• Katherine A Yeager, Bryan Williams, Jinbing Bai, Hannah L F Cooper, Tammie Quest, Salimah H Meghani, and Deborah W Bruner.
• Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA; Winship Cancer Institute, Emory University, Atlanta, Georgia, USA. Electronic address: kyeager@emory.edu.
• J Pain Symptom Manage. 2019 Jan 1; 57 (1): 283628-36.

ContextCancer pain relief is often inadequate because of poor adherence to pain medication, especially for black patients.ObjectivesThe purpose of this study is to describe factors related to adherence to around-the-clock opioids among 110 black patients being treated for cancer pain.MethodsSociodemographic, clinical, symptoms, and social support data were collected at baseline; pain and adherence data were collected at 30 days. Associations between these variables and opioid adherence measured by Medication Event Monitoring System were estimated using multiple regression.ResultsMean age was 56 (±10.1), the majority were women (63%) and college educated (56%). Mean pain severity at baseline equaled 4.6 (±2.3). Mean dose adherence was 60% (±28.5), while mean schedule adherence was 33.0% (±31.0). In adjusted analysis, 26% of the variance in dose adherence was explained by recent chemotherapy, changes in pain, concerns about nausea, and doctors' focus on cure versus pain control (P<0.001); 27% of the variance in schedule adherence was explained by recent chemotherapy, changes in pain, symptom burden, and concerns about doctors focus on cure versus pain control (P<0.001).ConclusionFindings confirm pain medication adherence is poor and pain was not well relieved. Multiple factors influence adherence to around-the-clock opioids. Clinicians need to partner with patients by providing a personalized pain treatment plan including an in-depth assessment of treatment choices and adherence.Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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