Pain and treatment of pain in minority patients with cancer. The Eastern Cooperative Oncology Group Minority Outpatient Pain Study.

BACKGROUND

Clinics that primarily see members of ethnic minority groups have been found to provide inadequate treatment of cancer-related pain. The extent of undertreatment of pain in these patients and the factors that contribute to undertreatment are not known.

OBJECTIVES

To evaluate the severity of cancer-related pain and the adequacy of prescribed analgesics in minority outpatients with cancer.

DESIGN

Prospective clinical study.

SETTING

Eastern Cooperative Oncology Group.

PATIENTS

281 minority outpatients with recurrent or metastatic cancer.

MEASUREMENTS

Patients and physicians independently rated severity of pain, pain-related functional impairment, and pain relief obtained by taking analgesic drugs. Analgesic adequacy was determined on the basis of accepted guidelines.

RESULTS

77% of patients reported disease-related pain or took analgesics; 41% of patients reporting pain had severe pain. Sixty-five percent of minority patients did not receive guideline-recommended analgesic prescriptions compared with 50% of non-minority patients (P < 0.001). Hispanic patients in particular reported less pain relief and had less adequate analgesia.

CONCLUSIONS

The awareness that minority patients do not receive adequate pain control and that better assessment of pain is needed may improve control of cancer-related pain in this patient population.