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J Pain Symptom Manage. 2019 Jan;57(1):28-36. doi: 10.1016/j.jpainsymman.2018.10.491. Epub 2018 Oct 12.

Factors Related to Adherence to Opioids in Black Patients With Cancer Pain.

Author information

1
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA; Winship Cancer Institute, Emory University, Atlanta, Georgia, USA. Electronic address: kyeager@emory.edu.
2
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.
3
Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
4
School of Medicine, Emory University, Atlanta, Georgia, USA.
5
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
6
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA; Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.

Abstract

CONTEXT:

Cancer pain relief is often inadequate because of poor adherence to pain medication, especially for black patients.

OBJECTIVES:

The purpose of this study is to describe factors related to adherence to around-the-clock opioids among 110 black patients being treated for cancer pain.

METHODS:

Sociodemographic, clinical, symptoms, and social support data were collected at baseline; pain and adherence data were collected at 30 days. Associations between these variables and opioid adherence measured by Medication Event Monitoring System were estimated using multiple regression.

RESULTS:

Mean age was 56 (±10.1), the majority were women (63%) and college educated (56%). Mean pain severity at baseline equaled 4.6 (±2.3). Mean dose adherence was 60% (±28.5), while mean schedule adherence was 33.0% (±31.0). In adjusted analysis, 26% of the variance in dose adherence was explained by recent chemotherapy, changes in pain, concerns about nausea, and doctors' focus on cure versus pain control (P<0.001); 27% of the variance in schedule adherence was explained by recent chemotherapy, changes in pain, symptom burden, and concerns about doctors focus on cure versus pain control (P<0.001).

CONCLUSION:

Findings confirm pain medication adherence is poor and pain was not well relieved. Multiple factors influence adherence to around-the-clock opioids. Clinicians need to partner with patients by providing a personalized pain treatment plan including an in-depth assessment of treatment choices and adherence.

KEYWORDS:

Black race; Cancer pain; adherence; electronic monitoring; opioids

PMID:
30316809
PMCID:
PMC6310640
[Available on 2020-01-01]
DOI:
10.1016/j.jpainsymman.2018.10.491
[Indexed for MEDLINE]

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