{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:45:26Z","timestamp":1792601126488,"version":"4.5.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T00:00:00Z","timestamp":1583712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Brain metastases (BM) cause symptoms that supportive medications can alleviate. We assessed whether racial disparities exist in supportive medication utilization after BM diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Medicare-enrolled patients linked with the Surveillance, Epidemiology, and End Results program (SEER) who had diagnoses of BM between 2007 and 2016 were identified. Fourteen supportive medication classes were studied: non-opioid analgesics, opioids, anti-emetics, anti-epileptics, headache-targeting medications, steroids, cognitive aids, antidepressants, anxiolytics, antidelirium\/antipsychotic agents, muscle relaxants, psychostimulants, sleep aids, and appetite stimulants. Drug administration \u226430 days following BM diagnosis was compared by race using multivariable logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 17,957 patients, headache aids, antidepressants, and anxiolytics were prescribed less frequently to African Americans (odds ratio [95% CI] = 0.81 [0.73\u20130.90], P &amp;lt; 0.001; OR = 0.68 [0.57\u20130.80], P &amp;lt; 0.001; and OR = 0.68 [0.56\u20130.82], P &amp;lt; 0.001, respectively), Hispanics (OR = 0.83 [0.73\u20130.94], P = 0.004 OR = 0.78 [0.64\u20130.97], P = 0.02; and OR = 0.63 [0.49\u20130.81], P &amp;lt; 0.001, respectively), and Asians (OR = 0.81 [0.72\u20130.92], P = 0.001, OR = 0.67 [0.53\u20130.85], P = 0.001, and OR = 0.62 [0.48\u20130.80], P &amp;lt; 0.001, respectively) compared with non-Hispanic Whites. African Americans also received fewer anti-emetics (OR = 0.75 [0.68\u20130.83], P &amp;lt; 0.001), steroids (OR = 0.84 [0.76\u20130.93], P &amp;lt; 0.001), psychostimulants (OR = 0.14 [0.03\u20130.59], P = 0.007), sleep aids (OR = 0.71 [0.61\u20130.83], P &amp;lt; 0.001), and appetite stimulants (OR = 0.85 [0.77\u20130.94], P = 0.002) than Whites. Hispanic patients less frequently received antidelirium\/antipsychotic drugs (OR = 0.57 [0.38\u20130.86], P = 0.008), sleep aids (OR = 0.78 [0.64\u20130.94, P = 0.01), and appetite stimulants (OR = 0.87 [0.76\u20130.99], P = 0.04). Asian patients received fewer opioids (OR = 0.86 [0.75\u20130.99], P = 0.04), anti-emetics (OR = 0.83 [0.73\u20130.94], P = 0.004), anti-epileptics (OR = 0.83 [0.71\u20130.97], P = 0.02), steroids (OR = 0.81 [0.72\u20130.92], P = 0.001), muscle relaxants (OR = 0.60 [0.41\u20130.89], P = 0.01), and appetite stimulants (OR = 0.87 [0.76\u20130.99], P = 0.03). No medication class was prescribed significantly less frequently to Whites.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Disparities in supportive medication prescription for non-White\/Hispanic groups with BM exist; improved provider communication and engagement with at-risk patients is needed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Key Points<\/jats:title>\n                  <jats:p>1.\u2002Patients with BM commonly experience neurologic symptoms.<\/jats:p>\n                  <jats:p>2.\u2002Supportive medications improve quality of life among patients with BM.<\/jats:p>\n                  <jats:p>3. Non-White patients with BM receive fewer supportive medications than White patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/neuonc\/noaa054","type":"journal-article","created":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T20:19:43Z","timestamp":1583180383000},"page":"1339-1347","source":"Crossref","is-referenced-by-count":47,"title":["Racial disparities in supportive medication use among older patients with brain metastases: a population-based analysis"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2598-6529","authenticated-orcid":false,"given":"Nayan","family":"Lamba","sequence":"first","affiliation":[{"name":"Dana-Farber Cancer Institute, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elie","family":"Mehanna","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel B","family":"Kearney","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J","family":"Catalano","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Harvard T.H. Chan School of Public Health, and Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2378-4800","authenticated-orcid":false,"given":"Daphne A","family":"Haas-Kogan","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian M","family":"Alexander","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel N","family":"Cagney","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen A","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Adult Palliative Care, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Division of Palliative Medicine, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayal A","family":"Aizer","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,3,9]]},"reference":[{"issue":"1","key":"2020092909445550700_CIT0001","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1007\/s11912-011-0203-y","article-title":"Epidemiology of brain metastases","volume":"14","author":"Nayak","year":"2012","journal-title":"Curr Oncol Rep."