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March 15, 2006
Clin J Pain. 2006 Mar-Apr;22(3):286-94.
Dobkin PL, Sita A, Sewitch MJ.
Department of Medicine, McGill University, Montreal, Quebec, Canada. patricia.dobkin@mcgill.ca
OBJECTIVES: The goal of this study was to identify predictors of general and medication adherence in women with fibromyalgia (FM).
METHODS: Participants were 142 women recruited from tertiary care hospitals or the community and 10 rheumatologists. Participants' demographic, clinical, and psychosocial characteristics, as well as patient-physician discordance, were assessed at the index visit. Adherence was assessed 6 months later. Multivariable generalized estimating equations were used to identify predictors of general adherence and adherence to medication.
RESULTS: The average age of participants was 50.9 years (SD=10.2) and the median duration of FM was 32 months. Participants reported extensive use of health services and medications. The mean score for general adherence was 61.0 (SD=22.4; range 0-100) and 52.9% of the cohort reported at least one form of behavior reflecting nonadherence to medications.
More general adherence was significantly predicted by lower patient-physician discordance on patient well-being and lower patient psychological distress. Medication adherence was significantly predicted by higher affective pain and lower patient psychological distress.
CONCLUSIONS: Adherence is influenced by both clinical (patient-physician discordance and pain) and psychological (distress) factors in women with FM. Improvements in these domains may improve adherence in FM.
PMID: 16514330 [PubMed - in process]
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