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

描述(申请人提供)：Meghani博士是一名初级教员，他的长期职业目标是作为一名独立调查员取得成功，致力于了解和消除癌症疼痛结果中的种族/民族差异。治疗疼痛的种族差异在文献中越来越多地被报道。尽管这些差异的证据越来越多，但它们的基础在很大程度上仍然不得而知。虽然提供者和系统水平的因素导致了这些差异，但同样重要的是了解与患者对癌症疼痛的止痛偏好和使用有关的因素。通过这项为期3年的K01奖项，Meghani博士试图通过参与消费者行为、患者决策和陈述偏好技术的理论和方法方面的广泛培训，拓宽她理解癌症疼痛结果差异的科学方法。培训计划利用了候选人著名的学术中心提供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。高素质的指导团队为培训计划提供了互补的专业知识，并代表了医学、护理和营销领域的多学科视角。利用基于选择的联合(CBC)分析，这是一种成熟的诱导消费者偏好的营销技术，拟议的研究调查1)非裔美国人和白人是否在癌症疼痛的止痛治疗方面具有不同的偏好结构，如果是，他们在做出癌症疼痛治疗决定时采用了哪些权衡；2)患者的社会人口、疾病和疼痛相关特征对他们的止痛偏好有何相对影响；以及3)患者所陈述的偏好和他们报告的遵守处方止痛治疗的癌症疼痛之间有何关系。这项研究得出的数据将为候选人开发以患者为中心的干预措施的长期目标奠定基础，该干预措施将患者的偏好纳入复杂的医疗决策。相关性：医疗保健往往涉及在风险和不确定性下做出相互竞争的选择。这项研究使用一种新的技术来了解患有癌症疼痛的非裔美国人和白人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使用止痛药治疗癌症疼痛有何关系。

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.