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Biopsychosocial Approach to Improving Treatment Adherence in Chronic Pain 

Biopsychosocial Approach to Improving Treatment Adherence in Chronic Pain
Chapter:
Biopsychosocial Approach to Improving Treatment Adherence in Chronic Pain
Author(s):

Martin D. Cheatle

and Lara Dhingra

DOI:
10.1093/med/9780190600075.003.0006
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date: 13 April 2021

Up to 53% of patients with chronic nonmalignant pain demonstrate medication nonadherence, and many are nonadherent with behavior-change interventions for pain, presenting a significant challenge to providers managing this population and compromising patient-reported outcomes related to treatment efficacy, symptom control, and quality of life. Patients with chronic pain are often highly complex and present with numerous medical and psychological comorbidities. Many of these comorbidities, including mood, sleep, and substance use disorders, in addition to maladaptive coping with pain and varied clinician, health system, and family-related factors, can influence adherence to pain interventions. This chapter applies a biopsychosocial framework to guide the clinical assessment of nonadherence behaviors in chronic pain, including the identification of risk factors, mechanisms, and underlying processes of nonadherence, and presents strategies providers can potentially implement to enhance patient adherence to pharmacologic and behavioral therapies for pain management.

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