Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium.
Clin J Pain. 2010 Feb;26(2):81-6. doi: 10.1097/AJP.0b013e3181b91b22.
Medication nonadherence is a frequent problem in chronic conditions. In chronic noncancer pain, medication is often used as an important cornerstone of the treatment. Studies on medication nonadherence in this population, however, are scarce.
The aim of this study was to determine the prevalence of medication underuse and overuse nonadherence in a large sample of chronic pain patients treated in a multidisciplinary pain center. Second, an extensive list of demographic, disease-related, treatment-related and health behavior-related factors was included to compare these factors between adherent, overusers, and underusers, respectively.
Self-report was used to measure medication adherence.
Forty-eight percent of the patients were nonadherent, with 34% of them showing underuse and 14% overuse of the prescribed medication. Multivariable analyses showed a significant association between younger age and medication nonadherence (both underuse and overuse). Furthermore, underuse was significantly associated with self-medication. Overuse was associated with current smoking, opioid prescription, and more medication intake moments.
We can conclude that medication nonadherence, especially underuse of medication, occurs frequently among patients with chronic nonmalignant pain. Prospective research is needed to learn about the impact of medication overuse or underuse on clinical outcomes. Future research should examine underuse and overuse as different types of nonadherence as different factors might predict this behavior.
药物依从性差是慢性疾病中的常见问题。在慢性非癌性疼痛中，药物常被用作治疗的重要基石。然而，针对该人群药物依从性的研究却很少。
本研究旨在确定在多学科疼痛中心治疗的大量慢性疼痛患者中，药物未充分使用和过度使用不依从的患病率。其次，纳入了广泛的人口统计学、疾病相关、治疗相关和健康行为相关因素的清单，以分别比较这些因素在依从者、过度使用者和未充分使用者之间的差异。
采用自我报告来衡量药物依从性。
48%的患者不依从，其中 34%的患者表现为药物未充分使用，14%的患者过度使用处方药物。多变量分析显示，年龄较小与药物不依从（包括未充分使用和过度使用）显著相关。此外，未充分使用与自我用药显著相关。过度使用与当前吸烟、阿片类药物处方和更多的用药次数有关。
我们可以得出结论，慢性非恶性疼痛患者中经常出现药物不依从，尤其是药物未充分使用。需要进行前瞻性研究以了解药物过度使用或未充分使用对临床结果的影响。未来的研究应将未充分使用和过度使用视为不同类型的不依从，因为不同的因素可能会预测这种行为。
