Adherence to Analgesics Among Outpatients Seriously Ill With Cancer.
Stephen J Stapleton, Brenda W Dyal, Andrew D Boyd and 4 others
PMID 35175950WHAT IT FOUND
Hospice and palliative care patients with cancer self-reported lower analgesic adherence when doses were due more often than every 8 hours.
Longer dosing intervals were the only factor linked to better adherence in this study.
Key findings
01Analgesic medications taken at longer prescribed dose intervals, such as 8, 12, or 24 hours, were associated with increased adherence, and dose interval was the only significant predictor in the adjusted model.
0288% of patients had prescriptions rated appropriate for pain management.
03Pain, symptom, demographic, and care-setting variables were not significantly associated with adherence in the adjusted model.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it can show associations but cannot prove that changing dose intervals causes better adherence. Adherence was based on patient self-report for only the previous 24 hours, and the paper notes that self-report often overestimates adherence. The analysis used 202 patients, while 240 consented and 189 were alive to be eligible for randomization after run-in procedures, so patients who died early or did not complete data were not represented. The sample was limited to English-speaking, literate patients with a Palliative Performance Scale score of 30 or higher, so it may not apply to patients who are too ill or unable to complete the measures. Patient-related barriers, caregiver medication management, beliefs about pain, and provider factors were not measured. Patients knew they were reporting pain and medication use for a study, which may have increased attention to treatment and short-term adherence. Some medications were excluded from the adherence calculation, including as-needed drugs and short-acting drugs prescribed with intervals of 8 hours or longer.
Declared interests
The authors declared no conflicts of interest. Publication types indicate NIH and non-U.S. government research support.
The easy way to misread this
Do not conclude that prescribing longer-interval analgesics will improve adherence or pain control. This was a cross-sectional study using self-reported medication use over the previous 24 hours, so it shows an association, not a proven treatment effect.