Lack of Adherence With the Analgesic Regimen: A Significant Barrier to Effective Cancer Pain Management

Abstract

One factor that seems to contribute to ineffective cancer pain management is poor adherence to the analgesic regimen.

Patient training in cancer pain management using integrated print and video materials: A multisite randomized controlled trial ☆

“…Side effects were a common reason for discontinuing analgesics according to patients. Yet they frequently had not told their physicians about the side effects or that they had stopped analgesics, consistent with findings of other adherence research (Ersek et al 1999;Miaskowski et al 2001). In sum, communication can be improved through patient training, but patients will still depend on their physicians and nurses to determine which tools are useful and to reinforce utilization of communication strategies.…”

“…Studies argue convincingly that improved cancer pain treatment depends in part on training patients, as well as physicians and nurses, to understand treatment options (Cleeland et al 1994a;DuPen et al 2000;Miaskowski et al 2001), to communicate effectively about pain and its treatment (Kimberlin et al 2004;Von Roenn et al 1993), and to use opioids appropriately (Ersek et al 1999;Schumacher et al 2002;Von Roenn et al 1993;Ward et al 1993).…”

The Challenges of Oral Agents as Antineoplastic Treatments

“…Poor adherence to medication is an ever-present and complex problem potentially contributing to substantial worsening of disease control, 101,102 altering the outcome of treatment. 14 In clinical practice there is a need to better understand how patients' determinants influence adherence and consequently develop interventions to assist patients to adhere to oral antineoplastic.…”

Qualitative research contribution to a randomized clinical trial

“…A third analysis focused on patients for whom the intervention did not work. During a quantitative analysis of adherence to prescribed pain management medications in relation to pain severity (Miaskowski et al, 2001), a question arose about why some patients in the intervention group did not increase their analgesic intake despite continuing high levels of pain severity. We decided to explore this question using the qualitative data, aiming for a better understanding of why the intervention did not work for this subset of patients.…”

“…In a recently completed RCT of a nursing intervention called the PRO-SELF ß Pain Control Program (Miaskowski et al, 2001(Miaskowski et al, , 2002(Miaskowski et al, , 2004, the teaching/coaching sessions with oncology outpatients experiencing pain from bone metastases and their family caregivers were audiotaped originally to monitor intervention fidelity. However, early reviews of the audiotapes revealed that they were a rich source of data about patients' and family caregivers' experiences with pain management.…”