Factors Associated With Guideline-Concordant Pharmacological Treatment for Neuropathic Pain Among Breast Cancer Survivors

This study identifies factors associated with receiving guideline-concordant treatment among breast cancer survivors with neuropathic pain using SEER-Medicare data from 2007 to 2015 by multivariable logistic regres-sion and backward selection. 16.7% of our study population developed a pain condition, on average 1.4 years after cancer treatment and received treatment at 2.4 months after diagnosis. Survivors with comorbidi-ties and continuous medication history were associated with receiving guideline-concordant treatment for treatment-related neuropathic pain. We found that non-White survivors were less likely to receive guideline-concordant treatment for treatment-related neuropathic pain. Our findings warrant attention towards minorities and survivors with comorbidities when prescribing concurrent pain medications for neuropathic pain devel-oped from guideline-concordant breast cancer treatment. Purpose: To identify factors associated with receiving guideline-concordant treatment among breast cancer survivors with neuropathic pain. Materials and Methods: A retrospective case-control study was conducted using the SEER-Medicare linked database. We included female breast cancer survivors diagnosed with non-metastatic breast cancer (stages 0-III) between 2007 and 2015 who developed treatment-related neuropathic pain during their survivorship period. Guideline-concordant treatment was defined based on NCCN guidelines. Factors associated with receiving guideline-concordant treatment were assessed using multivariable logistic regression and backward selection was used to identify potential associated factors. Results: Around 16.7% of breast cancer survivors in the study devel-oped a neuropathic pain condition. The mean time to develop neuropathic pain was 1.4 years after beginning adjuvant treatment. On average, patients who developed neuropathic pain and received guideline-concordant treatment did so at 2.4 months after their neuropathic pain diagnosis. We found that survivors that are black and of other races were less likely to receive guideline-concordant treatment for breast cancer treatment-related neuropathic pain. Whereas survivors with diabetes, mental health disorders, hemiplegia, prior continuous opioid use, benzodiazepine use, nonben-zodiazepine CNS depressant use, or antipsychotic medication use were less likely to receive guideline-concordant treatment. Conclusion: This study suggests that minor ity races, pr ior medication use, and comorbid conditions are associated with guideline-concordant treatment among breast cancer survivors with neuropathic pain. These findings warrant attention towards minority races to prescribe them guideline-concordant treatment as well as caution when prescribing concurrent pain medications to survivors with comorbidities and prior medication use.