},{"issue":"11","key":"2020092909445550700_CIT0002","first-page":"4655","article-title":"Recent trends in epidemiology of brain metastases: an overview","volume":"32","author":"Tabouret","year":"2012","journal-title":"Anticancer Res."},{"issue":"4","key":"2020092909445550700_CIT0003","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/S0959-8049(01)00150-2","article-title":"Symptom response after palliative radiotherapy for patients with brain metastases","volume":"38","author":"Bezjak","year":"2002","journal-title":"Eur J Cancer."},{"issue":"1","key":"2020092909445550700_CIT0004","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.clon.2007.09.007","article-title":"Symptom clusters in cancer patients with brain metastases","volume":"20","author":"Chow","year":"2008","journal-title":"Clin Oncol."},{"issue":"2","key":"2020092909445550700_CIT0005","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/01.coc.0000143016.15783.5b","article-title":"Radiosurgery with or without whole-brain radiotherapy for brain metastases: the patients\u2019 perspective regarding complications","volume":"28","author":"Kondziolka","year":"2005","journal-title":"Am J Clin Oncol."},{"issue":"3","key":"2020092909445550700_CIT0006","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S1040-8428(01)00143-3","article-title":"Radiotherapy-related fatigue","volume":"41","author":"Jereczek-Fossa","year":"2002","journal-title":"Crit Rev Oncol Hematol."},{"issue":"8","key":"2020092909445550700_CIT0007","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1056\/NEJMoa1000678","article-title":"Early palliative care for patients with metastatic non-small-cell lung cancer","volume":"363","author":"Temel","year":"2010","journal-title":"N Engl J Med."},{"issue":"2","key":"2020092909445550700_CIT0008","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1001\/jama.2017.7156","article-title":"Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment","volume":"318","author":"Basch","year":"2017","journal-title":"JAMA."},{"issue":"3","key":"2020092909445550700_CIT0009","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1001\/jama.2018.18085","article-title":"Two-year survival comparing web-based symptom monitoring vs routine surveillance following treatment for lung cancer","volume":"321","author":"Denis","year":"2019","journal-title":"JAMA."},{"issue":"10","key":"2020092909445550700_CIT0010","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1002\/cncr.28617","article-title":"Lack of reduction in racial disparities in cancer-specific mortality over a 20-year period","volume":"120","author":"Aizer","year":"2014","journal-title":"Cancer."},{"issue":"1","key":"2020092909445550700_CIT0011","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1200\/JCO.2017.74.2049","article-title":"Racial and ethnic disparities in cancer survival: the contribution of tumor, sociodemographic, institutional, and neighborhood characteristics","volume":"36","author":"Ellis","year":"2018","journal-title":"J Clin Oncol."},{"issue":"19","key":"2020092909445550700_CIT0012","doi-asserted-by":"crossref","first-page":"2265","DOI":"10.1200\/JCO.2015.64.8162","article-title":"Investigation of racial disparities in early supportive medication use and end-of-life care among Medicare beneficiaries with stage IV breast cancer","volume":"34","author":"Check","year":"2016","journal-title":"J Clin Oncol."},{"issue":"5","key":"2020092909445550700_CIT0013","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1007\/s00520-018-4406-8","article-title":"Examining potential gaps in supportive medication use for US and foreign-born Hispanic women with breast cancer","volume":"27","author":"Pinheiro","year":"2019","journal-title":"Support Care Cancer."},{"key":"2020092909445550700_CIT0014","doi-asserted-by":"crossref","first-page":"1695101","DOI":"10.1155\/2017\/1695101","article-title":"Managing an older adult with cancer: considerations for radiation oncologists","volume":"2017","author":"Chang","year":"2017","journal-title":"Biomed Res Int."},{"key":"2020092909445550700_CIT0015","author":"Surveillance, Epidemiology, and End Results (SEER) Program; National Cancer Institute"},{"key":"2020092909445550700_CIT0016","author":"National Cancer Institute, Division of Cancer Control and Population Sciences"},{"issue":"3","key":"2020092909445550700_CIT0017","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s11060-009-9943-z","article-title":"Utility of administrative claims data for the study of brain metastases: a validation study","volume":"95","author":"Eichler","year":"2009","journal-title":"J Neurooncol."