Unraveling Racial Disparities in Supportive Care Medication Use among End-of-Life Pancreatic Cancer Patients: Focus on Pain Management and Psychiatric Therapies

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.