title: Lack of adherence with the analgesic regimen: a significant barrier to effective cancer pain management.
abstract: OBJECTIVE
  To evaluate oncology outpatients' level of adherence to their analgesic regimen during a 5-week period.
  
  
  METHODS
  A random sample of 65 adult oncology outpatients with a Karnofsky performance status score of >or= 50, an average pain intensity score of >or= 2.5, and radiographic evidence of bone metastasis were recruited for this longitudinal study from seven outpatient settings. On a daily basis, patients rated their level of pain intensity and recorded pain medication intake. Adherence rates for opioid analgesics prescribed on an around-the-clock (ATC) and on an as-needed (PRN) basis were calculated on a weekly basis.
  
  
  RESULTS
  Overall adherence rates for ATC opioid analgesics ranged from 84.5% to 90.8% and, for PRN analgesics, from 22.2% to 26.6%. No significant differences over time were found in either of these adherence rates.
  
  
  CONCLUSIONS
  One factor that seems to contribute to ineffective cancer pain management is poor adherence to the analgesic regimen.
authors.affiliation: School of Nursing, University of California, San Francisco, CA 94143-0610, USA. chris.miaskowski@nursing.ucsf.edu
authors.forename: C
authors.initials: C
authors.lastname: Miaskowski
authors.forename: M J
authors.initials: MJ
authors.lastname: Dodd
authors.forename: C
authors.initials: C
authors.lastname: West
authors.forename: S M
authors.initials: SM
authors.lastname: Paul
authors.forename: D
authors.initials: D
authors.lastname: Tripathy
authors.forename: P
authors.initials: P
authors.lastname: Koo
authors.forename: K
authors.initials: K
authors.lastname: Schumacher
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D017567:Karnofsky Performance Status; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D009657:North Carolina; D010147:Pain Measurement; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology; D010349:Patient Compliance; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics