Treatment Adherence in Patients With Headache: A Systematic Review

Abstract

Objective To review and critically evaluate the extant research literature pertaining to adherence in youth and adults with headache and to provide recommendations for future research. Background This article provides the first systematic review of pediatric headache adherence and updates a previous review of treatment adherence in adults with headache. Design Systematic review of empirical literature. Methods A literature search with no date restriction was conducted using PubMed and PsycINFO electronic databases and bibliographies of relevant articles. Results Adherence rates in adults with headache range considerably from 25% to 94% across treatment, assessment method, and definition of adherence utilized. Methods to assess adherence included retrospective prescription claims data, paper or electronic diaries, follow-up appointment attendance, written and verbal self-report of general adherence, verbal self-report of adherence over a specific amount of time via in person interview or telephone, validated adherence measures, adherence questionnaires without validation, and counselor ratings of homework. Each methodology and assessment tool demonstrated strengths and weaknesses. No studies have systematically examined medication adherence in children with headache, and the few available studies examining adherence to behavioral treatment have documented adherence rates ranging from 52% to 86%. Conclusions Adherence research in adults with headache is growing, but studies demonstrate a number of methodological shortcomings. Adherence research in children with headache, and adherence intervention research in both adults and children, is scant. Future research should use objective measures of adherence, consider over-the-counter medications and medication overuse, examine demographic, psychological, and behavioral correlates of adherence, assess adherence to botulinum toxin type A, and examine the efficacy of adherence interventions in individuals with headache.

Incumplimiento del tratamiento antibiótico sistémico prescrito en servicios de urgencias de Atención Primaria (Estudio INCUMAT)

“…Por ello creemos que para el estudio del cumplimiento en tratamientos agudos es necesario incluir el análisis de la variable duración del tratamiento pautado, incorporando a los pacientes en los que no coinciden la finalización del tratamiento con las pautas dadas por el médico prescriptor; por este motivo creamos la variable VA, siempre teniendo presente que no es un test validado. Existe una gran variabilidad en los resultados encontrados en el porcentaje de incumplimiento terapéutico, ya que la mayoría son estudios en procesos crónicos; así, el porcentaje de incumplimiento es del 75% en enfermedad psiquiátrica o del 50% en hipertensos, diabéticos y dislipidémicos [22][23][24][25][26] . De este modo, en un metaanálisis realizado en 2005 por Kardas et al 12 se observó que el 37,8% de los pacientes se olvidaron de tomar alguna dosis de antibiótico.…”

Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study

“…One reason might be the consequent use of betahistine in considerably high dosage (48 mg three times a day) in MD, which has been reported to result in a good treatment effect [20]. However, acute and prophylactic migraine medication also has a considerable efficacy, even though adherence to prophylactic medication often is bad [21]. Another possible explanation for this finding could be that the proposed pathophysiology of MD as inner ear disease is much easier conceivable to the individual patient than migraine as rather complicated brain disorder [22].…”

Treatment Adherence in Child and Adolescent Chronic Migraine Patients

“…5,20,21,23,28 Given the high rates of adherence, there was a ceiling effect for adherence variables, preventing patients from being grouped as “adherent” versus “non-adherent”. Previous studies on adherence to migraine treatment, although quite limited, have not clearly defined a way to designate patients as “adherent” versus “non-adherent”.…”