title: Pharmacologic pain treatment in a multidisciplinary pain center: do patients adhere to the prescription of the physician?
abstract: BACKGROUND
  Medication nonadherence is a frequent problem in chronic conditions. In chronic noncancer pain, medication is often used as an important cornerstone of the treatment. Studies on medication nonadherence in this population, however, are scarce.
  
  
  OBJECTIVE
  The aim of this study was to determine the prevalence of medication underuse and overuse nonadherence in a large sample of chronic pain patients treated in a multidisciplinary pain center. Second, an extensive list of demographic, disease-related, treatment-related and health behavior-related factors was included to compare these factors between adherent, overusers, and underusers, respectively.
  
  
  METHODS
  Self-report was used to measure medication adherence.
  
  
  RESULTS
  Forty-eight percent of the patients were nonadherent, with 34% of them showing underuse and 14% overuse of the prescribed medication. Multivariable analyses showed a significant association between younger age and medication nonadherence (both underuse and overuse). Furthermore, underuse was significantly associated with self-medication. Overuse was associated with current smoking, opioid prescription, and more medication intake moments.
  
  
  CONCLUSIONS
  We can conclude that medication nonadherence, especially underuse of medication, occurs frequently among patients with chronic nonmalignant pain. Prospective research is needed to learn about the impact of medication overuse or underuse on clinical outcomes. Future research should examine underuse and overuse as different types of nonadherence as different factors might predict this behavior.
authors.affiliation: Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium. susan.broekmans@med.kuleuven.be
authors.forename: Susan
authors.initials: S
authors.lastname: Broekmans
authors.forename: Fabienne
authors.initials: F
authors.lastname: Dobbels
authors.forename: Koen
authors.initials: K
authors.lastname: Milisen
authors.forename: Bart
authors.initials: B
authors.lastname: Morlion
authors.forename: Steven
authors.initials: S
authors.lastname: Vanderschueren
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000145:classification / Q000627:therapeutic use*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000523:psychology*; D018710:Pain Clinics / Q000706:statistics & numerical data*; D010147:Pain Measurement; D010349:Patient Compliance / Q000523:psychology*; D010817:Physician-Patient Relations; D015995:Prevalence; D012189:Retrospective Studies; D012649:Self Concept; D012907:Smoking
chemical_list: D000700:Analgesics