Factors that influence medication adherence in women with fibromyalgia: A path analysis

Abstract

AbstractAimsTo investigate the relationships between depression symptoms, perceived stigma, disease severity, patient‐provider communication and medication adherence in fibromyalgia patients. The objectives were to explore how these factors influence treatment adherence and to develop a comprehensive model illustrating their interconnections.BackgroundFibromyalgia is a chronic pain syndrome with fatigue, sleep issues and idiopathic pain. Medication adherence is limited by insufficient symptom relief, side effects and costs. Stigma further complicates fibromyalgia. Disease severity affects patient‐provider communication. Associations between depression, stigma, severity, communication and adherence in fibromyalgia are unclear.DesignA cross‐sectional, correlational study.MethodsThe STROBE guidelines for cross‐sectional studies were followed. Participants included Hebrew‐speaking participants who were members of two Facebook groups: ‘Shades of Purple’ and ‘Fibromyalgia‐ Get to Know!’ Between February and April 2022. They undertook evaluations using The Patient Health Questionnaire‐9 to gauge depression symptoms, assessed perceived stigma, utilised The Revised Fibromyalgia Impact Questionnaire to determine disease severity, employed The Patient Reaction Assessment questionnaire for patient‐provider communication, and used the 8‐item Morisky Medication Adherence Scale (MMAS‐8). Associations between the variables were explored using Pearson's correlations and path analyses.ResultsThe study included 141 women with fibromyalgia, aged 22 to 76 years. Most reported having a stable partner (69.5%) and 75.2% had children. The treatment adherence levels were as follows: 53.2% (N = 75)—low, 33.3% (N = 47)—medium and 13.5% (N = 19)—high. Depression positively correlated with stigma. Stigma negatively correlated with patient‐provider communication. Patient‐provider communication positively correlated with treatment adherence. A significant negative indirect effect of depression on treatment adherence through stigma and patient‐provider communication was found.ConclusionsPerceived stigma and patient‐provider communication played a mediating role in the relationships between depression and treatment adherence among women with fibromyalgia.Relevance to Clinical PracticeAddressing stigma related to fibromyalgia and effective patient‐provider communication can positively influence treatment adherence.Patient or Public ContributionNo patient or public contribution.