},{"key":"2020092909445550700_CIT0018","doi-asserted-by":"crossref","DOI":"10.1093\/neuonc\/noz245","article-title":"Utility of claims data for identification of date of diagnosis of brain metastases [published online ahead of print January 6, 2020]","author":"Lamba","year":"2020","journal-title":"Neuro Oncol."},{"issue":"6","key":"2020092909445550700_CIT0019","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/0895-4356(92)90133-8","article-title":"Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases","volume":"45","author":"Deyo","year":"1992","journal-title":"J Clin Epidemiol."},{"issue":"17","key":"2020092909445550700_CIT0020","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1001\/archinte.162.17.1985","article-title":"Cancer survival among US whites and minorities: a SEER (Surveillance, Epidemiology, and End Results) Program population-based study","volume":"162","author":"Clegg","year":"2002","journal-title":"Arch Intern Med."},{"issue":"4","key":"2020092909445550700_CIT0021","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1001\/jama.2013.8272","article-title":"Characteristics associated with differences in survival among black and white women with breast cancer","volume":"310","author":"Silber","year":"2013","journal-title":"JAMA."},{"issue":"12","key":"2020092909445550700_CIT0022","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.jpain.2009.10.002","article-title":"Racial and ethnic disparities in pain: causes and consequences of unequal care","volume":"10","author":"Anderson","year":"2009","journal-title":"J Pain."},{"issue":"12","key":"2020092909445550700_CIT0023","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1176\/appi.ps.56.12.1600","article-title":"Disparities in mental health treatment in U.S. racial and ethnic minority groups: implications for psychiatrists","volume":"56","author":"Atdjian","year":"2005","journal-title":"Psychiatr Serv."},{"key":"2020092909445550700_CIT0024","doi-asserted-by":"crossref","article-title":"Racial and ethnic differences in mental illness stigma and discrimination among Californians experiencing mental health challenges","author":"Wong","DOI":"10.7249\/RR1441"},{"key":"2020092909445550700_CIT0025","first-page":"320902","article-title":"Depression among Asian Americans: review and recommendations","volume":"2011","author":"Kalibatseva","year":"2011","journal-title":"Depress Res Treat."},{"issue":"11","key":"2020092909445550700_CIT0026","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1017\/S0033291709992285","article-title":"Depression and cancer mortality: a meta-analysis","volume":"40","author":"Pinquart","year":"2010","journal-title":"Psychol Med."},{"issue":"4","key":"2020092909445550700_CIT0027","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1200\/JCO.2010.28.4455","article-title":"Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis","volume":"29","author":"Giese-Davis","year":"2011","journal-title":"J Clin Oncol."},{"issue":"1","key":"2020092909445550700_CIT0028","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1177\/0163278704273084","article-title":"Can physicians improve patient satisfaction with long waiting times?","volume":"28","author":"Feddock","year":"2005","journal-title":"Eval Health Prof."},{"issue":"1","key":"2020092909445550700_CIT0029","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1177\/082585979901500104","article-title":"Comparison of palliative care needs of English- and non-English-speaking patients","volume":"15","author":"Chan","year":"1999","journal-title":"J Palliat Care."},{"issue":"3","key":"2020092909445550700_CIT0030","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1093\/fampra\/cmi113","article-title":"Potential barriers to the use of health services among ethnic minorities: a review","volume":"23","author":"Scheppers","year":"2006","journal-title":"Fam Pract."},{"issue":"12","key":"2020092909445550700_CIT0031","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1097\/MLR.0b013e3181f380bc","article-title":"Do hospitals measure up to the national culturally and linguistically appropriate services standards?","volume":"48","author":"Diamond","year":"2010","journal-title":"Med Care."},{"issue":"2","key":"2020092909445550700_CIT0032","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1111\/j.1475-6773.2006.00629.x","article-title":"Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature","volume":"42","author":"Karliner","year":"2007","journal-title":"Health Serv Res."},{"issue":"3","key":"2020092909445550700_CIT0033","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.jpainsymman.2015.10.011","article-title":"Interpreting at the end of life: a systematic review of the impact of interpreters on the delivery of palliative care services to cancer patients with limited English proficiency","volume":"51","author":"Silva","year":"2016","journal-title":"J Pain Symptom Manage."