Awunti MegCholack, DeRemer David L, Rogers Sherise, Scarton Lisa, Adkins Lauren, WIlkie Diana J, Allen John M
Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, Florida.
Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, Florida.
J Am Coll Clin Pharm. 2022 Dec;5(12):1284-1296. doi: 10.1002/jac5.1727. Epub 2022 Nov 3.
There is surmounting levels of evidence on the health disparities within cancer treatment in the United States (US). Most of the research focused on cancer specific factors including anticancer incidence, screening, treatment and follow-up, and clinical outcomes such as overall survival (OS). Less is known about the disparities present with supportive care medication use in cancer patients. Supportive care utilization during cancer treatment has been linked to improved quality of life (QoL) and OS among patients. The goal of this scoping review is to summarize findings of current literature on the relationship between race and ethnicity and the receipt of supportive care medications during cancer treatment for pain and chemotherapy-induced nausea and vomiting (CINV). This scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA-ScR) guidelines. Our literature search included quantitative studies, qualitative studies, and grey literature written in the English language with clinically relevant outcomes pertaining to pain and CINV management in cancer treatment published from 2001-2021. Articles that met the predefined inclusion criteria were considered for inclusion in the analysis. The initial search yielded 308 studies. Following de-duplication and screening, 14 studies met the predefined inclusion criteria, with majority of the studies being quantitative studies (n=13). Collectively, results were mixed results regarding the presence of racial disparities for supportive care medication use. Half of the studies (n=7) supported this finding whereas, the other half (n=7) did not identify any racial disparities. In our review, multiple studies illustrate the existence of disparities in the use of supportive care medications in some cancer types. Clinical pharmacists should strive to eliminate supportive medication use disparities as part of a multidisciplinary team. In order to develop strategies to prevent supportive care medication use disparities in this population, further research and analysis of external factors that influence them are needed.
关于美国癌症治疗中的健康差异，有越来越多的证据。大多数研究集中在癌症特定因素上，包括抗癌发病率、筛查、治疗和随访，以及诸如总生存期（OS）等临床结果。对于癌症患者使用支持性护理药物方面存在的差异了解较少。癌症治疗期间的支持性护理利用与患者生活质量（QoL）的改善和总生存期相关。本范围综述的目的是总结当前文献中关于种族和民族与癌症治疗期间用于疼痛和化疗引起的恶心和呕吐（CINV）的支持性护理药物使用之间关系的研究结果。本范围综述是按照系统评价和Meta分析的首选报告项目（PRISMA-ScR）指南进行的。我们的文献检索包括定量研究、定性研究以及用英语撰写的灰色文献，这些文献具有与2001年至2021年发表的癌症治疗中疼痛和CINV管理相关的临床相关结果。符合预定义纳入标准的文章被考虑纳入分析。初步检索产生了308项研究。经过去重和筛选，14项研究符合预定义的纳入标准，其中大多数研究是定量研究（n = 13）。总体而言，关于支持性护理药物使用存在种族差异的结果喜忧参半。一半的研究（n = 7）支持这一发现，而另一半（n = 7）未发现任何种族差异。在我们的综述中，多项研究表明在某些癌症类型中支持性护理药物的使用存在差异。临床药师应努力消除支持性药物使用差异，作为多学科团队的一部分。为了制定预防该人群支持性护理药物使用差异的策略，需要对影响这些差异的外部因素进行进一步研究和分析。
