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Adherence to Analgesics Among Outpatients Seriously Ill With Cancer.
Stephen J Stapleton1, Brenda W Dyal, Andrew D Boyd
1Author Affiliations: Department of Nursing, Concordia College (Dr Stapleton), Moorhead, Minnesota; Department of Biobehavioral Nursing Science, College of Nursing, University of Florida (Drs Dyal, Ezenwa, Yao, and Wilkie), Gainesville; and Department of Biomedical and Health Information Sciences, College of Applied Health Sciences (Dr Boyd), and Department of Biobehavioral Nursing Science, College of Nursing (Dr Suarez), University of Illinois Chicago.
Improving cancer pain management requires better analgesic adherence. Longer dosing intervals, not cost, are key to enhancing patient comfort and pain control in serious illness.
Area of Science:
- Oncology
- Palliative Care
- Pain Management
Background:
- Effective pain management is crucial for seriously ill cancer patients.
- Adherence to prescribed analgesics is essential for patient comfort.
Purpose of the Study:
- To assess analgesic adherence in advanced cancer patients.
- To identify factors associated with adherence, including clinical and demographic characteristics.
Main Methods:
- A cross-sectional study involving 202 advanced cancer patients receiving hospice/palliative care.
- Patients completed validated questionnaires on pain, mood, sleep, and adherence via pen tablet.
- Data collected included pain intensity, satisfaction, and adherence rates for various analgesics.
Main Results:
- Over half of patients were dissatisfied with their pain levels.
- Adherence rates varied by analgesic type, with nonsteroidal anti-inflammatory drugs and WHO Step 2 opioids showing lower adherence.
- Shorter dosing intervals (less than 8 hours) were significantly linked to lower adherence rates (P < .001).
Conclusions:
- Improving analgesic adherence in advanced cancer patients remains a challenge.
- Focusing on optimizing analgesic dosing intervals, rather than cost, is crucial for enhancing pain management.
- Longer-acting analgesics and extended dosing intervals (≥8 hours) are recommended strategies to improve end-of-life pain control.
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