• Kevin Jefferson, Tammie Quest, and Katherine A Yeager.
• Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.
• J Palliat Med. 2019 Sep 1; 22 (9): 114311481143-1148.

AbstractBackground: Black cancer patients experience pain. Barriers to opioid medications for pain may include geographic factors. This study examines neighborhood factors associated with difficulties receiving prescription opioids from pharmacies for black cancer patients. Design: A secondary data analysis of a study on opioid adherence was used to examine neighborhood-level and individual factors related to difficulties filling prescriptions for opioids. Setting/Subjects: Patients being treated for cancer pain with opioids (n = 104) were recruited. All self-identified as black, were 21 years or older, had cancer diagnoses, and had been prescribed extended release opioids. Measurements: A seven-item survey to identify problems filling opioids was completed by 98 participants along with a nine-item scale to assess perceived neighborhood characteristics. Scales of neighborhood amenities and neglect were created from the perceived neighborhood characteristics scale using principal components analysis. The 2009-2013 American Community Survey data were used to estimate the census tract percentage of non-Hispanic black residents, residents ≥25 years of age without a high school degree or equivalent, and households earning below the federal poverty level within the past 12 months. Results: Nearly 51% reported problems getting their opioids filled: 28% had to wait days and 24% had to return to the pharmacy multiple times. The main theme identified in analysis of an open-ended question was pharmacies not stocking medication. Neighborhood locations that rated higher on the amenities scale were protective for pharmacies sufficiently stocking opioids. Conclusions: Additional research on pharmacies sufficiently stocking opioid pain and neighborhood perceptions is warranted.

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