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Rheumatology Advance Access originally published online on February 24, 2004
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Rheumatology 2004; 43: 648-654
Rheumatology Vol. 43 No. 5 (c) British Society for Rheumatology 2004; all rights reserved

Clinical

Medication non-adherence in women with fibromyalgia

M. J. Sewitch1, P. L. Dobkin1, S. Bernatsky2, M. Baron3, M. Starr4, M. Cohen4 and M.-A. Fitzcharles4

Departments of 1Medicine and 2Epidemiology and Biostatistics, McGill University, 3Division of Rheumatology, Jewish General Hospital, McGill University Health Centre and 4Division of Rheumatology, McGill University Health Centre, Montreal, Canada.

Correspondence to: M. J. Sewitch, Division of Clinical Epidemiology, MUHC-The Montreal General Hospital, 1650 Cedar Avenue, Room L10-321.1, Montreal, Quebec, Canada H3G 1A4. E-mail: maida.sewitch{at}mail.mcgill.ca

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.

KEY WORDS: Fibromyalgia, Determinants, Medication, Non-adherence, Women.


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