title: Predictors of adherence to treatment in women with fibromyalgia.
abstract: OBJECTIVE
  The goal of this study was to identify predictors of general and medication adherence in women with fibromyalgia (FM).
  
  
  METHODS
  Participants were 142 women recruited from tertiary care hospitals or the community and 10 rheumatologists. Participants' demographic, clinical, and psychosocial characteristics, as well as patient-physician discordance, were assessed at the index visit. Adherence was assessed 6 months later. Multivariable generalized estimating equations were used to identify predictors of general adherence and adherence to medication.
  
  
  RESULTS
  The average age of participants was 50.9 years (SD=10.2) and the median duration of FM was 32 months. Participants reported extensive use of health services and medications. The mean score for general adherence was 61.0 (SD=22.4; range 0-100) and 52.9% of the cohort reported at least one form of behavior reflecting nonadherence to medications. More general adherence was significantly predicted by lower patient-physician discordance on patient well-being and lower patient psychological distress. Medication adherence was significantly predicted by higher affective pain and lower patient psychological distress.
  
  
  CONCLUSIONS
  Adherence is influenced by both clinical (patient-physician discordance and pain) and psychological (distress) factors in women with FM. Improvements in these domains may improve adherence in FM.
authors.affiliation: Department of Medicine, McGill University, Montreal, Quebec, Canada. patricia.dobkin@mcgill.ca
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Dobkin
authors.forename: Aurelio
authors.initials: A
authors.lastname: Sita
authors.forename: Maida J
authors.initials: MJ
authors.lastname: Sewitch
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011379:Prognosis; D011792:Quebec / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors