Factors Related to Adherence to Opioids in Black Patients With Cancer Pain

Context. Cancer pain relief is often inadequate because of poor adherence to pain medication, especially for black patients. Objectives. The purpose of this study is to describe factors related to adherence to around-the-clock opioids among 110 black patients being treated for cancer pain. Methods. Sociodemographic, clinical, symptoms, and social support data were collected at baseline; pain and adherence data were collected at 30 days. Associations between these variables and opioid adherence measured by Medication Event Monitoring System were estimated using multiple regression. Results. Mean age was 56 (+/- 10.1), the majority were women (63%) and college educated (56%). Mean pain severity at baseline equaled 4.6 (+/- 2.3). Mean dose adherence was 60% (+/- 28.5), while mean schedule adherence was 33.0% (+/- 31.0). In adjusted analysis, 26% of the variance in dose adherence was explained by recent chemotherapy, changes in pain, concerns about nausea, and doctors' focus on cure versus pain control (P<0.001); 27% of the variance in schedule adherence was explained by recent chemotherapy, changes in pain, symptom burden, and concerns about doctors focus on cure versus pain control (P<0.001). Conclusion. Findings confirm pain medication adherence is poor and pain was not well relieved. Multiple factors influence adherence to around-the-clock opioids. Clinicians need to partner with patients by providing a personalized pain treatment plan including an in-depth assessment of treatment choices and adherence. (C) 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.