• Sebastiano Mercadante, Claudio Adile, Walter Tirelli, Patrizia Ferrera, Italo Penco, and Alessandra Casuccio.
• Main Regional Center for Pain Relief and Palliative/Supportive Care, La Maddalena Cancer Center Palermo, Palermo, Italy.
• Pain Pract. 2021 Apr 1; 21 (4): 388-393.

AimTo assess patients' barriers to pain management and analgesic medication adherence in patients with advanced cancer.MethodsThis was a prospective cross-sectional study in patients with advanced cancer receiving chronic opioid therapy. Age, gender, cancer diagnosis, Karnofsky level, and educational status were recorded. The Brief Pain Inventory (BPI), Edmonton Symptom Assessment Scale (ESAS), Memorial Delirium Assessment Scale (MDAS), Barriers Questionnaire II (BQ-II), Medication Adherence Rating Scale (MARS), and Hospital Anxiety and Depression Scale (HADS) were the measurement instruments used.ResultsOne-hundred-thirteen patients were analyzed. The mean age was 68 (±13) years, and 59 (52%) were male. The mean Karnofsky status was 51.4 (standard deviation [SD] 11.5). The mean score for BQ-II items was 1.77 (SD 0.7). The BQ-II score was independently related to the HADS-Depression score (P = 0.033) and the total HADS score (P = 0.049). Negative side-effects and attitudes toward psychotropic medication globally prevailed among MARS items. These items were independently associated with gender (P = 0.030), pain (P = 0.003), and depression (P = 0.047).ConclusionBarriers to pain management were mild. Psychological factors such as depression were the main factor associated with barriers. Poor adherence to analgesic medication was mostly manifested as negative side-effects and attitudes toward psychotropic medication, was more frequent observed in females, and was associated with the ESAS items pain and depression.© 2020 World Institute of Pain.

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