Office for monitoring and quality improvement, Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.
Pain Med. 2013 Feb;14(2):247-56. doi: 10.1111/pme.12035. Epub 2013 Jan 31.
Medication nonadherence is a frequent problem in the treatment of chronic conditions.
To study the adherence to pharmacological treatment of chronic nonmalignant pain, as well as factors and patient attitudes related to nonadherence in patients aged ≥65 years.
The cross-sectional study was conducted with a self-administered questionnaire among 100 patients aged ≥65 years by five family physicians at the Health Care Centre Mostar, Bosnia and Herzegovina.
According to their own statements, 57% of the patients were nonadherent, while 84% exhibited some form of nonadherence on the Morisky scale. The patients reported a mean pain intensity of 6.6 ± 2.2 on a visual analog scale. The most common deviation from the prescribed therapy was self-adjustment of the dose and medical regimen based on the severity of pain. Polymedication correlated positively with nonadherence. Nonsteroidal anti-inflammatory drugs were the most frequently prescribed medications. The majority of the participants (59%) believed that higher pain intensity indicates progression of the disease, and half of the participants believed that one can easily become addicted to pain medications. Nonadherence was associated with patient attitudes about addiction to analgesics and ability of analgesics to control pain. CONCLUSION.: High pain intensity and nonadherence found in this study suggest that physicians should monitor older patients with chronic nonmalignant pain more closely and pay more attention to patients' beliefs regarding analgesics to ensure better adherence to pharmacological therapy.
药物依从性是慢性疾病治疗中的一个常见问题。
研究≥65 岁慢性非恶性疼痛患者的药物治疗依从性，以及与不依从相关的因素和患者态度。
在波斯尼亚和黑塞哥维那莫斯塔尔医疗中心，由五名家庭医生对 100 名≥65 岁的患者进行了横断面研究，采用自我管理问卷调查。
根据他们自己的陈述，57%的患者不依从，而 84%的患者在 Morisky 量表上表现出某种形式的不依从。患者报告的平均疼痛强度为视觉模拟评分 6.6±2.2。最常见的偏离规定治疗方案的行为是根据疼痛严重程度自行调整剂量和医疗方案。多药治疗与不依从呈正相关。非甾体抗炎药是最常开的药物。大多数参与者（59%）认为更高的疼痛强度表明疾病的进展，一半的参与者认为人们很容易对止痛药上瘾。不依从与患者对阿片类药物成瘾的态度和阿片类药物控制疼痛的能力有关。结论：本研究发现高疼痛强度和不依从性表明，医生应更密切监测患有慢性非恶性疼痛的老年患者，并更加关注患者对镇痛药的看法，以确保更好地遵守药物治疗。
