Cancan Chen, Zizi He, Jing Zhang, Longteng Ma, Li Kang, Hui Su, Zhenjie Ma, Shuqing Wang, Yunyun Huo, Shengyuan Yu, Ye Ran, Zhao Dong
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引用次数: 0
Abstract
Objective: To investigate the current adherence status and influencing factors for acute and preventive pharmacotherapy among migraine patients in China.
Methods: Utilizing a prospective cohort design with retrospective identification, migraine patients first attending the Headache Clinic (Chinese PLA General Hospital, May-November 2024) were prospectively assessed for treatment adherence and influencing factors via structured telephone follow-ups.
Results: Among 456 enrolled patients (75.9% female, 24.1% male), migraine subtypes included probable migraine (14.9%), migraine without aura (72.6%), migraine with aura (4.2%), and chronic migraine (8.3%). Good adherence rates were 30.5% for acute and 53.3% for preventive pharmacotherapy. Key non-adherence behaviors for acute medication: Abstinence from medication during attacks (63.1%) and administration after pain progression to moderate/severe intensity (35.0%). Primary reasons: mild headache deemed non-requiring medication (43.3%) and fear of potential adverse effects (36.0%). Key non-adherence behaviors for preventive medication: incomplete treatment course duration (76.4%), failure to obtain prescribed medications (15.3%), and non-adherence to prescribed medication schedule (11.1%). Primary reasons given for nonadherence to preventive medication included perceived prescription inappropriateness (43.1%) and adverse effects that occurred (19.4%). Multivariate regression analysis revealed that adherence to acute pharmacotherapy increased with higher educational level, medical insurance coverage, satisfaction with pain relief, and enhanced patient valuation of pharmacotherapy (all p < 0.05). For preventive medication, adherence was associated with adverse effects, satisfaction with treatment efficacy, and enhanced patient valuation of pharmacotherapy (all p < 0.05). Good adherence independently predicted fewer monthly headache days (MHD: 3.4 ± 3.9 days vs. 7.7 ± 6.1 days, p < 0.01).
Conclusion: Suboptimal medication adherence persists among Chinese migraine patients, with patient valuation of pharmacotherapy being the strongest modifiable factor. Interventions should prioritize patient education, personalized treatment plans, and tailored adherence strategies to improve outcomes.
期刊介绍：
The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data.
With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.
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