Adherence to Opioids for Cancer-Related Pain Among Patients with Cancer in a Resource-Restricted Hospital in Palestine

Abstract

Purpose: Cancer-related pain is a critical symptom that significantly impacts patients’ quality of life. This study aimed to assess adherence and identify factors influencing adherence to opioid analgesics for cancer-related pain among cancer patients at a hospital setting in Gaza, Palestine. Patients and Methods: A cross-sectional study was conducted from December 2021 to March 2022, involving cancer patients receiving opioid for cancer-related pain. Participants completed a set of questionnaires on socioeconomic data, pain intensity and interference using the Brief Pain Inventory (BPI), adherence to opioids using the General Medication Adherence Scale (GMAS), and beliefs about pain and opioids using the Pain and Opioid Analgesic Beliefs-Cancer (POASB-CA) scale. Patients’ clinical data were collected from the patients’ medical records. Simple and multiple linear regression analyses were utilized to elucidate factors associated with adherence towards opioids for cancer-related pain. Results: A total of 270 patients were recruited. Most patients (88.5%) were at least partially adherent to the opioid analgesic. The average pain intensity score was 5.796 (SD = 1.98), and pain interference scored 7.093 (SD = 3.63). Simple linear regression identified the following parameters to be significantly associated with adherence: education level, presence of comorbidity, average percentage of pain relief experienced over the past 24 hours, negative effect beliefs and pain endurance beliefs. Based on multiple linear regression analysis, education level, percentage of pain relief and presence of side effects were positive predictors of higher adherence score (B=1.082, CI 0.139 to 2.025, p=0.025; B=0.076, CI 0.046 to 0.105, p<0.001 and B=1.578, CI 0.116 to 3.041, p=0.034, respectively). Conclusion: Adherence to opioids for cancer-related pain was generally good. Influencing factors included education level, average pain relief in the past 24 hours, and opioid side effects. These results highlight the complex nature of adherence in managing cancer pain and suggest areas for targeted interventions.