Analgesic Beliefs Research Articles

Relationship Between Adherence to Opioid Analgesics and Pain Beliefs Among Patients with Cancer Pain at Tertiary Care Hospitals in Malaysia.

ContextPain is a common and distressing symptom among cancer patients. Opioid analgesics are the mainstay of cancer pain management, and adequate adherence plays an important role in achieving good pain control.PurposeTo determine the level of adherence to opioid analgesics in patients with cancer pain and to identify factors that may influence the adherence.Patient and MethodsThis was a cross-sectional study conducted from March to June 2018 at two tertiary care hospitals in Malaysia. Study instruments consisted of a set of validated questionnaires; the Medication Compliance Questionnaire, Brief Pain Inventory and Pain Opioid Analgesic Beliefs─Cancer scale.ResultsA total of 134 patients participated in this study. The patients’ adherence scores ranged from 52–100%. Factors with a moderate, statistically significant negative correlation with adherence were negative effect beliefs (rs= −0.53, p<0.001), pain endurance beliefs (rs = −0.49, p<0.001) and the use of aqueous morphine (rs = −0.26, p=0.002). A multiple linear regression model on these predictors resulted in a final model which accounted for 47.0% of the total variance in adherence (R2 = 0.47, F (7, 126) = 15.75, p<0.001). After controlling for other variables, negative effect beliefs were the strongest contributor to the model (β = −0.39, p<0.001) and uniquely explained 12.3% of the total variance.ConclusionThe overall adherence to opioid analgesics among Malaysian patients with cancer pain was good. Negative effects beliefs regarding cancer pain and opioids strongly predicted adherence.

Patient Trade-Offs Related to Analgesic Use for Cancer Pain: A MaxDiff Analysis Study

PurposeMany patients with cancer pain deviate from prescribed analgesic regimens. Our aim was to elicit the trade-offs patients make based on their beliefs about analgesic use and rank utilities (importance scores) using maximum difference (MaxDiff) scaling. We also investigated if there were unique clusters of patients based on their analgesic beliefs. MethodsThis was a secondary analysis of a three-month, prospective observational study. Patients (N = 207) were self-identified African Americans and Whites, >18 years, diagnosed with multiple myeloma or solid tumor, and were prescribed at least one around-the-clock analgesic for cancer pain. MaxDiff analysis allowed us to identify patients utilities. Second, a cluster analysis assisted in ranking how analgesic beliefs differed by groups. Third, clusters were described by comparing key sociodemographic and clinical variables. ResultsParticipants’ beliefs were a significant factor in choices related to analgesic use (chi-square = 498.145, p < .0001). The belief, ‘Pain meds keep you from knowing what is going on in your body’, had the highest patient endorsement. Two distinct clusters of patients based on analgesic beliefs were identified; ‘knowing body’ was ranked as top priority for both clusters. The belief that cancer patients become addicted to analgesics was moderately important for both clusters. Severity of side effects was the only key variable significantly different between clusters (p = .043). ConclusionsOur findings support tailored pain management interventions that attend to individual beliefs about cancer pain and analgesic use. Future research should explore the relationship between analgesic utilities, actual analgesic taking behaviors, and how they impact patients’ cancer pain outcomes.

Everyday pain, analgesic beliefs and analgesicbehaviours in Europe and Russia: An epidemiologicalsurvey and analysis

Беше проведено анкетно проучване в осем държави, в т.ч. Белгия, Германия, Великобритания, Италия, Полша, Русия и Испания. Оценена беше честотата на оплакване от болка при 8 506 души (52% жени), както и използването на аналгетици и нагласите спрямо тях. Предварителните анализи потвърждават високата честота на оплаквания от болка, като 70% от анкетираните посочват, че поне веднъж в месеца изпитват такава. Най-често се съобщава за главоболие и болки в гърба, a болшинството анкетирани лица - 77%, споделят, че използват аналгетични средства, когато страдат от болка. Предмет на по-нататъшните анализи бяха различията по пол, статус на заетост, държава по местоживеене и възраст. В сравнение с мъжете, жените по-често изпитват болка, употребата на аналгетици сред тях е по-голяма, както и притесненията им във връзка с тази употреба, като проявяват склонност да базират употребата върху своите познания относно лекарствените продукти. Безработните също съобщават за по-голямо използване на аналгетици и повече притеснения във връзка с това, сравнено със заетите лица. Като цяло при хората, живеещи в Русия и Полша, се отчита по-рядко болка и по-малко използване на обезболяващи средства в сравнение с останалата част на Европа. Те също така се тревожат повече във връзка с аналгетиците и по отношение на това, че използването на аналгетици от тяхна страна е слабо свързано с познания относно лекарствата. Отчитането на фактора „възраст` показва, че при по-младите епизодите на болка са по-малко, употребата на аналгетици - по-честа, a притесненията относно аналгетиците са по-слаби в сравнение с по-възрастните. Също така, по-младите са по-склонни да използват аналгетици въз основа на своите познания за продукта. Тези резултати повтарят съществуващи констатации във връзка с честотата на болката. Дават и нови сведения за различията при изпитването на болка, използването на аналгетици и нагласите към аналгетиците в Европа и Русия.

Everyday pain, analgesic beliefs and analgesic behaviours in Europe and Russia: an epidemiological survey and analysis

A questionnaire survey was conducted across eight countries, including Belgium, France, Germany, Great Britain, Italy, Poland, Russia and Spain. Frequency of pain experience was assessed in 8506 individuals (52% women),...

