Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Department of Emergency Medicine, School of Medicine, Emory University, Atlanta, Georgia.
J Palliat Med. 2019 Sep;22(9):1143-1148. doi: 10.1089/jpm.2018.0536. Epub 2019 Mar 18.
Black cancer patients experience pain. Barriers to opioid medications for pain may include geographic factors. This study examines neighborhood factors associated with difficulties receiving prescription opioids from pharmacies for black cancer patients. A secondary data analysis of a study on opioid adherence was used to examine neighborhood-level and individual factors related to difficulties filling prescriptions for opioids. Patients being treated for cancer pain with opioids ( = 104) were recruited. All self-identified as black, were 21 years or older, had cancer diagnoses, and had been prescribed extended release opioids. A seven-item survey to identify problems filling opioids was completed by 98 participants along with a nine-item scale to assess perceived neighborhood characteristics. Scales of neighborhood amenities and neglect were created from the perceived neighborhood characteristics scale using principal components analysis. The 2009-2013 American Community Survey data were used to estimate the census tract percentage of non-Hispanic black residents, residents ≥25 years of age without a high school degree or equivalent, and households earning below the federal poverty level within the past 12 months. Nearly 51% reported problems getting their opioids filled: 28% had to wait days and 24% had to return to the pharmacy multiple times. The main theme identified in analysis of an open-ended question was pharmacies not stocking medication. Neighborhood locations that rated higher on the amenities scale were protective for pharmacies sufficiently stocking opioids. Additional research on pharmacies sufficiently stocking opioid pain and neighborhood perceptions is warranted.
黑人癌症患者会经历疼痛。他们在获得阿片类药物治疗疼痛方面可能存在障碍，其中包括地理因素。本研究调查了与黑人癌症患者从药店获得处方阿片类药物相关的困难有关的邻里因素。利用一项关于阿片类药物依从性的研究的二次数据分析，考察了与接受阿片类药物处方困难相关的邻里层面和个体层面的因素。招募了正在接受阿片类药物治疗癌症疼痛的患者（n=104）。所有患者均自我认定为黑人，年龄在 21 岁或以上，患有癌症，并被开具了延长释放阿片类药物。98 名参与者完成了一份包含七项内容的问卷，以确定填写阿片类药物处方时遇到的问题，以及一项九项内容的量表，以评估对邻里特征的感知。利用主成分分析法，从感知邻里特征量表中创建了邻里便利设施和忽视量表。利用 2009-2013 年美国社区调查数据，估算了在过去 12 个月内，每个普查小区非西班牙裔黑人居民的比例、25 岁以上未获得高中文凭或同等学历的居民比例，以及收入低于联邦贫困线的家庭比例。近 51%的患者报告称他们在获取阿片类药物方面存在问题：28%的人需要等待数天，24%的人需要多次返回药店。在对一个开放式问题的分析中，确定的主要主题是药店没有储存药物。在便利设施量表上评分较高的邻里位置对药店充分储备阿片类药物具有保护作用。有必要进一步研究药店充分储备阿片类药物以治疗疼痛以及邻里认知问题。
