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Predictors of Adherence to Treatment in Women With Fibromyalgia

Dobkin, Patricia L. PhD*; Sita, Aurelio PhD; Sewitch, Maida J. PhD*

doi: 10.1097/01.ajp.0000173016.87612.4b
Original Articles

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.

*Department of Medicine, McGill University, Montreal, Quebec, Canada

Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada

Supported by Arthritis Society of Canada Grant ♯410-96-0516.

Reprints: Dr. Patricia L. Dobkin, McGill University Health Centre, Division of Clinical Epidemiology, L10 417, 1650 Ave. Cedar, Montreal, Quebec, Canada H3G 1A4 (e-mail:

Received for publication April 20, 2004; first revision August 23, 2004; second revision February 27, 2005; accepted May 23, 2005

© 2006 Lippincott Williams & Wilkins, Inc.