The Association Between Analgesic Treatment Beliefs and Electronically Monitored Adherence for Cancer Pain.
William E Rosa, Barbara Riegel, Connie M Ulrich and 3 others
PMID 33337438WHAT IT FOUND
Analgesic belief clusters did not predict electronically monitored adherence to around-the-clock cancer pain medication.
Side effects, pain relief, strongest analgesic prescribed, disease duration, and race were associated.
Key findings
01Belief clusters based on analgesic treatment preferences were not significantly associated with electronically monitored dose adherence.
02In the final models, race, side effects, most potent analgesia prescribed, pain relief with analgesics, and duration of disease were significant predictors of electronically monitored dose adherence.
03The final models explained about 21% of variance in electronically monitored dose adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Secondary analysis of existing parent-study data, not a trial designed to test belief clusters as the primary exposure. Only two belief clusters were tested, so the null result does not mean all analgesic beliefs are irrelevant. Patients were limited to African American or White adults with multiple myeloma or solid tumors who used at least one around-the-clock oral analgesic; transdermal opioid users were excluded. Data were collected between December 2009 and August 2011. Attrition was 14% between baseline and follow-up, although attrition was not significantly related to health status or race. Observational models cannot show that any factor caused nonadherence. The final models explained only 21% of adherence variance. MEMS records bottle openings, and patients knew they were being monitored; a sensitivity analysis supported consistency after removing the first 30 days.
Declared interests
The supplied text does not include a conflict-of-interest declaration. Publication metadata list NIH extramural and non-U.S. government research support, and the parent study grant number RC1-NR011591 is given.
The easy way to misread this
Do not conclude that analgesic beliefs are irrelevant to cancer pain adherence. The study tested only two belief clusters and did not find an association with electronically monitored adherence; other factors, including side effects, pain relief, prescribed analgesic strength, disease duration, and race, were associated.