Factors influencing non-adherence to opioids in cancer patients: a mixed-methods cross-sectional study

Seangrung, Rattaphol; Ahuja, Mallika; Pasutharnchat, Koravee; Mahawan, Rungwipha

doi:10.12688/f1000research.27725.2

Cited by 5 publications

(3 citation statements)

References 38 publications

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“…In head and neck patients the prevalence of pain is particularly high [ 89 ]. Overall, cancer pain impacts 66% of patients across all cancer types [ 90 , 91 ]. The evidence suggests that management of cancer pain is far from optimal [ 92 ].…”

Section: Informationmentioning

confidence: 99%

When can cancer patient treatment nonadherence be considered intentional or unintentional? A scoping review

2023

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Background Treatment nonadherence in cancer patients remains high with most interventions having had limited success. Most studies omit the multi-factorial aspects of treatment adherence and refer to medication adherence. The behaviour is rarely defined as intentional or unintentional. Aim The aim of this Scoping Review is to increase understanding of modifiable factors in treatment nonadherence through the relationships that physicians have with their patients. This knowledge can help define when treatment nonadherence is intentional or unintentional and can assist in predicting cancer patients at risk of nonadherence and in intervention design. The scoping review provides the basis for method triangulation in two subsequent qualitative studies: 1. Sentiment analysis of online cancer support groups in relation to treatment nonadherence; 2. A qualitative validation survey to refute / or validate claims from this scoping review. Thereafter, framework development for a future (cancer patient) online peer support intervention. Methods A Scoping Review was performed to identify peer reviewed studies that concern treatment / medication nonadherence in cancer patients—published between 2000 to 2021 (and partial 2022). The review was registered in the Prospero database CRD42020210340 and follows the PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Searches. The principles of meta-ethnography are used in a synthesis of qualitative findings that preserve the context of primary data. An aim of meta-ethnography is to identify common and refuted themes across studies. This is not a mixed methods study, but due to a limited qualitativevidence base and to broaden findings, the qualitative elements (author interpretations) found within relevant quantitative studies have been included. Results Of 7510 articles identified, 240 full texts were reviewed with 35 included. These comprise 15 qualitative and 20 quantitative studies. One major theme, that embraces 6 sub themes has emerged: ‘Physician factors can influence patient factors in treatment nonadherence’. The six (6) subthemes are: 1. Suboptimal Communication; 2. The concept of Information differs between Patient and Physician; 3.Inadequate time. 4. The need for Treatment Concordance is vague or missing from concepts; 5. The importance of Trust in the physician / patient relationship is understated in papers; 6. Treatment concordance as a concept is rarely defined and largely missing from studies. Line of argument was drawn Treatment (or medication) nonadherence that is intentional or unintentional is often attributed to patient factors—with far less attention to the potential influence of physician communication factors. The differentation between intentional or unintentional nonadherence is missing from most qualitative and quantitative studies. The holistic inter-dimensional / multi-factorial concept of ‘treatment adherence’ receives scant attention. The main focus is on medication adherence / nonadherence in the singular context. Nonadherence that is unintentional is not necessarily passive behaviour and may overlap with intentional nonadherence. The absence of treatment concordance is a barrier to treatment adherence and is rarely articulated or defined in studies. Conclusion This review demonstrates how cancer patient treatment nonadherence is often a shared outcome. An equal focus on physican and patient factors can increase understanding of the two main types of nonadherence (intentional or unintentional). This differentation should help improve the fundamentals of intervention design.

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Section: Informationmentioning

confidence: 99%

When can cancer patient treatment nonadherence be considered intentional or unintentional? A scoping review

2023

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“…The barriers to compliance were fear of the possible long-term outcomes, concern about opioid side effects, and a poor understanding of their illness. 7 A meta-analysis by Bennett showed that educational interventions on cancer pain improve patients' knowledge of and attitudes toward pain and analgesia. It was also found that the interventions increased medication adherence, thereby minimizing pain intensity.…”

