Katherine A Yeager1, Bryan Williams2, Jinbing Bai2, Hannah L F Cooper3, Tammie Quest4, Salimah H Meghani5, Deborah W Bruner6. 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.
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.
Authors: William E Rosa; Barbara Riegel; Connie M Ulrich; Jesse Chittams; Ryan Quinn; Salimah H Meghani Journal: Oncol Nurs Forum Date: 2021-01-04 Impact factor: 2.172
Authors: Jennifer C Plumb Vilardaga; Hannah M Fisher; Joseph G Winger; Shannon N Miller; Christine Nuñez; Catherine Majestic; Sarah A Kelleher; Tamara J Somers Journal: Support Care Cancer Date: 2022-05-02 Impact factor: 3.359
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: Salimah H Meghani; William E Rosa; Jesse Chittams; April Hazard Vallerand; Ting Bao; Jun J Mao Journal: Pain Manag Nurs Date: 2019-09-06 Impact factor: 1.929