Compliance with Opioid Therapy: Distinguishing Clinical Characteristics and Demographics Among Patients with Cancer Pain

Koyyalagunta, Dhanalakshmi; Bruera, Éduardo; Engle, Mitchell P.; Driver, Larry C.; Dong, Wenli; Demaree, Chris; Novy, Diane M.

doi:10.1093/pm/pnx178

Cited by 23 publications

(21 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding the drug, other researches show that adherence can vary even among active principles, given the occurrence of posological variations and adverse reactions, which are frequent with the use of opioids and which tend to predispose to nonadherence. 5,12,13 In this study, besides the large number of patients who scored in the reminder domain, a significant association was noted between patients who used a controlled-release (CR) drug and the adherence, a fact that may be correlated with better ease in administering this type of pharmaceutical form, information also observed by Meghani et al 20 Furthermore, as seen by Zhu and et al, patients with better educational levels presented a positive association with therapeutic adherence. 14 Believing in the therapy is a great facilitator for adherence, but the presence of symptoms and adverse effects can affect it negatively.…”

Section: Discussionsupporting

confidence: 72%

“…Although not observed in this study, the literature also shows that female gender, younger age, and black ethnicity may be associated with less commitment to the drug treatment, the latter mainly due to demographic and access differences to the drug. 7,12,13 In parallel, in other studies, a lower financial condition seems to be a negative factor for continuing treatment. 12,14…”

Section: Rbfhss Revista Brasileira De Farmácia Hospitalar E Serviços De Saúdesupporting

confidence: 51%

See 1 more Smart Citation

Evaluation of oral drug adherence in patients with oncological pain in Pernambuco reference hospital

Silva¹,

Cruz²,

Silva³

2020

Rev Bras Farm Hosp Serv Saude

View full text Add to dashboard Cite

Objectives: The aim of this study was to describe the profile of patients with cancer pain using oral opioids, to evaluate the therapeutic adherence of these patients and to identify the factors associated with it. Methods: It was a cross-sectional study carried out at the Pharmacy of the Hospital de Câncer de Pernambuco, from March to September 2019. Each patient were selected for convenience and were interviewed once, and the Medicines Evaluation Questionnaire (BMQ) was used to determine adherence and FACS for determine the socioeconomic, demographic and clinical profile. The data was analyzed using the Statistical Package for Social Sciences (SPSS) program. Results: In total, 46 patients were interviewed, aged between 19 and 82 years, 59% did not have complete elementary school, 74% had family income equal or less than 1 minimum wage and 71% classified as non-adherent, with the domain “recall screen” the most scored (84%). Patients using controlled-release medications (p = 0.0000352) and with higher levels of education (p = 0.016) obtain better adherence results in the BMQ questionnaire. Conclusions: Through the study it was possible to identify a high incidence of patients not adhering to drug therapy and their socioeconomic profile, highlighting the need for political and institutional interventions. Due to the scarcity of publications, further studies are needed to determine adherence factors in patients with cancer pain.

show abstract

Section: Discussionsupporting

confidence: 72%

Section: Rbfhss Revista Brasileira De Farmácia Hospitalar E Serviços De Saúdesupporting

confidence: 51%

Evaluation of oral drug adherence in patients with oncological pain in Pernambuco reference hospital

Silva¹,

Cruz²,

Silva³

2020

Rev Bras Farm Hosp Serv Saude

View full text Add to dashboard Cite

show abstract

“…7 The authors did not speculate as to the reasons for sex differences in ECS compliance. Cigarette smoking has been found to be a predictor of noncompliance with prescribed therapy across several fields of research, [8][9][10][11][12][13][14][15][16] and smoking cessation has been reported to be predictive of increased adherence to therapy. 17 To our knowledge, cigarette smoking has not previously been reported as a predictor of noncompliance with compression stocking use.…”

Section: Discussionmentioning

confidence: 99%

Patient‐reported reasons for and predictors of noncompliance with compression stockings in a randomized trial of stockings to prevent postthrombotic syndrome

