Abstract A027: Evaluation of psychotropic medication usage patterns in patients with pancreatic cancer by race/ethnicity

Abstract

Abstract Background: Pancreatic cancer (PC) has been associated with detrimental impacts on psychological wellbeing. Reported PC-related depression and anxiety rates are higher than in other types of cancer. A substantial component to improve psychological well-being in patients with PC is the use of drug therapy to provide symptomatic relief. The presence of racial disparities in the utilization of psychotropic medication has been reported in some cancer types. However, despite these known racial disparities and the increased psychiatric symptoms in patients with PC, there has not been an evaluation of racial disparities in psychotropic medication use among patients with PC. The purpose of this study was to describe usage patterns of psychotropic medications by race among patients diagnosed with PC. Methods: Utilizing the National Cancer Institute Surveillance Epidemiology and End Results (NCI SEER)- Medicare linked database, our analysis included all patients with a PC diagnosis and an active outpatient prescription claim for psychotropic medications from 2009-2018. Prescription claims were specific to patients diagnosed with PC and stratified by self-identified race/ethnicity. Patients who were on psychotropic medications before PC diagnosis, or unspecified race/ethnicity were excluded from the analysis. Psychotropic pharmacological agents consisted of anxiolytics, antidepressants, and anti-delirium/antipsychotic medications. Results: 71,700 participants were included in the analysis. Racial/ethnic participant breakdown included 80% White, 12% African American/Black, 4.5% Asian/Pacific Islander, 3% Hispanic, and 0.25% Native American. Results are presented as an unadjusted relative risk (RR) and 95% Confidence Interval (CI). As compared to White patients, African American/Black (RR 0.60; 95% CI 0.57-0.64), Asian/Pacific Islander (RR 0.52; 95% CI 0.48-0.58), and Hispanic (RR 0.61; 95% CI 0.55-0.67) patients had lower utilization of anxiolytics. For antidepressant medications, African American/Black (RR 0.74; 95% CI 0.71-0.77), Asian/Pacific Islander (RR 0.61; 95% CI 0.58-0.66), and Hispanic (RR 0.87; 95% CI 0.82-0.92) patients had less utilization compared to White patients. For anti-delirium/antipsychotic agents, African American/Black (RR 1.09; 95% CI 1.01-1.17) had a higher risk of utilization while Asian/Pacific Islander (RR 0.83; 95% CI 0.73-0.95) had less utilization when compared to White patients. No other differences were noted in psychotropic medication use by race/ethnicity. Conclusion: The study showed that utilization patterns of psychotropic agents in patients with PC varied by race/ethnicity. Racial/ethnic minorities had lower utilization rates for most of the drug classes except anti-delirium/antipsychotic agents in which African American/Black had higher utilization rates when compared to White patients. Further research needs to be carried out to examine social and clinical factors causing this phenomenon. Citation Format: MegCholack Awunti, Yi Guo, Sherise Rogers, Lisa Scarton, Diana Wilkie, John Allen. Evaluation of psychotropic medication usage patterns in patients with pancreatic cancer by race/ethnicity [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 A027.