},{"issue":"3","key":"2020092909445550700_CIT0034","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.ijrobp.2009.08.004","article-title":"Effect of radiotherapy interruptions on survival in Medicare enrollees with local and regional head-and-neck cancer","volume":"78","author":"Fesinmeyer","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys."},{"issue":"11","key":"2020092909445550700_CIT0035","doi-asserted-by":"crossref","first-page":"3183","DOI":"10.1007\/s00520-015-2698-5","article-title":"Chemotherapy interruptions in relation to symptom severity in advanced breast cancer","volume":"23","author":"Wyatt","year":"2015","journal-title":"Support Care Cancer."},{"issue":"2","key":"2020092909445550700_CIT0036","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.ijrobp.2016.01.043","article-title":"Radiation therapy noncompliance and clinical outcomes in an urban academic cancer center","volume":"95","author":"Ohri","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys."},{"issue":"1","key":"2020092909445550700_CIT0037","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1377\/hlthaff.28.1.160","article-title":"A matter of race: early-versus late-stage cancer diagnosis","volume":"28","author":"Virnig","year":"2009","journal-title":"Health Aff (Millwood)."},{"issue":"11","key":"2020092909445550700_CIT0038","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1158\/1055-9965.EPI-15-0293","article-title":"Racial disparities in breast cancer diagnosis and treatment by hormone receptor and HER2 status","volume":"24","author":"Chen","year":"2015","journal-title":"Cancer Epidemiol Biomarkers Prev."},{"issue":"3","key":"2020092909445550700_CIT0039","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.jamcollsurg.2012.11.014","article-title":"Racial disparities in surgical care and outcomes in the United States: a comprehensive review of patient, provider, and systemic factors","volume":"216","author":"Haider","year":"2013","journal-title":"J Am Coll Surg."},{"issue":"1","key":"2020092909445550700_CIT0040","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s10585-019-10005-2","article-title":"Disparities in the use of stereotactic radiosurgery for the treatment of lung cancer brain metastases: a SEER-Medicare study","volume":"37","author":"Ascha","year":"2020","journal-title":"Clin Exp Metastasis."},{"issue":"12","key":"2020092909445550700_CIT0041","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.6004\/jnccn.2017.7003","article-title":"Radiosurgery for brain metastases: changing practice patterns and disparities in the United States","volume":"15","author":"Kann","year":"2017","journal-title":"J Natl Compr Canc Netw."},{"issue":"1","key":"2020092909445550700_CIT0042","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1200\/JCO.2016.70.1474","article-title":"Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline Update","volume":"35","author":"Ferrell","year":"2017","journal-title":"J Clin Oncol."},{"issue":"7","key":"2020092909445550700_CIT0043","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1001\/jama.2009.1198","article-title":"Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial","volume":"302","author":"Bakitas","year":"2009","journal-title":"JAMA."},{"issue":"8","key":"2020092909445550700_CIT0044","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1200\/JCO.2011.38.5161","article-title":"American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care","volume":"30","author":"Smith","year":"2012","journal-title":"J Clin Oncol."},{"key":"2020092909445550700_CIT0045","author":"National Cancer Institute"},{"issue":"2","key":"2020092909445550700_CIT0046","doi-asserted-by":"crossref","first-page":"e109","DOI":"10.1016\/j.ijrobp.2012.08.007","article-title":"Use of stereotactic radiosurgery for brain metastases from non-small cell lung cancer in the United States","volume":"85","author":"Halasz","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys."}],"container-title":["Neuro-Oncology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/neuro-oncology\/advance-article-pdf\/doi\/10.1093\/neuonc\/noaa054\/33037458\/noaa054.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/neuro-oncology\/article-pdf\/22\/9\/1339\/33802733\/noaa054.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/neuro-oncology\/article-pdf\/22\/9\/1339\/33802733\/noaa054.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T13:45:55Z","timestamp":1601387155000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/neuro-oncology\/article\/22\/9\/1339\/5800995"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,9]]},"references-count":46,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,3,9]]},"published-print":{"date-parts":[[2020,9,29]]}},"URL":"https:\/\/doi.org\/10.1093\/neuonc\/noaa054","relation":{},"ISSN":["1522-8517","1523-5866"],"issn-type":[{"value":"1522-8517","type":"print"},{"value":"1523-5866","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,9]]},"published":{"date-parts":[[2020,3,9]]}}}