The Value of Medication-Specific Education on Medication Adherence and Treatment Outcome in Patients with Chronic Pain: A Randomized Clinical Trial

Timmerman, Leon; Stronks, Dirk L.; Groeneweg, George; Huygen, Frank

doi:10.1093/pm/pnw013

Cited by 16 publications

(26 citation statements)

References 18 publications

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“…Of interest, specific education on medication did not improve adherence or outcome parameters. There was no association between medication adherence, as measured using the Morisky Medication Adherence Scale, and pain treatment outcome 25 …”

Section: Discussionmentioning

confidence: 86%

Barriers and Adherence to Pain Management in Advanced Cancer Patients

Mercadante

Adile

Tirelli³

et al. 2020

Pain Practice

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Aim To assess patients’ barriers to pain management and analgesic medication adherence in patients with advanced cancer. Methods This was a prospective cross‐sectional study in patients with advanced cancer receiving chronic opioid therapy. Age, gender, cancer diagnosis, Karnofsky level, and educational status were recorded. The Brief Pain Inventory (BPI), Edmonton Symptom Assessment Scale (ESAS), Memorial Delirium Assessment Scale (MDAS), Barriers Questionnaire II (BQ‐II), Medication Adherence Rating Scale (MARS), and Hospital Anxiety and Depression Scale (HADS) were the measurement instruments used. Results One‐hundred‐thirteen patients were analyzed. The mean age was 68 (±13) years, and 59 (52%) were male. The mean Karnofsky status was 51.4 (standard deviation [SD] 11.5). The mean score for BQ‐II items was 1.77 (SD 0.7). The BQ‐II score was independently related to the HADS‐Depression score (P = 0.033) and the total HADS score (P = 0.049). Negative side‐effects and attitudes toward psychotropic medication globally prevailed among MARS items. These items were independently associated with gender (P = 0.030), pain (P = 0.003), and depression (P = 0.047). Conclusion Barriers to pain management were mild. Psychological factors such as depression were the main factor associated with barriers. Poor adherence to analgesic medication was mostly manifested as negative side‐effects and attitudes toward psychotropic medication, was more frequent observed in females, and was associated with the ESAS items pain and depression.

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Section: Discussionmentioning

confidence: 86%

Barriers and Adherence to Pain Management in Advanced Cancer Patients

Mercadante

Adile

Tirelli³

et al. 2020

Pain Practice

View full text Add to dashboard Cite

show abstract

“…Therefore, these data would suggest that individuals on short-term prescribed oxycodone regimens may not wish to skip prescribed days of treatment in an attempt to 'tough it out', as this may in fact lead to increased liability for abuse. These findings highlight the importance of adherence monitoring or adherence enhancing interventions, as non-adherence to pain medication use is very common (49) and particularly because there does not appear to be an association between medication adherence and pain treatment outcome (50).…”

Section: Discussionmentioning

confidence: 91%

Withdrawal-induced escalated oxycodone self-administration is mediated by kappa opioid receptor function

Nguyen

Kirson

Steinman

et al. 2017

Preprint

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“…For example, these data would suggest that individuals on short-term prescribed oxycodone regimens do not skip prescribed days of treatment in an attempt to ‘tough it out’, as this may in fact lead to increased liability for abuse. These findings highlight the importance of adherence monitoring or adherence enhancing interventions, as non-adherence to pain medication use is very common (Timmerman, Stronks, Groeneweg & Huygen, 2016b) and particularly because there does not appear to be an association between medication adherence and pain treatment outcome (Timmerman, Stronks, Groeneweg & Huygen, 2016a). These data further suggest that a lack of medication adherence may increase a liability for the early stages of oxycodone addiction.…”

Section: Discussionmentioning

confidence: 97%

Paradoxical changes in brain reward status during oxycodone self-administration in a novel test of the negative reinforcement hypothesis

Nguyen

Grant

Taffe

2018

Preprint

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Background and Purpose: The extra-medical use and addiction of prescription opioid analgesics is a growing health problem. To characterize how prescription opioid abuse develops, this study investigated the affective consequences of escalating prescription opioid use using intracranial self-stimulation (ICSS) reward and oxycodone intravenous self-administration (IVSA) models.Experimental Approach: Male Wistar rats were given access to oxycodone IVSA (0.15 mg/kg/infusion, i.v.) in Short Access (ShA; 1 h) or Long Access (LgA; 12 h) sessions for 5 sessions/week followed by intermittent 60 h discontinuations from drug access, a novel explicit test of the negative reinforcement hypothesis. A separate group was first trained in the ICSS procedure and then in oxycodone IVSA in 11 h LgA sessions.Key Results: Rats given LgA to oxycodone escalated their responding more than ShA rats, with significant increases following 60 h discontinuations. Pre-session brain reward thresholds increased with sequential daily LgA IVSA sessions, consistent with a growing negative affective state consequent to successive daily intoxication/abstinence cycles. A 1 h oxycodone IVSA interval was sufficient to normalize these elevated reward thresholds, as was, paradoxically, a 60 h weekend abstinence. The increase in ICSS thresholds was attenuated in a group administered the long-acting kappa opioid antagonist norBNI prior to IVSA training. Conclusions and Implications:Changes in brain reward function during escalation of oxycodone selfadministration is driven by an interplay between kappa opioid receptor-mediated negative affective state associated with escalated oxycodone intake and dynamic restoration of brain reward status during longer periods of abstinence.

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The Value of Medication-Specific Education on Medication Adherence and Treatment Outcome in Patients with Chronic Pain: A Randomized Clinical Trial

Abstract: Medication-specific education did increase knowledge of the prescribed therapy but did not improve adherence or treatment outcome parameters. There was no association between medication adherence and pain treatment outcome.

Cited by 16 publications

References 18 publications

Barriers and Adherence to Pain Management in Advanced Cancer Patients

Barriers and Adherence to Pain Management in Advanced Cancer Patients

Withdrawal-induced escalated oxycodone self-administration is mediated by kappa opioid receptor function

Paradoxical changes in brain reward status during oxycodone self-administration in a novel test of the negative reinforcement hypothesis

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