She skips some days of the medication

Mrs. AP does not like to go to doctors, has many misconceptions regarding medicines and thinks that everythins is bad for her. So, some days she skips a few doses thinking that this won't affect the outcome of her pain management. 

She also thinks than her doctor cannot understand her fears. At the same time, her pain keeps getting worse.

This is something that she will need to discuss with her GP in her follow up visit as well as find out about alternative, non pharmacological treatments to manage pain for hand OA.