Both Race and Insurance Type Independently Predict the Selection of Oral Opioids Prescribed to Cancer Outpatients.

BackgroundPrevious research suggests that racial disparities in patients' reported analgesic adverse effects are partially mediated by the type of opioid prescribed to African Americans despite the presence of certain comorbidities, such as renal disease.AimsWe aimed to identify independent predictors of the type of opioid prescribed to cancer outpatients and determine if race and chronic kidney disease independently predict prescription type, adjusting for relevant sociodemographic and clinical confounders.DesignWe conducted a secondary analysis of a 3-month observational study.SettingOutpatient oncology clinics of an academic medical center.Participants/subjectsPatients were older than 18 years of age, self-identified as African American or White, and had an analgesic prescription for cancer pain.MethodsCancer patients (N = 241) were recruited from outpatient oncology clinics within a large mid-Atlantic healthcare system.ResultsConsistent with published literature, most patients (75.5%) were prescribed either morphine or oxycodone preparations as oral opioid therapy for cancer pain. When compared with Whites, African Americans were significantly more likely to be prescribed morphine (33% vs 14%) and less likely to be prescribed oxycodone (38% vs 64%) (p ConclusionsBoth race and insurance type independently predict type of opioid selection for cancer outpatients. Larger clinical studies are needed to fully understand the sources and clinical consequences of racial differences in opioid selection for cancer pain.