggett

Kim

et al. 2021

JNCI: Journal of the National Cancer Institute

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Background No population-based studies have examined chronic opioid use among cancer survivors who are diverse with respect to diagnosis, age group, and insurance status. Methods We conducted a retrospective cohort study using North Carolina (NC) cancer registry data linked with claims from public and private insurance (2006–2016). We included adults with non-metastatic cancer who had no prior chronic opioid use (N = 38,366). We used modified Poisson regression to assess the adjusted relative risk of chronic opioid use in survivorship (>90-day continuous supply of opioids in the 13–24 months following diagnosis) associated with patient characteristics. Results Only 3.0% of cancer survivors in our cohort used opioids chronically in survivorship. Predictors included younger age (adjusted risk ratio [aRR], 50–59 vs 60–69 = 1.23, 95% confidence interval [CI] = 1.05–1.43), baseline depression (aRR = 1.22, 95% CI = 1.06–1.41) or substance use (aRR = 1.43, 95% CI = 1.15–1.78) and Medicaid (aRR vs Private = 1.93, 95% CI = 1.56–2.40). Survivors who used opioids intermittently (vs not at all) before diagnosis were twice as likely to use opioids chronically in early survivorship (aRR = 2.62, 95% CI = 2.28–3.02). Those who used opioids chronically (vs intermittently or not at all) during active treatment had a nearly 17-fold increased likelihood of chronic use in survivorship (aRR = 16.65, 95 CI = 14.30–19.40). Conclusions Younger and low-income survivors, those with baseline depression or substance use, and those who require chronic opioid therapy during treatment are at increased risk for chronic opioid use in survivorship. Our findings point to opportunities improve assessment of psychosocial histories and to engage patients in shared decision-making around long-term pain management, when chronic opioid therapy is required during treatment.

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“…Uptake of complementary medicines likely depends on a number of attitudes and beliefs (Bauml et al., 2015), including expected benefits, perceived barriers and subjective norms, but also has a number of socio‐demographic and cultural components (Ludwick, Corey, & Meghani, 2020). Close relatives and friends are often involved in providing information and counselling with regard to complementary medicines (Hirai et al., 2008; Klafke, Eliott, Olver, & Wittert, 2014; Latte‐Naor, Sidlow, Sun, Li, & Mao, 2018; Molassiotis et al., 2006; Saghatchian et al., 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Close relatives and friends are often involved in providing information and counselling with regard to complementary medicines (Hirai et al., 2008; Klafke, Eliott, Olver, & Wittert, 2014; Latte‐Naor, Sidlow, Sun, Li, & Mao, 2018; Molassiotis et al., 2006; Saghatchian et al., 2014). The benefits of complementary medicines in helping patients endure traditional treatments have already been described (Ludwick et al., 2020; Shalom‐Sharabi et al., 2017), though the methodology of studies on complementary medicines is often weak (Lee, Choi, & Hyun, 2019). Moreover, adverse interactions between complementary medicines and conventional treatment (Velicer & Ulrich, 2008) and the risk of patients delaying or discontinuing conventional treatment have both been seen to be associated with reductions in survival in complementary medicine users (Greenlee et al., 2016; Johnson et al., 2018a; Johnson, Park, Gross, & Yu, 2018b; Samuels, Ben‐Arye, Maimon, & Berger, 2017).…”

Section: Discussionmentioning

confidence: 99%

Patient perspectives on supportive care in cancer: Results of the Calista 2 study

Simon¹,

Ganem

Touboul³

et al. 2020

Eur J Cancer Care

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Over recent decades, the management of cancer patients has improved as a result of earlier diagnosis, better management of side effects, and more effective therapies. The question of patient quality of life-both during and following cancer treatment-consequently requires greater attention than has previously been the case, with supportive and palliative care playing a particularly important role. Dedicated clinical practice guidelines are regularly updated to improve of the management of a variety of issues, both during and after the active disease stage. Patient-reported outcome measures have emerged as an important aspect of improving quality of life in a period of patient-centred

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Racial and Socioeconomic Factors Associated with the Use of Complementary and Alternative Modalities for Pain in Cancer Outpatients: An Integrative Review

Cited by 22 publications

References 40 publications

Psychological Evaluation of Patients With Cancer Presenting to the Emergency Department With Pain: Independent Predictors of Worse Pain Severity, Interference, and Higher Hourly Opioid Administration

Psychological Evaluation of Patients With Cancer Presenting to the Emergency Department With Pain: Independent Predictors of Worse Pain Severity, Interference, and Higher Hourly Opioid Administration

Predictors of Chronic Opioid Use: A Population-Level Analysis of North Carolina Cancer Survivors Using Multi-Payer Claims

Patient perspectives on supportive care in cancer: Results of the Calista 2 study

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