Medication non-adherence in women with fibromyalgia.
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.


CONCLUSIONS
The therapeutic relationship, in addition to clinical and psychosocial characteristics, influenced non-adherence to medication.
Sewitch
M J
MJ
Department of Medicine, McGill University, Montreal, Quebec, Canada. maida.sewitch@mail.mcgill.ca
Dobkin
P L
PL
Bernatsky
S
S
Baron
M
M
Starr
M
M
Cohen
M
M
Fitzcharles
M-A
MA
D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012959:Socioeconomic Factors; D016312:Treatment Refusal / Q000523:psychology*