Participants

Study participants were ambulatory adult patients at the Massachusetts General Hospital Cancer Center who were diagnosed with metastatic cancer (genitourinary, breast, colorectal) or with locally advanced or metastatic cancer (thoracic, sarcoma, noncolorectal gastrointestinal) and who were currently prescribed a long-acting opioid (pill or fentanyl patch) for cancer pain. Patients were excluded if they had impaired cognition or limited English language proficiency to complete study procedures, were not responsible for administering their pain medication, or were determined by their oncology clinician to have physical or mental health symptoms that could interfere with participation.

Participants consented to a prospective study of adherence to a long-acting opioid regimen over eight weeks (n = 135). The aim of this study was to prospectively examine patient adherence to a prescribed long-acting opioid for chronic cancer pain and to examine predictors and outcomes of adherence. Midway through this study, procedures were added to invite consecutive patients who completed the parent study to review their eight-week adherence data and complete a semistructured interview. Inclusion and exclusion criteria were not modified. Recruitment for the semistructured interviews continued until no new themes emerged (data saturation; n = 17).