Predictors of adherence to treatment in women with fibromyalgia

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 (patientphysician discordance and pain) and psychological (distress) factors in women with FM. Improvements in these domains may improve adherence in FM.