The association of patients' analgesic treatment beliefs and trade-offs with analgesic adherence behaviors among outpatients with cancer pain
Dr. William E. Rosa, PhD, MBE, NP-BC, FAANP, FAAN
- Sigma Affiliation
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Rosa, William E. by View
Popular Works for Rosa, William E. by Download
Pain is one of the most burdensome symptoms for patients with cancer. Per cancer pain guidelines, opioids remain one of the primary modalities for managing moderate to severe cancer pain. Analgesic nonadherence is common among cancer patients despite unmanaged pain symptoms. We investigated how patients prioritized analgesic treatment beliefs for cancer pain and whether those beliefs predicted objective analgesic adherence behaviors.
This is a secondary analysis of an existing dataset (n=207) that used a three-month prospective observational design. Subjects were from outpatient oncology clinics of a large Philadelphia health system and were > 18 years, self-identified as African-American or White, diagnosed with solid tumor or multiple myeloma, and prescribed at least one around-the-clock analgesic for reported cancer pain.
We conducted three studies to achieve the aims. First, we performed a concept analysis (Chapter 2) of analgesic nonadherence for cancer pain and qualified its utility in the context of the United States opioid epidemic. In Chapter 3, we used maximum difference scaling to identify how patients traded-off on analgesic treatment beliefs. Utilities (importance scores) were ranked using a k means cluster analysis; clusters were compared in terms of key variables. Finally, we employed general linear modeling to evaluate if analgesic belief clusters predicted analgesic adherence behaviors, assessed longitudinally using electronic medication monitoring while accounting for relevant confounders (Chapter 4).
Initial results showed beliefs weigh significantly in subjective analgesic trade-offs. We identified two distinct belief clusters. Side effect severity was the only variable that significantly differed between clusters. Subjects mostly traded-off based on the belief, ‘pain medicines keep you from knowing what is going on in your body.’ Addiction was not a top priority. Belief clusters did not predict analgesic adherence. However, in an adjusted analysis, it was the experiential variables (e.g., side effects, most potent analgesia, pain relief with analgesics, duration of disease), as well as patients’ race, that were statistically significant in explaining analgesic adherence.
Our findings suggest that experiential variables rather than analgesic beliefs were associated with analgesic adherence in this sample of cancer outpatients. Additional studies should explore patients’ cancer pain self-management practices while considering patient, provider, and system/ structural factors to optimizing cancer pain management.
|Review Type||None: Degree-based Submission|
|Research Approach||Quantitative Research|
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Showing items related by title, author, creator and subjects.
Boer, Meghan (2017-06-26)Despite the lack of compelling evidence to support long-term efficacy in the treatment of opioid abuse, opioids are one of the most common classes of medications prescribed in the United States. As such, the significant ...
Addressing the Opioid Epidemic Among Under-Resourced Populations: Development of a Team-Based Medication Assisted Treatment Program Curtis, Alexa ColgoveThis presentation will explore the epidemiology and management of opioid use disorder and then describe the development and evaluation of an interprofessional, team-based, medication assisted treatment program for ...
Implementation & evaluation of safe opioid prescribing guidelines for chronic non-cancer pain in primary care Parsons, NicoleUptake of evidence-based guidelines varies among primary care providers when treating chronic non-cancer pain patients in managed primary care settings. This project aimed to determine the feasibility and compliance of the ...
Ethical considerations when caring for unconscious transgender patients: Promoting TGD-inclusive and gender-affirming interdisciplinary healthcare Lippe, Megan E. Pfitzinger; Eyer, Joshua C.; Rosa, William Edward; Candrian, Carey; McKinney, Robert E. Jr.; Patterson, Brianna; Townsend, Haley F.Transgender and gender-diverse (TGD) patients are a highly marginalized population. Ethical issues abound when TGD patients enter the healthcare system in unconscious states and are incapable of disclosing their gender-identity. ...
Is Tai Chi acceptable for improving health outcomes in opioid-use-disordered patients receiving outpatient medication-assisted treatment? Tsai, Pao-Feng; Chang, Jason Y.; Mancino, Michael J.; Landes, Reid D.; Oliveto, Alison H.This study examined characteristics of patients with opioid use disorder (OUD) who were receiving outpatient medication-assisted treatment (MAT) with methadone (MTD) or buprenorphine/naltrexone (BUP) at the time of ...