Prescription Opioid Use Among Cancer Patients before and after the Onset of COVID-19: Evidence from Real-World Data

Objectives: Opioids play a significant role in the effective management of cancer-related pain. The COVID-19 lock down may have reduced access to opioids and caused a decline in the use of prescription of opioids among cancer survivors. This study compared opioid prescription rates among cancer survivors before and after the onset of COVID-19 pandemic using real-world electronic health records (EHR). Method(s): Cohort analyses of cancer patients using data from EHR database from the TriNetX, a global federated health research network across 76 healthcare organizations. We analyzed changes in prescription opioid use before (March 1, 2018, through March 1, 2019) and after onset of COVID-19 (April 01, 2020, through March 2021) among cancer survivors. The key outcome variable was any opioid prescription within 1 year of cancer diagnosis. One-to-one propensity score matching was used to balance the characteristics (age, sex, race, diagnoses including diabetes, hypertensive diseases, overweight, mood disorders, and visual disturbances) of the two cohorts. Data were analyzed using the TriNetX platform. Result(s): There were 1,502,143 cancer survivors before COVID-19 and 1,412,599 cancer survivors after the onset of COVID-19. The one-to-one propensity-score match yielded 1,382,561 cancer patients, mean age 64 at cancer diagnosis, and 73% were white. Percentage of opioid use among cancer patients declined from 35.6% before the COVID-19 to 35.1% after the onset of the pandemic (OR=0.976, 95% CI 0.971-0.981). Average number of opioid prescriptions within 1 year of cancer diagnosis declined from 5.7 before to 5.3 after the COVID-19 onset (p<0.001). Conclusion(s): Among cancer survivors, a small decline in prescription opioid use was observed after the onset of COVID-19 pandemic. Future studies are needed to distinguish the impact of revised guidelines, opioid prescription policy changes, and COVID-19 lock down on lower rates of prescription opioid use among cancer survivors.Copyright © 2023

Barriers to in-Person Focus Group Participation during the Third-Year of COVID-19 Pandemic: A Case Study of Colorectal Cancer (CRC) Screening in Underrepresented Groups

Objectives: In the process of conducting research to understand barriers to colorectal cancer (CRC) screening in underrepresented groups such as Blacks and Hispanics, it became evident that there were also barriers to recruitment in this population. This study assesses the challenges faced in recruitment of focus group participants regarding CRC screening practices among underrepresented groups. Since the COVID-19 pandemic, qualitative research participants have primarily been interviewed through online video or audio interactions. However, as restrictions on in-person interactions have been lifted, in-person focus groups are being increasingly considered. Method(s): The study investigators began recruitment through community health workers in August 2022, when COVID-19 vaccines were available for all adults (age>18 years). Eligible individuals were: age 45-75, Black or Hispanic, with Medicaid or no insurance, and no family history of CRC or diagnosis of certain colon-related diseases. We combined in-person and virtual recruitment strategies, including posting flyers in communities, advertising our study at health fairs, and on social media. Participants would receive a $50 gift card. Result(s): Fifty-five met the eligibility criteria among 144 respondents, and 45 subjects (29 women and 16 men) agreed to be contacted. An average of 2.5 attempts were made per eligible subject. Unfortunately, we were able to recruit only four women (3 Hispanic and one non-Hispanic black). Traveling to the research site was a barrier to participation. Many subjects (49%) requested virtual participation (online video or audio interactions);some declined because the topic was too sensitive (considered taboo), and eligible men were reluctant to participate in-person. Conclusion(s): The requirement of in-person participation affected our recruitment goals, suggesting that COVID-19 has shifted the preferences of research participants to virtual interaction. In response to the eligible participant preferences, the study protocol has been revised to re-contact patients and schedule virtual FG sessions.Copyright © 2023

PIN124 Analysis of Race and Ethnicity of COVID-19 Deaths in the United States

Objectives: Coronavirus Disease 2019 (COVID-19) is an ongoing pandemic in certain populations and regions in the United States. Understanding the health disparities associated with COVID-19 deaths can help determine the populations in most need of COVID-19 preventive care and treatment. The aim of this study was to assess statistical differences between race/ethnicity distribution and their possible association with COVID-19-related mortality rates. Methods: A cross-sectional study used Centers of Disease Control (CDC) COVID Data Tracker (March-July2020). Demographic trends such as ethnicity counts reported by the CDC were analyzed for possible health disparities among individuals who died from COVID-19. Included individuals diagnosed with COVID-19 in the U.S.A. and reported demographic information provided by the CDC. Statistical analysis using Chi Square and MANOVA was conducted using SPSS and R. Results: Analyzed 100,653 Americans who died from COVID-19 based on CDC (March-July6) COVID Data Tracker. Mostly Whites (49.5%), Blacks (22.8%), and Hispanics (14.5%) died from COVID-related complications. Bivariate analysis shows that Whites had 3.45 times more odds [OR-3.45,95%CI:3.40-3.50] of dying from COVID-19 compared to non-White races. Bivariate analysis among all the ethnicities identified that Hispanics [OR:0.345,95% CI:0.338-0.352] and Native Americans [OR:0.310,95% CI:0.283-0.338] had the lowest risk of dying from COVID-19 compared to Whites. Conclusions: Using a snapshot of population-level data in an ongoing pandemic, White Americans currently have a higher odds of mortality. Seemingly, Whites are more likely to get tested and diagnosed with COVID-19, which may confound case reporting and subsequent analysis. Future research will focus on other significant factors and underlying health conditions that may correlate or confound with COVID-19 mortality among the different ethnicities. Payers, providers, and decision makers should be aware of COVID-19 health disparities to better identify at-risk populations and create targeted interventions to reduce hospitalizations and mortality. Policy makers and clinicians can create synergy to address COVID-19-related health disparities.