Bath Centre for Pain Research, University of Bath, Bath, UK Bath Centre for Pain Services, Royal National Hospital for Rheumatic Diseases, Bath, UK.
Pain. 2011 May;152(5):1201-1205. doi: 10.1016/j.pain.2011.01.053. Epub 2011 Mar 3.
This study examines the concerns and beliefs about medication reported by patients with nonmalignant chronic pain encountered within general practice. Two hundred thirty-nine patients with chronic pain took part in this research. Patients completed the Pain Medication Attitudes Questionnaire, a measure of patient concerns and beliefs relating to addiction, withdrawal, side effects, mistrust in doctors, perceived need of medication, scrutiny from others, and tolerance. The data revealed that patient concerns and beliefs predicted general medication nonadherence. In addition, concerns were related to the direction of nonadherence: overuse of medication was related to increased perceived need for medication and greater concern over side effects; underuse was related to decreased concerns over withdrawal and increased mistrust in the prescribing doctor. Analyses also indicated that patient attitudes and concerns about medication were more predictive of nonadherence than both level of pain and the reported frequency of experienced side effects. This research contributes to the increasing evidence that patient attitudes and beliefs about pain medication are associated with adherence behavior. Training general practitioners to identify and address these concerns may reduce concerns, improve adherence, and facilitate the doctor-patient relationship.
本研究考察了在普通诊所中遇到的非恶性慢性疼痛患者报告的药物使用相关顾虑和信念。共有 239 名慢性疼痛患者参与了这项研究。患者完成了《疼痛药物态度问卷》，该问卷衡量了与成瘾、戒断、副作用、对医生的不信任、对药物的需求、他人的审视和耐受性相关的患者顾虑和信念。研究结果显示，患者的顾虑和信念可以预测整体药物不依从性。此外，顾虑与不依从的方向有关：过度使用药物与增加对药物需求的感知以及对副作用的更大担忧有关；药物使用不足与对戒断的担忧减少以及对开处方医生的信任度增加有关。分析还表明，与疼痛水平和报告的副作用频率相比，患者对药物的态度和顾虑更能预测不依从性。这项研究为越来越多的证据提供了支持，即患者对疼痛药物的态度和信念与依从行为有关。培训全科医生识别和解决这些问题可能会减少顾虑、提高依从性，并促进医患关系。
