Leon Timmerman1, Dirk L Stronks2, Frank J P M Huygen2. 1. a Department of Anesthesiology, Intensive Care and Pain Medicine , St. Antonius Hospital , Nieuwegein , the Netherlands. 2. b Center for Pain Medicine, Erasmus MC University Medical Center , Rotterdam , the Netherlands.
Abstract
OBJECTIVE: Non-adherence to pain medication is common in chronic pain patients and may result in unfavorable treatment outcomes. Interventions to improve adherence behavior often fail to significantly change medication use. In this report, we describe the application of a theoretical psychological model of behavior change in order to design an intervention to improve medication adherence in chronic pain patients. METHODS: This study applies the Behavior Change Wheel framework and the Behavior Change Techniques Taxonomy to design a theory-based intervention to improve pain medication use. Available literature was used to extract determinants of adherence in chronic pain patients. RESULTS: Selected target behaviors to improve medication adherence are: share agreement on follow up policy, monitor medication adherence, provide patient education routinely, discuss attitudes and concerns towards pain medication, develop medication taking habits and use medication reminders. The intervention consists of three components in which relevant behavior change techniques are applied: (1) changes in the electronic patient data management systems to enable medical staff to apply target behaviors; (2) bi-annual education of medical staff to commit the team to the proposed intervention and provide feedback; (3) routine and mandatory education of chronic pain patients following prescription of pain medication. CONCLUSIONS: To improve medication adherence in chronic pain patients, most interventions should be focused on providers of pain therapy. Prescribing chronic pain medication should be seen as part of a larger treatment regimen including adequate follow-up, adherence monitoring and patient education during the course of treatment.
OBJECTIVE: Non-adherence to pain medication is common in chronic painpatients and may result in unfavorable treatment outcomes. Interventions to improve adherence behavior often fail to significantly change medication use. In this report, we describe the application of a theoretical psychological model of behavior change in order to design an intervention to improve medication adherence in chronic painpatients. METHODS: This study applies the Behavior Change Wheel framework and the Behavior Change Techniques Taxonomy to design a theory-based intervention to improve pain medication use. Available literature was used to extract determinants of adherence in chronic painpatients. RESULTS: Selected target behaviors to improve medication adherence are: share agreement on follow up policy, monitor medication adherence, provide patient education routinely, discuss attitudes and concerns towards pain medication, develop medication taking habits and use medication reminders. The intervention consists of three components in which relevant behavior change techniques are applied: (1) changes in the electronic patient data management systems to enable medical staff to apply target behaviors; (2) bi-annual education of medical staff to commit the team to the proposed intervention and provide feedback; (3) routine and mandatory education of chronic painpatients following prescription of pain medication. CONCLUSIONS: To improve medication adherence in chronic painpatients, most interventions should be focused on providers of pain therapy. Prescribing chronic pain medication should be seen as part of a larger treatment regimen including adequate follow-up, adherence monitoring and patient education during the course of treatment.
Authors: Owis Eilayyan; Aliki Thomas; Marie-Christine Hallé; Sara Ahmed; Anthony C Tibbles; Craig Jacobs; Silvano Mior; Connie Davis; Roni Evans; Michael J Schneider; Heather Owens; Fadi Al Zoubi; Jan Barnsley; Cynthia R Long; Andre Bussières Journal: Chiropr Man Therap Date: 2019-10-16