Relationship Between Pain-Specific Beliefs and Adherence to Analgesic Regimens in Taiwanese Cancer Patients

Abstract

This pilot cross-sectional study aimed to 1) explore pain beliefs and adherence to prescribed analgesics in Taiwanese cancer patients, and 2) examine how selected pain beliefs, pain sensory characteristics, and demographic factors predict analgesic adherence. Pain beliefs were measured by the Chinese version of Pain and Opioid Analgesic Beliefs Scale-Cancer (POABS-CA) and the Survey of Pain Attitudes (SOPA). Analgesic adherence was measured by patient self-report of all prescribed pain medicine taken during the previous 7 days. Only 66.5% of hospitalized cancer patients with pain (n = 194) adhered to their analgesic regimen. Overall, patients had relatively high mean scores in beliefs about disability, medications, negative effects, and pain endurance, and low scores in control and emotion beliefs. Medication and control beliefs significantly predicted analgesic adherence. Patients with higher medication beliefs and lower control beliefs were more likely to be adherent. Findings support the importance of selected pain beliefs in patients' adherence to analgesics, suggesting that pain beliefs be assessed and integrated into pain management and patient education to enhance adherence.

Relationship Between Belief about Analgesics, Analgesic Adherence and Pain Experience in Taiwanese Cancer Outpatients

“…Medication adherence rates amongst patients who have prescribed analgesics for their cancer pain, however, are lower than what is needed to achieve optimal pain control (Zeppetella, 1999;Miaskowski et al, 2001;Chang, et al, 2002;Lai et al, 2002). Evidence suggests that patients are often reluctant to use pain medication and that many patients have negative beliefs regarding analgesics (Chang et al, 2002;Gunnarsdottir, et al, 2002;Yates et al, 2002).…”

“…For example, studies suggest that pain beliefs can influence a person's ability to cope with pain (Jensen et al, 1999) and perceive pain (Thastum and Herlin, 2011). Beliefs regarding opioids may also influence patients' behavior with adhering to their prescribed medication (Lai et al, 2002) and therefore affect pain experience of patients.…”

“…Although limited study in Taiwan (Lai et al, 2002) has demonstrated the relationship between concerns about analgesics and analgesics adherence. However, the researchers have not directly examined patients' pain experience.…”

Multidimensional Pain Inventory-Screening Chinese version (MPI-sC): psychometric testing in terminal cancer patients in Taiwan

“…However, test-retest reliability was not examined due to logistical concerns in readministering the test to hospice cancer patients. Construct validity was tested by five theoretically or empirically related assumptions: (1) higher levels of pain severity (measured by the MPI-sC Pain Severity subscale and four items in BPI-Pain intensity subscale) are related to increased affective distress (assessed by the MPI-sC Affective Distress subscale), mood disturbance (measured by the Hospital Anxiety and Depression Scale [HADS], one of the most frequently used depression and anxiety scales in cancer pain populations) [3,5,32,36], and decreased sense of control in life because of pain (measured by the MPI-sC Life Control subscale); (2) higher levels of pain intensity are related to increased pain interference with activities (assessed by the MPI-sC Pain Interference subscale and the Karnofsky Performance Scale [KPS]) [15]; (3) higher levels of pain interference with activities are related to affective distress (assessed by the MPI-sC Affective Distress subscale and HADS subscales); (4) higher levels of Pain Interference are related to lower Life Control because of pain (both assessed by MPI-sC subscales); and (5) higher levels of pain-related Affective Distress are related to lower levels of Life Control because of pain [10,11,17,18,20,21,27,33,35].…”

Gender Differences Associated with Pain Characteristics and Treatment in Taiwanese Oncology Outpatients

“…While pain is experienced by approximately 38% to 90% of cancer patients (Grond et al, 1994;Ger et al, 1998), research has suggested the need for better programmatic efforts in providing cancerpain relief for Taiwanese outpatients (Chang et al, 2002;Lai et al, 2002, Liang et al, 2010. Prior to this study, the role of patient gender in cancer pain perception, analgesic prescription, and analgesic consumption has rarely been examined.…”