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

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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.