Abstract 4360: Opioid, non-opioid, and non-pharmacological pain management in patients with a history of cancer

Abstract Background Pain is highly prevalent among individuals with cancer. Consequently, adequate and equitable pain management are hallmarks of quality cancer care. Unfortunately, up to one-third of patients with cancer consider their pain symptoms poorly managed. Objective To characterize clinical and sociodemographic factors associated with opioid, non-opioid, and non-pharmacological pain management among individuals with a history of cancer. Methods We used the 2018 to 2020 full-year consolidated data files of the Medical Expenditure Panel Survey (MEPS), linked to the medical conditions, prescribed medicines, outpatient visits and office-based medical provider visits files. We estimated adjusted relative risk (aRR) of receipt of opioid, non-opioid, and non-pharmacological pain management (acupuncture, chiropractor, and massage/occupational/physical therapy), based on clinical (cancer site, comorbidities, depression status) and sociodemographic (race, sex, age, marital status, education, insurance, income, English speaking ability) factors, accounting for complex survey design in quasi-Poisson regression models. Results The study cohort was composed of 7,035 individuals with cancer, with 19.2% (0.65%; weighted proportions (standard error) receiving opioids, 51.09% (0.9%) receiving non-opioids, and 20.56% (0.75%) receiving non-pharmacological pain management. In our final models, compared to Other cancers, patients with bladder cancer were more likely to receive opioids (aRR 1.52; 95% CI 1.06, 2.17), while those with lung cancer were less likely to receive non-pharmacological pain management (aRR 0.46; 95% CI 0.25, 0.84). Also, depression was associated with increased risk of both opioid (aRR 1.26; 95% CI 1.09, 1.46) and non-opioid (aRR 1.26; 95% CI 1.18, 1.34), but not non-pharmacological pain management. There were no statistically significant differences in risk of opioid prescription between Black vs. White patients with cancer; however, Asian patients were significantly less likely to receive opioids (aRR 0.18; 95% CI 0.05, 0.67) as were patients who did not speak English well (aRR 0.22; 95% CI 0.11, 0.43). Female patients with cancer were significantly more likely to receive non-opioids (aRR 1.21; 95% CI 1.12, 2.31) and non-pharmacological pain management (aRR 1.49; 95% CI 1.27, 1.75) than males. Conclusions There are clinical and sociodemographic factors associated with opioid, non-opioid, and non-pharmacological pain management among individuals with cancer, and those who are depressed are at highest risk for opioid prescription, while those who cannot speak English well are less likely to receive opioids. For equitable pain care in patients with cancer, it is important that barriers associated with pain management are eliminated. Citation Format: Oyomoare L. Osazuwa-Peters, Justin M. Barnes, Eric Adjei Boakye, Trinitia Y. Cannon, Tammara L. Watts, Tomi Akinyemiju, Nosayaba Osazuwa-Peters. Opioid, non-opioid, and non-pharmacological pain management in patients with a history of cancer. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4360.