Dawson

Akaberi

Galanaud

et al. 2020

Research and Practice in Thrombosis and Haemostasis

View full text Add to dashboard Cite

Introduction Elastic compression stockings (ECSs) are used to treat symptoms of venous insufficiency. However, lack of patient compliance can limit their effectiveness. In a secondary analysis of the SOX Trial, a randomized trial of active vs. placebo ECSs worn for 2 years to prevent postthrombotic syndrome after deep vein thrombosis, we aimed to describe patient‐reported reasons for nondaily use of ECS and to identify predictors of noncompliance during follow‐up. Methods At each follow‐up visit of the SOX Trial, patients were asked how many days per week they wore study stockings, and if not worn daily, to specify the reason(s). Reasons for nondaily use of ECSs were tabulated. Multiple logistic regression modeling was used to identify predictors of stocking noncompliance during follow‐up (defined as use <3 days per week). Results Among the 776 patients who attended at least 1 follow‐up visit, daily use of stockings at each visit was similar in the active and placebo ECS groups. Reasons for nondaily use of stockings was most frequently related to aversive aspects of stockings (~three‐fourths of patients) and less often related to patient behaviors (~one‐fourth of patients). In multivariate analyses, behavior‐related and aversive aspect–related reasons for nondaily use of ECSs at the 1‐month visit were significant predictors of noncompliance during follow‐up (odds ratio [OR] = 4.41 [95% confidence interval, 2.12‐9.17] and OR = 3.99 [2.62‐6.08], respectively). Conclusions Aversive aspects of ECSs and patient behaviors are important reasons for noncompliance. Improving the appeal and tolerability of ECS and education directed at modifying patient behaviors may improve compliance.

show abstract

“…Other studies reporting on the frequency of abnormal UDT in patients with cancer were conducted with a purposefully selected sample of patients with an already known elevated risk of NMOU, and this raises questions about a potential selection bias. Such studies may, therefore, not be reflective of the true frequency in this patient population 18,23,31‐33 . We acknowledge that the cohort in our study consisted of patients referred to a supportive care clinic with a relatively high level of symptom burden and distress and may, therefore, be more inclined to have a higher risk for NMOU than the average oncology patient.…”

Section: Discussionmentioning

confidence: 98%

Random urine drug testing among patients receiving opioid therapy for cancer pain

Arthur

Tang

et al. 2020

Cancer

Self Cite

View full text Add to dashboard Cite

Background There is limited information regarding the true frequency of nonmedical opioid use (NMOU) among patients receiving opioid therapy for cancer pain. Data to guide patient selection for urine drug testing (UDT) as well as the timing and frequency of ordering UDT are insufficient. This study examined the frequency of abnormal UDT among patients with cancer who underwent random UDT and their characteristics. Methods Demographic and clinical information for patients with cancer who underwent random UDT were retrospectively reviewed and compared with a historical cohort that underwent targeted UDT. Random UDT was ordered regardless of a patient's risk potential for NMOU. Targeted UDT was ordered on the basis of a physician's estimation of a patient's risk for NMOU. Results In all, 552 of 573 eligible patients (96%) underwent random UDT. Among these patients, 130 (24%) had 1 or more abnormal results; 38 of the 88 patients (43%) who underwent targeted UDT had 1 or more abnormal results. When marijuana was excluded, 15% of the random group and 37% of the targeted group had abnormal UDT findings (P < .001). It took a shorter time from the initial consultation to detect 1 or more abnormalities with the random test than the targeted test (median, 130 vs 274 days; P = .02). Abnormal random UDT was independently associated with younger age (P < .0001), male sex (P = .03), Cut Down, Annoyed, Guilty, and Eye Opener–Adapted to Include Drugs positivity (P = .001), and higher Edmonton Symptom Assessment System anxiety (P = .01). Conclusions Approximately 1 in 4 patients receiving opioids for cancer pain at a supportive care clinic who underwent random UDT had 1 or more abnormalities. Random UDT detected abnormalities earlier than the targeted test. These findings suggest that random UDT is justified among patients with cancer pain.

show abstract

Compliance with Opioid Therapy: Distinguishing Clinical Characteristics and Demographics Among Patients with Cancer Pain

Cited by 23 publications

References 47 publications

Evaluation of oral drug adherence in patients with oncological pain in Pernambuco reference hospital

Evaluation of oral drug adherence in patients with oncological pain in Pernambuco reference hospital

Patient‐reported reasons for and predictors of noncompliance with compression stockings in a randomized trial of stockings to prevent postthrombotic syndrome

Random urine drug testing among patients receiving opioid therapy for cancer pain

Contact Info

Product

Resources

About