BACKGROUND: Uncontrolled pain remains prevalent in patients with advanced cancer and has been associated with worse quality of life and greater health care utilization. Poor adherence to analgesics may represent a modifiable barrier to pain management. OBJECTIVE: This pilot study aimed to establish feasibility/utility of evaluating self-reported adherence to long-acting (LA) opioids in patients with advanced lung cancer, and to explore rates and correlates of adherence. METHODS: Consecutive patients attending an ambulatory thoracic oncology clinic with a diagnosis of advanced lung cancer and a current LA opioid regimen were approached to complete a brief questionnaire during their clinic visit. Participants reported LA opioid adherence during the past 4 weeks (0%-100%) and knowledge of their LA opioid regimen, and completed the Patient Health Questionnaire-2 (PHQ-2) depression screen. Demographic and clinical information were confirmed via electronic health record review. RESULTS: Fifty-four eligible patients were approached to reach our target sample (n=50; enrollment=92.6%). Self-reported adherence to LA opioids was 85.4% (standard deviation [SD]=21.0). Twenty-eight percent reported a frequency of medication use that did not match the prescribed daily frequency. Lower adherence was associated with inaccurate frequency (p=0.004), positive depression screen (p=0.005), and older age (p=0.04). CONCLUSIONS: Our results demonstrate the feasibility of integrating self-report assessments of LA opioid adherence into a thoracic oncology clinic. Patients reported high adherence, but more than one-quarter did not accurately report the prescribed frequency of daily doses. Understanding of LA opioid regimens may be a critical indicator of adherence in patients with advanced cancer.
BACKGROUND: Uncontrolled pain remains prevalent in patients with advanced cancer and has been associated with worse quality of life and greater health care utilization. Poor adherence to analgesics may represent a modifiable barrier to pain management. OBJECTIVE: This pilot study aimed to establish feasibility/utility of evaluating self-reported adherence to long-acting (LA) opioids in patients with advanced lung cancer, and to explore rates and correlates of adherence. METHODS: Consecutive patients attending an ambulatory thoracic oncology clinic with a diagnosis of advanced lung cancer and a current LA opioid regimen were approached to complete a brief questionnaire during their clinic visit. Participants reported LA opioid adherence during the past 4 weeks (0%-100%) and knowledge of their LA opioid regimen, and completed the Patient Health Questionnaire-2 (PHQ-2) depression screen. Demographic and clinical information were confirmed via electronic health record review. RESULTS: Fifty-four eligible patients were approached to reach our target sample (n=50; enrollment=92.6%). Self-reported adherence to LA opioids was 85.4% (standard deviation [SD]=21.0). Twenty-eight percent reported a frequency of medication use that did not match the prescribed daily frequency. Lower adherence was associated with inaccurate frequency (p=0.004), positive depression screen (p=0.005), and older age (p=0.04). CONCLUSIONS: Our results demonstrate the feasibility of integrating self-report assessments of LA opioid adherence into a thoracic oncology clinic. Patients reported high adherence, but more than one-quarter did not accurately report the prescribed frequency of daily doses. Understanding of LA opioid regimens may be a critical indicator of adherence in patients with advanced cancer.
Authors: Emily M Wright; Areej El-Jawahri; Jennifer S Temel; Alaina Carr; Steven A Safren; Elyse R Park; William F Pirl; Eduardo Bruera; Lara Traeger Journal: J Pain Symptom Manage Date: 2019-03-01 Impact factor: 3.612
Authors: Stephen J Stapleton; Brenda W Dyal; Andrew D Boyd; Marie L Suarez; Miriam O Ezenwa; Yingwei Yao; Diana J Wilkie Journal: Cancer Nurs Date: 2022-02-16 Impact factor: 2.760
Authors: Kathryn E Smith; J Graham Thomas; Kristine J Steffen; Richard B Lipton; Samantha G Farris; Jelena M Pavlovic; Dale S Bond Journal: Transl Behav Med Date: 2021-08-13 Impact factor: 3.046
Authors: David F Lobach; Ellis B Johns; Barbara Halpenny; Toni-Ann Saunders; Jane Brzozowski; Guilherme Del Fiol; Donna L Berry; Ilana M Braun; Kathleen Finn; Joanne Wolfe; Janet L Abrahm; Mary E Cooley Journal: JMIR Med Inform Date: 2016-11-08