Comparative analysis of depression, anxiety, suicidality, substance use, and palliative care use in pain-afflicted multiple myeloma patients across White, Black, and Hispanic populations.

Abstract

e19501 Background: Bone pain affects 93% of multiple myeloma (MM) patients, significantly impairing quality of life and triggering psychological distress, potentially leading to depression, anxiety, suicidal ideation, and substance use disorders. We explored these outcomes across racial groups. Methods: White, Black, and Hispanic patients with MM and neoplastic pain were identified from the National Inpatient Sample (2016-2022). We compared demographics and evaluated odds of depression, anxiety, suicidality, substance use disorders, and palliative care utilization across racial groups using multivariable regression with White patients as reference. STATA 18.0 was used, accounting for NIS survey design. Results: We evaluated 49,400 MM patients with pain: 32,835 (66.47%) White, 11,585 (23.45%) Black, and 4,980 (10.08%) Hispanic. White patients were the oldest (mean 65.97 years) compared to Black (62.41 years) and Hispanic patients (62.00 years, p<0.001). White (58.25%) and Hispanic (55.08%) patients were predominantly male, while Black patients were predominantly female (46.8% male).Black patients had lower odds of depression (aOR 0.59, 95% CI 0.50–0.70, p<0.001) and anxiety (aOR 0.47, 95% CI 0.41–0.54, p<0.001) versus White patients. Hispanic patients showed similar patterns for depression (aOR 0.62, 95% CI 0.49–0.79, p<0.001) and anxiety (aOR 0.67, 95% CI 0.56–0.80, p<0.001). Suicidality did not differ significantly (Black: aOR 0.96, 95% CI 0.43–2.14, p=0.914; Hispanic: aOR 0.20, 95% CI 0.02–1.54, p=0.121). Black patients had higher odds of cocaine use (aOR 6.61, 95% CI 3.00–14.57, p<0.001) and cannabis use (aOR 2.12, 95% CI 1.41–3.18, p<0.001), while Hispanic patients showed no differences (cocaine: aOR 0.42, 95% CI 0.05–3.59, p=0.431; cannabis: aOR 0.59, 95% CI 0.27–1.27, p=0.178). Opioid use (Black: aOR 0.94, 95% CI 0.72–1.24, p=0.679; Hispanic: aOR 1.05, 95% CI 0.73–1.51, p=0.800) and alcohol abuse (Black: aOR 1.12, 95% CI 0.74–1.68, p=0.603; Hispanic: aOR 0.75, 95% CI 0.40–1.43, p=0.389) were comparable. Palliative care use (Black: aOR 1.08, 95% CI 0.96–1.22, p=0.201; Hispanic: aOR 1.12, 95% CI 0.92–1.35, p=0.255) and mortality (Black: aOR 0.93, 95% CI 0.73–1.19, p=0.569; Hispanic: aOR 1.02, 95% CI 0.74–1.40, p=0.923) were similar across groups. Conclusions: Our study found significant racial disparities in mental health and substance use patterns among MM bone pain patients. Despite these differences, palliative care utilization and in-hospital mortality were comparable among racial groups. These findings emphasize the importance of culturally sensitive screening for mental health disorders among MM patients with bone pain and call for future research to assess targeted interventions to enhance care for patients across all ethnic backgrounds.