National Study of Pain Medicine Access Among Māori and Non-Māori Patients With Lung Cancer in New Zealand

Abstract

PURPOSE Pain is among the most common and consequential symptoms of cancer, particularly in the context of lung cancer. M ¯ aori have extremely high rates of lung cancer, and there is evidence that M ¯ aori patients with lung cancer are less likely to receive curative treatment and more likely to receive palliative treatment and to wait longer for their treatment than non-M ¯ aori New Zealanders. The extent to which M ¯ aori patients with lung cancer are also less likely to have access to pain medicines as part of their supportive care remains unclear. METHODS Using national-level Cancer Registry and linked health records, we describe access to subsidized pain medicines among patients with lung cancer diagnosed over the decade spanning 2007-2016 and compare access between M ¯ aori and non-M ¯ aori patients. Descriptive and logistic regression methods were used to compare access between ethnic groups. RESULTS We observed that the majority of patients with lung cancer are accessing some form of pain medicine and there do not appear to be strong differences between M ¯ aori and non-M ¯ aori in terms of overall access or the type of pain medicine dispensed. However, M ¯ aori patients appeared more likely than non-M ¯ aori to first access pain medicines within 2 weeks before their death and commensurately less likely to access them more than 24 weeks before death. CONCLUSION Given the plausibility that there are differences in first access to pain medicines (particularly opioid medicines) among M ¯ aori approaching end of life, further investigation of the factors contributing to this disparity is required.