Exploring age and race/ethnic associations with the multiple dimensions of pain among cancer patients receiving home hospice care

Abstract Aim: Racial disparities in pain are well known, but most hospice studies included few underrepresented minority patients, which limits understanding of pain disparities among cancer patients receiving hospice care. Our study purpose was to explore age and racial/ethnic associations with the sensory, affective, evaluative, and temporal dimensions of cancer pain in the hospice setting. Methods: We analyzed control group data from a stepped-wedge randomized control trial of the PAINRelieveIt app. 150 home hospice patients with a variety of cancers (mean age 68.0±14.6 years, 52% female, 44% White, 37% Black, 19% Hispanic) completed PAINReportIt, an electronic McGill Pain Questionnaire, on an internet-enabled tablet at baseline and 1 week later. We compared racial/ethnic groups for age (ANOVA) and gender (Chi square) differences. We also conducted regression analyses of baseline and posttest sensory pain (current pain intensity [0-10], worst pain intensity [0-10], Pain Rating Index[PRI]-Sensory), affective pain (PRI-Affective [0-14), evaluative pain (PRI-Evaluative), and pain pattern scores, adjusting for age, and comparing Black and Hispanic with White groups. Results: Gender was relatively balanced across the racial/ethnic groups (p=.54). There was significant difference among groups in mean age (p=.01; Black: 64.1±12.1, Hispanic: 66.5±16.6, White: 71.9±14.8). Baseline current and worst pain intensity were moderate and severe respectively across Black (4.7±2.9; 7.1±1.9), Hispanic (5.4±2.6; 7.7±2.1), and White (4.4±2.7; 6.7±2.6) groups (p>.05). Posttest current and worst pain intensity remained moderate and severe across Black (4.6±2.8; 6.5±2.3), Hispanic (4.7±2.4; 6.5±2.2) and White (4.0±2.4 and 5.9±2.4) groups (p>.05). Baseline values were not significantly different across racial/ethnic groups for PRI-Sensory, PRI-Evaluative, and pain pattern. Baseline PRI-Affective scores differed significantly among Black (1.8±2.0), Hispanic (3.8±3.9) and White (3.1±2.6) groups (p=.003). Higher baseline pain values for all variables except current pain were associated with younger age (p≤.02) and the Black group had significantly lower PRI-Affective (p=.001). Posttest, higher current pain and worst pain were associated with younger age (p=.04). Other pain variables were not associated with age or race/ethnicity (p>.05). Conclusions: Patients with advanced cancer, regardless of race or ethnicity, reported clinically important current and worst pain intensity suggesting the need for better pain control in the hospice setting. Younger patients reported more intense pain than older patients. Younger patients reported more intense pain than older patients. The significantly lower affective contribution to pain among Black patients at baseline represents a novel finding that warrants additional research. Insufficient pain control remained consistent across racial/ethnic groups in usual hospice care. The racial/ethnic disparities commonly observed in pain management was not evident in this sample. Citation Format: Jeronda C. Jenkins, Dottington Fullwood, Yingwei Yao, Diana Wilkie, Miriam O. Ezenwa. Exploring age and race/ethnic associations with the multiple dimensions of pain among cancer patients receiving home hospice care [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A028.