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Rheumatology Advance Access published online on February 24, 2004
Rheumatology, doi:10.1093/rheumatology/keh141
Rheumatology © British Society for Rheumatology 2004; all rights reserved
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© 2004 Rheumatology © British Society for Rheumatology 2004; all rights reserved

Original Papers

Medication non-adherence in women with fibromyalgia

M. J. Sewitch 1*, P. L. Dobkin 1, S. Bernatsky 2, M. Baron 3, M. Starr 4, M. Cohen 4, and M.-A. Fitzcharles 4

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

* Corresponding author. E-mail: maida.sewitch{at}mail.mcgill.ca.

Received 25 February 2003 ; accepted 23 December 2003

Abstract

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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