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Medication non-adherence in women with fibromyalgia
M J Sewitch1, P L Dobkin, S Bernatsky
1Department of Medicine, McGill University, Montreal, Quebec, Canada. maida.sewitch@mail.mcgill.ca
Objective:
To identify the determinants of medication non-adherence in women with fibromyalgia (FM).
Methods:
Participants included 10 rheumatologists and 127 women recruited from tertiary care hospitals and the community. Demographic, clinical and psychosocial characteristics and patient-physician discordance were assessed at the baseline visit. Non-adherence was assessed 2 weeks later. Multivariable generalized estimating equations were used to identify determinants of non-adherence to medication.
Results:
The average age of the women was 50.4 (s.d. 10.5) yr and the mean disability score was 60.3 (16.0) yr. Sixty (47.2%) women were non-adherent to medication; 20 (33.3%) of these were intentionally non-adherent, 24 (40.0%) were unintentionally non-adherent, and the remaining subjects were both. Overall non-adherence was predicted by higher patient-physician discordance. Unintentional non-adherence was predicted by community subjects, not being under a rheumatologist's care, less disease activity, less use of instrumental coping, and higher patient-physician discordance. Intentional non-adherence was predicted by shorter duration under a rheumatologist's care and higher patient-physician discordance.
Conclusion:
The therapeutic relationship, in addition to clinical and psychosocial characteristics, influenced non-adherence to medication.