Disparities in Analgesic Preference for Cancer Pain: A Conjoint Analysis Study

描述（由申请人提供）：Meghani博士是一名初级教员，他的长期职业目标是成为一名独立的研究者，致力于理解和消除癌症疼痛结果的种族差异。越来越多的文献报道了治疗疼痛的种族差异。尽管有关这些差异的证据越来越多，但其基础在很大程度上仍不为人所知。虽然提供者和系统层面的因素导致了这些差异，但同样重要的是了解与患者偏爱和使用镇痛治疗癌症疼痛相关的因素。通过这个为期3年的K01奖，Meghani博士通过在消费者行为、患者决策和陈述偏好技术的理论和方法方面进行广泛的培训，寻求拓宽她的科学方法，以理解癌症疼痛结果的差异。该培训计划充分利用了候选人在著名学术中心的大量资源和学术机会，包括结构化的指导、教学课程、非正式研讨会、研究所和座谈会。高素质的指导团队为培训计划提供专业知识，并代表医学，护理和营销领域的多学科视角。利用基于选择的联合分析（CBC）这一成熟的市场营销技术来引发消费者偏好，本研究拟调查1)非裔美国人和白人在癌症疼痛镇痛治疗方面是否有不同的偏好结构，如果有，他们在做出癌症疼痛治疗决策时采用了哪些权衡；2)患者的社会人口学、疾病和疼痛相关特征对其镇痛偏好的相对影响是什么？3)患者陈述的偏好与他们报告的处方镇痛治疗癌症疼痛的依从性之间的关系。从研究中获得的数据将为候选人的长期目标奠定基础，即发展以患者为中心的干预措施，将患者的偏好纳入复杂的医疗决策。相关性：医疗保健经常涉及在风险和不确定性下做出相互竞争的选择。这项研究使用了一种新颖的技术来了解非裔美国人和白人癌症疼痛患者在做出疼痛治疗决定时是否使用不同的心理权衡；对癌症疼痛治疗有不同的偏好；以及这可能与他们坚持服用治疗癌症疼痛的止痛药有关。

DESCRIPTION (provided by applicant): Dr. Meghani is a junior faculty member whose long-term career goal is to attain success as an independent investigator devoted to understanding and eliminating racial/ethnic disparities in cancer pain outcomes. Racial differences in the treatment of pain are increasingly reported in the literature. While the evidence of these differences is growing, the basis for them remains largely unknown. While provider and system-level factors contribute to these disparities, equally important is to understand factors that relate to patients' preference and use of analgesia for cancer pain. Through this 3-year K01 award, Dr. Meghani seeks to broaden her scientific approach to understanding disparities in cancer pain outcomes by engaging in extensive training in the theory and methodology of consumer behavior, patients' decision-making, and stated-preference techniques. The training plan takes advantage of the vast resources and scholarly opportunities available at the candidate's renowned academic center inclusive of the structured mentorship, didactic courses, informal seminars, institutes, and colloquia. The highly qualified mentorship team contributes complimentary expertise to the training plan and a multidisciplinary perspective representing the fields of medicine, nursing, and marketing. Utilizing Choice-based Conjoint (CBC) Analysis, a well established marketing technique to elicit consumer preference, the proposed research investigates 1) if African Americans and Whites have different preference structures related to analgesic treatment for cancer pain, and if so, what trade-offs they employ in making cancer pain treatment decisions; 2) what is the relative impact of patients' socio-demographic, illness, and pain-related characteristics on their analgesic preference; and 3) what is the relationship between patients' stated preferences and their reported adherence to prescription analgesic treatment for cancer pain. Data derived from the study will lay the foundation for candidate's long-term goal of developing patient-centered interventions incorporating patient preferences into complex medical decision-making. Relevance: Healthcare often involves making competing choices under risks and uncertainties. This research uses a novel technique to understand if African American and White patients with cancer pain use different mental trade-offs in arriving at pain treatment decisions; have differential preferences for cancer pain treatment; and how this may relate to their adherence to pain medications for cancer pain.