{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:56:44Z","timestamp":1790607404721,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chronic pain has been associated with comorbid psychological symptoms and prescription medication nonadherence, including nonadherence due to financial limitations. Despite noted independent associations with chronic pain, the association of medication nonadherence and psychological symptoms in the context of chronic pain is unclear. Therefore, this study aimed to explore the associations between depression and anxiety medication nonadherence due to cost among adults living with chronic pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Data from the 2023 National Health Interview Survey were utilized in these analyses. Adults (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a07736) with self\u2010reported chronic pain responded to items assessing cost\u2010related medication nonadherence (skipping medication, taking less medication, delaying filling prescriptions, not getting prescription) and psychological symptoms (depression and anxiety).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 87.2% of individuals with chronic pain reported taking prescription medication during the past year. Skipping medication doses to save money, taking less medication to save money, delaying filling a prescription to save money, and not getting a prescription due to cost were each associated with depression and anxiety (all\n                      <jats:italic>p<\/jats:italic>\n                      s\u00a0&lt;\u00a00.001) among individuals with chronic pain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Psychological symptoms and medication nonadherence due to cost are intricately related in the context of chronic pain. Screening individuals with chronic pain for medication adherence issues and psychological symptoms, as well as educating patients regarding applicable policies or programs for affordable medication access may be particularly important steps for increasing healthcare equity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/puh2.70345","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:25:21Z","timestamp":1787066721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Financial Barriers, Mental Health, and Medication Nonadherence Among Individuals With Chronic Pain"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6309-365X","authenticated-orcid":false,"given":"Zoe","family":"Sirotiak","sequence":"first","affiliation":[{"name":"Department of Kinesiology and Health Iowa State University  Ames Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009742.2012.697916"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2374373518786013"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/J.PAIN.0000000000000160"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/MMWR.MM7215A1"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3344\/KJP.22357"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JPAIN.2022.05.001"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/J.PAIN.0000000000000542"},{"issue":"2","key":"e_1_2_11_9_1","first-page":"173","article-title":"Pain and Psychology\u2014A Reciprocal Relationship","volume":"17","author":"Vadivelu N.","year":"2017","journal-title":"Ochsner Journal"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/J.PAIN.0000000000003056"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291705006859"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.PNPBP.2017.08.020"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.03.040"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2025.118243"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/JGP.0b013e3181b972d1"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/JJNS.12065"},{"key":"e_1_2_11_17_1","volume-title":"Chronic Pain Management","author":"Center for Substance Abuse Treatment","year":"2012"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/J.PAIN.0000000000002291"},{"key":"e_1_2_11_19_1","volume-title":"Pain Management Medications","author":"Milani D. 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