Rheumatology (Oxford). 2004 Feb 24 [Epub ahead of print]
Sewitch MJ, Dobkin PL, Bernatsky S, Baron M, Starr M, Cohen M, Fitzcharles MA.
Department of Medicine, McGill University, Montreal, Canada.
OBJECTIVE: To identify the determinants of medication non-adherence in women with fibromyalgia (FM).
METHODS: Participants included 10 rheumatologists and 127 women recruited from tertiary care hospitals and the community. Demographic, clinical and psychosocial characteristics and patient-physician discordance were assessed at the baseline visit. Non-adherence was assessed 2 weeks later. Multivariable generalized estimating equations were used to identify determinants of non-adherence to medication.
RESULTS: The average age of the women was 50.4 (s.d. 10.5) yr and the mean disability score was 60.3 (16.0) yr. Sixty (47.2%) women were non-adherent to medication; 20 (33.3%) of these were intentionally non-adherent, 24 (40.0%) were unintentionally non-adherent, and the remaining subjects were both. Overall non-adherence was predicted by higher patient-physician discordance. Unintentional non-adherence was predicted by community subjects, not being under a rheumatologist’s care, less disease activity, less use of instrumental coping, and higher patient-physician discordance. Intentional non-adherence was predicted by shorter duration under a rheumatologist’s care and higher patient-physician discordance.
CONCLUSION: The therapeutic relationship, in addition to clinical and psychosocial characteristics, influenced non-adherence to medication.
PMID: 14983107 [PubMed – as supplied by publisher]