Comprehensive intervention study on medication compliance of analgesics in home-based patients with moderate and severe cancer pain / 中国实用护理杂志

ABSTRACT

Objective To explore the comprehensive intervention mode of compliance with analgesics for home-based patients with moderate or severe cancer pain and to improve the medication compliance of home-based patients with cancer pain. Methods A self-designed questionnaire was designed to investigate the influencing factors of taking analgesics for home-based patients with moderate or severe cancer pain, 143 home-based patients with moderate to severe cancer pain were conveniently selected from Hospice Unit of Zhongnan Hospital of Wuhan University, from February 2016 to December2017. To investigate the subjective, objective and psychological factors affecting patients' compliance with analgesics, comprehensive interventions such as health education, behavioral intervention, cognitive intervention and psychological counseling were carried out. Before and after the intervention, Morisky′s self-report questionnaire on medication compliance, pain digital grading (NRS score), and pain relief degree were assessed. Using self control design method and comparing the compliance of patients taking analgesics, number of complete compliance and non-compliance in patients taking analgesics and NRS score and pain relief before and after 8 weeks of intervention. Pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after comprehensive intervention were evaluated. Results The main factors affecting patients' medication compliance with analgesics were fear of morphine addiction(16.37％, 37/226), single use of drugs and insufficient dosage (15.93％, 36/226), and fear of adverse drug reactions(13.72％, 31/226). The scores of NRS decrease in patients with different influencing factors were compared, with statistical difference (F=5.367, P=0.006). There were significant differences in the number and compliance of patients with complete compliance and non-compliance before and after 8-week-comprehensive intervention (χ2=25.583, P=0.000; t =-7.387, P=0.000). There were significant differences in pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after 8-week-comprehensive intervention (χ2=76.572, 62.998, all P=0.000). Conclusions Comprehensive intervention on subjective, objective and psychological factors affecting the medication compliance of home-based patients with moderate or severe cancer pain can improve the medication compliance of patients to take analgesics and alleviate pain.