Section: Introductionmentioning

confidence: 99%

Comparative Effectiveness of Video and Face-to- Face Sessions to Educate Hospitalized Patients on Cancer Pain Management

et al. 2023

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Objective: Patients’ lack of knowledge of cancer pain management affects pain outcomes. This study compared the effectiveness of cancer pain management achieved in a previous retrospective study (“P-group”), in which hospitalized cancer pain individuals received no pain education, with the pain management achieved by 2 study groups. One group received pain management information via video sessions (“V-group”) and the other via face-to-face coaching (“F-group”). The study’s secondary aims were to compare the 2 interventions’ psychological, quality-of-life, and opioid-consumption impacts. Materials and Methods: This single-blinded, randomized, controlled trial enrolled hospitalized cancer pain patients aged between 18 and 70 with an Eastern Clinical Oncology Group performance status < 4. They were assigned to V- and F-groups to receive information on managing cancer pain. “Successful pain control” was defined as “no to mild pain” or a numerical rating scale score < 4 on Day 6. Pain intensity and opioid consumption (morphine-equivalent daily dosage) were recorded daily from baseline to Day 6. Psychological status (Hospital Anxiety and Depression Scale) and quality of life (Functional Assessment of Cancer Therapy–General) were assessed at baseline and Day 6. Results: Fifty-nine participants were analyzed (V-group: 31; F-group: 28). Both groups had significantly higher successful pain outcomes than the P-group (P < .001). The V- and F-groups had no significant differences in successful pain control (20 [65%] vs 19 [68%]; P = .787), psychological effects, quality of life, or opioid consumption. Conclusions: Video sessions are an alternative means of educating hospitalized cancer pain patients and reducing healthcare providers’ workloads.

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“…Consequently, people are at risk of antimicrobial resistance (Pumtong et al, 2020 ). Importantly, irrational drug use is common in persons with chronic illnesses such as cancer (Seangrung et al, 2020 ) and diabetes mellitus (Yensabai et al, 2016 ). In addition, a high prevalence of potentially inappropriate medication use was found among older Thai persons (Jenghua et al, 2019 ; Vatcharavongvan & Puttawanchai, 2019 ).…”

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confidence: 99%

Evaluation of the integrated model of the rational drug use into the Bachelor of Nursing Science program in Thailand: A mixed-methods study

et al. 2021

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Background: Integration of rational drug use (RDU) into a nursing program to increase nurse graduates’ RDU competencies is essential to solving the problem of irrational drug use. Objective: This study aimed to evaluate the integrated model of the RDU into the Bachelor of Nursing Science (BNS) program developed by the Thailand Nursing and Midwifery Council (TNMC). Methods: A mixed-methods study was designed using a sequential explanatory design. The whole population of 3,848 nurse educators and 9,249 nurse graduates from 86 nursing education institutions across Thailand in Academic Year 2018 were recruited for quantitative data collection. Fifty nurse educators selected as representatives of the nursing education institutions were recruited for qualitative data collection. Online questionnaires were sent to collect information regarding the context, input, process, and product relating to the model, while structured focus group guidelines were developed to obtain more details in assessing the model. The data were analyzed using descriptive statistics and content analysis. Results: The findings showed that the context and policy of utilizing the model to increase nurse graduates’ RDU competencies were well accepted. The nurse educators’ RDU competencies, the input of the model, were rated at a high level. The process of the model was implemented as guided at almost all nursing education institutions. The product of the model, the RDU competencies of the nurse graduates, was reported at a high level. Conclusion: The model of integrating the RDU into the BNS program developed by the TNMC was well performed and resulted in high RDU competencies of the nurse graduates. This integration model should be published and applied in nursing schools worldwide to enhance RDU competencies of nurse graduates. Funding: This study was financially supported by the Thailand Nursing and Midwifery Council.

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Factors influencing non-adherence to opioids in cancer patients: a mixed-methods cross-sectional study

Cited by 5 publications

References 38 publications

When can cancer patient treatment nonadherence be considered intentional or unintentional? A scoping review

When can cancer patient treatment nonadherence be considered intentional or unintentional? A scoping review

Comparative Effectiveness of Video and Face-to- Face Sessions to Educate Hospitalized Patients on Cancer Pain Management

Evaluation of the integrated model of the rational drug use into the Bachelor of Nursing Science program in Thailand: A mixed-methods study

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