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 grou ps have been found to provide inadequate treatment of cancer-related p ain. The extent of undertreatment of pain in these patients and the fa ctors that contribute to undertreatment are not known. Objectives: To evaluate the severity of cancer-related pain and the adequacy of presc ribed analgesics in minority outpatients with cancer. Design: Prospect ive clinical study. Setting: Eastern Cooperative Oncology Group. Patie nts: 281 minority outpatients with recurrent or metastatic cancer. Mea surements: Patients and physicians independently rated severity of pai n, pain-related functional impairment, and pain relief obtained by tak ing 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 pa in. Sixty-five percent of minority patients did not receive guideline- recommended analgesic prescriptions compared with 50% of nonminority p atients (P < 0.001). Hispanic patients in particular reported less pai n relief and had less adequate analgesia. Conclusions: The awareness t hat minority patients do not receive adequate pain control and that be tter assessment of pain is needed may improve control of cancer-relate d pain in this patient population.