Race, Affordability and Utilization of Supportive Care in Ovarian Cancer Patients.
J Pain Symptom Manage
; 64(6): 537-545, 2022 12.
Article
en En
| MEDLINE
| ID: mdl-36058401
ABSTRACT
OBJECTIVE:
Lack of access to supportive care (SC) among cancer patients have been well documented. However, the role of affordability in this disparity among ovarian cancer (OC) patients remain poorly understood.METHODS:
Patients with OC between 2008 and 2015 were identified from the SEER-Medicare dataset. Racial disparities in utilization of SC medications within the six months of OC diagnosis among patients with Medicare Part D coverage was examined. Multivariable log-binomial regression models were used to examine the associations of race, affordability and SC medications after adjusting for clinical covariates among all patients and separately among patients with advanced-stage disease.RESULTS:
The study cohort included 3697 patients 86% non-Hispanic White (NHW), 6% non-Hispanic Black (NHB), and 8% Hispanic. In adjusted models, NHB and Hispanic patients were less likely to receive antidepressants compared to NHW patients (NHB aOR 0.46; 95% CI 0.33-0.63 and Hispanic aOR 0.79; 95% CI 0.63-0.99). This association persisted for NHB patients with advanced-stage disease (aOR 0.42; 95% CI 0.28-0.62). Patients dual enrolled in Medicaid were more likely to receive antidepressants (overall aOR 1.34; 95% CI 1.17-1.53 and advanced-stage aOR 1.29; 95% CI 1.10-1.52). However, patients residing in areas with higher vs. lower proportions of lower educated adults (overall aOR 0.82; 95% CI 0.70-0.97 and advanced-stage aOR 0.82; 95% CI 0.68-0.99) were less likely to receive antidepressants.CONCLUSION:
Black OC patients and those living in lower educated areas were less likely to receive antidepressants as SC. Given the importance of post-primary treatment quality of life for cancer patients, interventions are needed to enhance equitable access to SC.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Ováricas
/
Población Blanca
Tipo de estudio:
Health_economic_evaluation
Aspecto:
Determinantes_sociais_saude
/
Patient_preference
Límite:
Adult
/
Aged
/
Female
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Pain Symptom Manage
Asunto de la revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
/
TERAPEUTICA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos