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Pain and Opioid Use Among Black and White Patients With Cancer Using Remote Symptom Monitoring
Joud El Dick1, Sandra Olisakwe1, Courtney P Williams2
1Division of Hematology and Oncology (J.E.D., S.O., A.A., N.L.H., G.B.R.), University of Alabama at Birmingham, Birmingham, Alabama, USA.
Journal of Pain and Symptom Management
|June 4, 2026
Summary
Remote symptom monitoring (RSM) may help reduce racial disparities in cancer pain management. This study found similar pain reporting and opioid use between Black and White patients in an RSM program, indicating potential for more equitable care.
Area of Science:
- Oncology
- Health Services Research
- Pain Management
Background:
- Black cancer patients experience higher pain and undertreatment compared to White patients.
- Remote symptom monitoring (RSM) using electronic patient-reported outcomes can standardize pain assessment.
Purpose of the Study:
- To determine if racial disparities in pain severity or opioid use persist in cancer patients within an RSM program.
- Investigate the impact of RSM on pain reporting and opioid utilization across racial groups.
Main Methods:
- Secondary analysis of a single-group trial involving adult cancer patients in an RSM program (2020-2023).
- Weekly PRO-CTCAE surveys assessed pain severity; electronic health records provided opioid use data.
- Multivariable mixed models analyzed associations between race, pain, and opioid use.
Main Results:
- Among 913 patients, 27% were Black; Black patients had higher rates of obesity, breast cancer, and late-stage disease.
- Pain severity reporting was similar between racial groups at 0-6 months post-enrollment.
- Adjusted analyses showed similar probabilities of moderate to severe pain between Black and White patients; opioid use decreased in both groups during RSM.
Conclusions:
- Pain severity and the link between opioid use and pain were comparable between Black and White patients in the RSM program.
- Opioid prescribing decreased for both racial groups, suggesting RSM supports equitable cancer pain management.
- RSM shows promise in standardizing care and potentially reducing racial disparities in cancer pain management.
