Wen-Chi Chou1, Jen-Shi Chen2, Chia-Yen Hung2,3, Chang-Hsien Lu4, Yu-Yun Shao5, Tzeon-Jye Chiou6, Yung-Chuan Sung7, Kun-Ming Rau8, Chia-Jui Yen9, Su-Peng Yeh10, Ta-Chih Liu11, Ming-Fang Wu12, Ming-Yang Lee13, Ming-Sun Yu14, Wen-Li Hwang15, Pang-Yu Lai16, Cheng-Shyong Chang17, Ruey-Kuen Hsieh3. 1. Division of Hematology-Oncology, Department of Internal Medicine, Linkuo Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, 5 Fu-Hsing Street, Guishan Township, Taoyuan County, 333, Taiwan. wenchi3992@yahoo.com.tw. 2. Division of Hematology-Oncology, Department of Internal Medicine, Linkuo Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, 5 Fu-Hsing Street, Guishan Township, Taoyuan County, 333, Taiwan. 3. Division of Hematology-Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan. 4. Division of Hematology-Oncology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 5. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan. 6. Division of Hematology-Oncology, Taipei Veterans General Hospital, Taipei, Taiwan. 7. Division of Hematology-Oncology, Cathay General Hospital, Taipei, Taiwan. 8. Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. 9. Division of Hematology-Oncology, National Cheng Kung University Hospital, Tainan, Taiwan. 10. Division of Hematology-Oncology, China Medical University Hospital, Taichung, Taiwan. 11. Division of Hematology-Oncology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan. 12. Divisions of Medical Oncology and Chest Medicine, Chung Shan Medical University Hospital, School of Medicine, Chung Shan Medical University, Taichung, Taiwan. 13. Division of Hematology-Oncology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan. 14. Division of Hematology-Oncology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 15. Division of Hematology-Oncology, Taichung Veterans General Hospital, Taichung, Taiwan. 16. Division of Hematology-Oncology, E-DA Hospital, Kaohsiung, Taiwan. 17. Division of Hematology-Oncology, Changhua Christian Hospital, Changhua, Taiwan.
Abstract
PURPOSE: Poor adherence to analgesic drugs is one of the most common barriers to adequate pain management. This prospective, cross-sectional, patient-oriented observational study aimed to explore the adherence rate, clinical factors, and impact of adherence to analgesic drugs on the quality of life (QoL) among cancer outpatients in Taiwan. METHODS: Eight hundred ninety-seven consecutive adult outpatients with cancer who had reported tumor pain and received regular analgesic drug treatment were enrolled from 16 medical centers across Taiwan. The Brief Pain Inventory was used to assess pain intensity and QoL. Morisky's four-item medication adherence scale was used to assess adherence to analgesic drugs. Clinical factors possibly associated with good adherence to analgesic drugs were analyzed using multivariate logistic regression analyses. RESULTS: Of the 897 patients, 26.9% met criteria for the good, 35.5% for the moderate, and 37.6% for the poor adherence groups. The good adherence group had significantly better QoL outcomes than the moderate and poor adherence groups (all p < 0.05). Age ≥ 50 years, head and neck or hematological malignancies, cancer-related pain, patients who agreed or strongly agreed that the side effects of analgesic drugs were tolerable, and patients who disagreed or strongly disagreed that the dosing schedule could be flexibly self-adjusted to deal with the actual pain were predictors of good adherence to analgesic drugs. CONCLUSIONS: Awareness of the clinical factors associated with adherence to analgesic drugs may help clinicians to identify cancer patients at a greater risk of non-adherence, reinforce optimal pain management, and improve the QoL by enhancing adherence to pain medications.
PURPOSE: Poor adherence to analgesic drugs is one of the most common barriers to adequate pain management. This prospective, cross-sectional, patient-oriented observational study aimed to explore the adherence rate, clinical factors, and impact of adherence to analgesic drugs on the quality of life (QoL) among cancer outpatients in Taiwan. METHODS: Eight hundred ninety-seven consecutive adult outpatients with cancer who had reported tumor pain and received regular analgesic drug treatment were enrolled from 16 medical centers across Taiwan. The Brief Pain Inventory was used to assess pain intensity and QoL. Morisky's four-item medication adherence scale was used to assess adherence to analgesic drugs. Clinical factors possibly associated with good adherence to analgesic drugs were analyzed using multivariate logistic regression analyses. RESULTS: Of the 897 patients, 26.9% met criteria for the good, 35.5% for the moderate, and 37.6% for the poor adherence groups. The good adherence group had significantly better QoL outcomes than the moderate and poor adherence groups (all p < 0.05). Age ≥ 50 years, head and neck or hematological malignancies, cancer-related pain, patients who agreed or strongly agreed that the side effects of analgesic drugs were tolerable, and patients who disagreed or strongly disagreed that the dosing schedule could be flexibly self-adjusted to deal with the actual pain were predictors of good adherence to analgesic drugs. CONCLUSIONS: Awareness of the clinical factors associated with adherence to analgesic drugs may help clinicians to identify cancerpatients at a greater risk of non-adherence, reinforce optimal pain management, and improve the QoL by enhancing adherence to pain medications.
Entities:
Keywords:
Adherence; Cancer; Pain; Predictive factor; Quality of life