Inadequate Analgesia in African Americans with Cancer Pain

African Americans have been found to receive less medication and experience more pain than Caucasians. Unfortunately, many studies simply highlight the disparities that exist between African Americans and Caucasian in pain management, but there is a lack of understanding at the etiology of these disparities. The purpose of this study was to determine the adequacy of analgesia that was prescribed for African Americans with cancer pain and elucidate any potential characteristics that contributed to receiving appropriate analgesia. This was a secondary analysis of baseline data of an intervention study of African Americans with cancer pain. In order to determine the adequacy of analgesics received, the Pain Management Index (PMI) was calculated for 302 African Americans with cancer pain. Structure equation modeling was utilized to determine which patient factors (age, gender, presence of caregiver, employment status, educational level, perceived control over pain, pain-related distress, pain intensity, functional status) led to adequate analgesia. Forty percent of African Americans with cancer pain did not receive adequate analgesia based on the drug class alone. African Americans with cancer pain who reported higher levels of pain received higher levels of analgesics. Cancer metastasis (p = .03) was the only significant predictor of an increased likelihood of receiving adequate analgesia. Despite national attention to racial disparities, African Americans with cancer pain continue to receive inadequate analgesia. Forty percent of African Americans did not get the appropriate drug based on their reported pain score. The only significant predictor of receiving appropriate analgesia was cancer metastasis. Ensuing studies testing whether these results would be the same for other races will clarify if this disparity was due to race alone. Interventions should then be created and utilized to decrease these disparities.