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A nationwide survey of adherence to analgesic drugs among cancer patients in Taiwan: prevalence, determinants, and impact on quality of life

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Abstract

Purpose

Poor adherence to analgesic drugs is one of the most common barriers to adequate pain management. This prospective, cross-sectional, patient-oriented observational study aimed to explore the adherence rate, clinical factors, and impact of adherence to analgesic drugs on the quality of life (QoL) among cancer outpatients in Taiwan.

Methods

Eight hundred ninety-seven consecutive adult outpatients with cancer who had reported tumor pain and received regular analgesic drug treatment were enrolled from 16 medical centers across Taiwan. The Brief Pain Inventory was used to assess pain intensity and QoL. Morisky’s four-item medication adherence scale was used to assess adherence to analgesic drugs. Clinical factors possibly associated with good adherence to analgesic drugs were analyzed using multivariate logistic regression analyses.

Results

Of the 897 patients, 26.9% met criteria for the good, 35.5% for the moderate, and 37.6% for the poor adherence groups. The good adherence group had significantly better QoL outcomes than the moderate and poor adherence groups (all p < 0.05). Age ≥ 50 years, head and neck or hematological malignancies, cancer-related pain, patients who agreed or strongly agreed that the side effects of analgesic drugs were tolerable, and patients who disagreed or strongly disagreed that the dosing schedule could be flexibly self-adjusted to deal with the actual pain were predictors of good adherence to analgesic drugs.

Conclusions

Awareness of the clinical factors associated with adherence to analgesic drugs may help clinicians to identify cancer patients at a greater risk of non-adherence, reinforce optimal pain management, and improve the QoL by enhancing adherence to pain medications.

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Author information

Authors and Affiliations

  1. Division of Hematology-Oncology, Department of Internal Medicine, Linkuo Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, 5 Fu-Hsing Street, Guishan Township, Taoyuan County, 333, Taiwan

    Wen-Chi Chou, Jen-Shi Chen & Chia-Yen Hung

  2. Division of Hematology-Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan

    Chia-Yen Hung & Ruey-Kuen Hsieh

  3. Division of Hematology-Oncology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan

    Chang-Hsien Lu

  4. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan

    Yu-Yun Shao

  5. Division of Hematology-Oncology, Taipei Veterans General Hospital, Taipei, Taiwan

    Tzeon-Jye Chiou

  6. Division of Hematology-Oncology, Cathay General Hospital, Taipei, Taiwan

    Yung-Chuan Sung

  7. Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Kun-Ming Rau

  8. Division of Hematology-Oncology, National Cheng Kung University Hospital, Tainan, Taiwan

    Chia-Jui Yen

  9. Division of Hematology-Oncology, China Medical University Hospital, Taichung, Taiwan

    Su-Peng Yeh

  10. Division of Hematology-Oncology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan

    Ta-Chih Liu

  11. Divisions of Medical Oncology and Chest Medicine, Chung Shan Medical University Hospital, School of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Ming-Fang Wu

  12. Division of Hematology-Oncology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan

    Ming-Yang Lee

  13. Division of Hematology-Oncology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Ming-Sun Yu

  14. Division of Hematology-Oncology, Taichung Veterans General Hospital, Taichung, Taiwan

    Wen-Li Hwang

  15. Division of Hematology-Oncology, E-DA Hospital, Kaohsiung, Taiwan

    Pang-Yu Lai

  16. Division of Hematology-Oncology, Changhua Christian Hospital, Changhua, Taiwan

    Cheng-Shyong Chang

Authors
  1. Wen-Chi Chou
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  2. Jen-Shi Chen
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  17. Cheng-Shyong Chang
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  18. Ruey-Kuen Hsieh
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Corresponding author

Correspondence to Wen-Chi Chou.

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Acknowledgements

The authors gratefully acknowledge the assistance of the patients who participated in this study, and support grants from the Taiwan Society of Cancer Palliative Medicine and Johnson & Johnson.

Conflicts of interest

The authors declare that they have no competing interests.

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Chou, WC., Chen, JS., Hung, CY. et al. A nationwide survey of adherence to analgesic drugs among cancer patients in Taiwan: prevalence, determinants, and impact on quality of life. Support Care Cancer 27, 2857–2867 (2019). https://doi.org/10.1007/s00520-018-4599-x

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  • DOI: https://doi.org/10.1007/s00520-018-4599-x

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