Relationship Between Belief about Analgesics, Analgesic Adherence and Pain Experience in Taiwanese Cancer Outpatients

Social and behavioral scientists have proposed that a person's belief system crucially influences his or her behaviour, and therefore may affect outcomes of pain management. The purpose of this study was to explore the relationship between analgesic beliefs, analgesic adherence and pain experience amongst Taiwanese cancer outpatients. The cross-sectional study included 92 oncology outpatients in two teaching hospitals in the Taipei area of Taiwan. The research instruments included the Pain Opioid Analgesic Beliefs Scale-Cancer (POABS- CA), opioid adherence, and the Brief Pain Inventory-Chinese (BPI-Chinese). Beliefs about pain and opioids demonstrated a significant relationship with patients' opioid adherence (r = -0.30, p < 0.01). The more negative beliefs regarding opioids and pain the patient had, the worse their adherence to around the clock (ATC) analgesic regimen. However, there was no significant correlation between opioid belief and pain experience. As well, there were no significant relationships between adherence to opioid regimen and any of the measures of pain experience. The study highlights the potential importance of a patient's pain and opioid beliefs in adherence to pain medication.

A Pilot Study to Identify Correlates of Intentional Versus Unintentional Nonadherence to Analgesic Treatment for Cancer Pain

Existing studies of medication adherence treat “nonadherence” as a monolithic concept. The goal of this study was to isolate correlates of intentional versus unintentional nonadherence for analgesic treatment for cancer pain. Patients were recruited from outpatient oncology clinics in the middle Atlantic region, ≥18 years old, and diagnosed with solid tumors, and had an active prescription of at least one around-the-clock analgesic. The Morisky Medication Adherence Scale (MMAS) was used to assesses “unintentional” (forgetfulness/carelessness) and “intentional” (stopping use of medication if feeling better or worse) dimensions of analgesic nonadherence. A visual analog scale was used to assess the percentage of analgesic doses taken in the preceding month. A majority of participants (85.5%) took prescribed analgesics in the index period. However, 51% reported taking only up to 60% of the analgesic doses prescribed to them. Stopping taking analgesics when feeling better was the most commonly reported nonadherence behavior (74%); those reporting “intentional” nonadherence when feeling better were more likely to report not using analgesics in the index week (100% vs. 67.7%; p = .029) and agree that pain medication can keep you from knowing what is going on in your body (p = .029) and were less likely to need stronger pain medication (33.3% vs. 81.5%; p = .003). “Unintentional” nonadherence, i.e., forgetfulness/carelessness, though associated with many analgesic beliefs, was not associated with measures of analgesic use in the index period. These preliminary data indicate that different heuristics underlie intentional versus unintentional nonadherence to analgesia and that intentional and unintentional nonadherence behaviors may have different implications for pain treatment outcomes.

Factors influencing opioid‐taking self‐efficacy and analgesic adherence in Taiwanese outpatients with cancer

Although research has suggested that medication adherence rates are lower than what is needed to achieve optimal pain control, the role of patient beliefs and attitudes in influencing opioid adherence has rarely been examined. Perceived self-efficacy is reported to be an important construct in predicting and enhancing adherence behaviour. The purpose of this study was to explore the relationship between opioid-taking self-efficacy, opioid beliefs, adherence behaviours, and pain experience amongst Taiwanese cancer outpatients. The cross-sectional study included 92 oncology outpatients in two teaching hospitals in the Taipei area of Taiwan. The research instruments included the Opioid-Taking Self-Efficacy Scale-Cancer (OTSES-CA), the Pain Opioid Analgesic Beliefs Scale-Cancer (POABS-CA), opioid adherence, and the Brief Pain Inventory-Chinese (BPI-Chinese). Opioid-taking self-efficacy demonstrated a significant positive relationship with patients' opioid adherence (r=0.22, p<0.05) and pain relief (r=0.35, p<0.01), while also demonstrating a significant positive correlation with worst pain (r=0.25, p<0.05). In addition, the more negative beliefs regarding opioids the patient had, the worse their adherence to around the clock analgesic regimen (r=-0.30, p<0.01). Multivariate analysis identified opioid-taking self-efficacy continued to have a significant independent influence on opioid adherence and pain relief, after controlling for key demographic variables. Self-efficacy accounted for 4% (R(inc) (2)=0.04, p=0.043) of the variance and opioid beliefs accounted for 8% (R(inc) (2)=0.08, p=0.007) of the variance in opioid adherence. Multivariate analysis also identified that opioid-taking self-efficacy accounted for 11% (R(inc) (2)=0.11, p=0.001) of the variance in pain relief, but opioid beliefs did not continue to have an independent effect for this outcome. The study highlights the potential importance of a patient's self-efficacy beliefs in adherence to medication and key pain outcomes.

Relationship Between Pain-Specific Beliefs and Adherence to Analgesic Regimens in Taiwanese Cancer Patients: A Preliminary Study

This pilot cross-sectional study aimed to 1) explore pain beliefs and adherence to prescribed analgesics in Taiwanese cancer patients, and 2) examine how selected pain beliefs, pain sensory characteristics, and demographic factors predict analgesic adherence. Pain beliefs were measured by the Chinese version of Pain and Opioid Analgesic Beliefs Scale—Cancer (POABS-CA) and the Survey of Pain Attitudes (SOPA). Analgesic adherence was measured by patient self-report of all prescribed pain medicine taken during the previous 7 days. Only 66.5% of hospitalized cancer patients with pain (n = 194) adhered to their analgesic regimen. Overall, patients had relatively high mean scores in beliefs about disability, medications, negative effects, and pain endurance, and low scores in control and emotion beliefs. Medication and control beliefs significantly predicted analgesic adherence. Patients with higher medication beliefs and lower control beliefs were more likely to be adherent. Findings support the importance of selected pain beliefs in patients' adherence to analgesics, suggesting that pain beliefs be assessed and integrated into pain management and patient education to enhance adherence.