title: A pilot study to investigate adherence to long-acting opioids among patients with advanced lung cancer.
abstract: BACKGROUND
  Uncontrolled pain remains prevalent in patients with advanced cancer and has been associated with worse quality of life and greater health care utilization. Poor adherence to analgesics may represent a modifiable barrier to pain management.
  
  
  OBJECTIVE
  This pilot study aimed to establish feasibility/utility of evaluating self-reported adherence to long-acting (LA) opioids in patients with advanced lung cancer, and to explore rates and correlates of adherence.
  
  
  METHODS
  Consecutive patients attending an ambulatory thoracic oncology clinic with a diagnosis of advanced lung cancer and a current LA opioid regimen were approached to complete a brief questionnaire during their clinic visit. Participants reported LA opioid adherence during the past 4 weeks (0%-100%) and knowledge of their LA opioid regimen, and completed the Patient Health Questionnaire-2 (PHQ-2) depression screen. Demographic and clinical information were confirmed via electronic health record review.
  
  
  RESULTS
  Fifty-four eligible patients were approached to reach our target sample (n=50; enrollment=92.6%). Self-reported adherence to LA opioids was 85.4% (standard deviation [SD]=21.0). Twenty-eight percent reported a frequency of medication use that did not match the prescribed daily frequency. Lower adherence was associated with inaccurate frequency (p=0.004), positive depression screen (p=0.005), and older age (p=0.04).
  
  
  CONCLUSIONS
  Our results demonstrate the feasibility of integrating self-report assessments of LA opioid adherence into a thoracic oncology clinic. Patients reported high adherence, but more than one-quarter did not accurately report the prescribed frequency of daily doses. Understanding of LA opioid regimens may be a critical indicator of adherence in patients with advanced cancer.
authors: Caritas Christi Hospice, St. Vincent's Hospital (Melbourne), Victoria, Australia. jackieyoong@hotmail.com
authors: Jaclyn
authors: J
authors: Yoong
authors: Lara N
authors: LN
authors: Traeger
authors: Emily R
authors: ER
authors: Gallagher
authors: William F
authors: WF
authors: Pirl
authors: Joseph A
authors: JA
authors: Greer
authors: Jennifer S
authors: JS
authors: Temel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001900:Boston; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010865:Pilot Projects
chemical_list: D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations