Whites and African-Americans in Headache Specialty Clinics Respond Equally Well to Treatment

Abstract

This study sought to determine if Whites and African-Americans respond similarly to headache treatment administered in 'real-world' headache specialty treatment clinics. Using a naturalistic, longitudinal design, 284 patients receiving treatment for headache disorders completed 30-day daily diaries that assessed headache frequency and severity at pretreatment and 6-month follow-up and also provided data on their headache disability and quality of life at pretreatment and 1-, 2- and 6-month follow-up. Controlling for socioeconomic status and psychiatric comorbidity, hierarchical linear models found that African-Americans and Whites reported significant reductions in headache frequency and disability and improvements in life quality over the 6-month treatment period. African-Americans, unlike Whites, also reported significant decreases in headache severity. Nevertheless, Africans-Americans had significantly more frequent and disabling headaches and lower quality of life after treatment relative to Whites. Although Whites and African Americans responded favourably to headache treatments, more efficacious treatments are needed given the elevated level of headache frequency that remained in both racial groups following treatment.

Triggers, symptoms, and treatment in two populations of migraneurs in Brazil and Spain. A cross-cultural study

“…In the United States, Africans-Americans may have more frequent and disabling headaches and lower quality of life after treatment relative to Whites [17]. Socio-demographic disparities may also exist in pediatric headache care [18].…”

Dynamics of Changes in Self-Efficacy and Locus of Control Expectancies in the Behavioral and Drug Treatment of Severe Migraine

“…To construct the socioeconomic status variable, a principal components analysis was conducted using the variables "Number of Years of Education Completed" and "Annual Income." These two variables are commonly used when creating a composite measure of socioeconomic status [36,37]. The principal components analysis identified one factor in the analysis (eigenvalue = 1.3) which accounted for 62.7% of the variance in the two measures.…”

Preventive Medication Adherence in African American and Caucasian Headache Patients

“…While this study identified predictors of medication adherence in headache patients, and a previous report using this dataset identified predictors of treatment appointment nonattendance in this sample, 31 predictors of the 2 health‐related behaviors are likely to differ. For example, medication adherence is likely to be related to factors such as negative medication side effects, medication costs, and beliefs that medications are inefficacious.…”

“…No research has examined if race‐related differences in medication adherence observed in persons with other chronic health conditions (eg, AIDS, diabetes) 22‐25 generalize to individuals with headache disorders or if predictors of medication adherence differ by race. Racial differences in adherence to headache medications have not been studied even though: (1) 3.3% of African Americans in the USA are diagnosed with a headache disorder; 26 (2) African Americans living with a variety of chronic health conditions (eg, HIV/AIDS, hypertension, diabetes) often report poorer adherence to medication regimens than Caucasians; 27‐30 and (3) African American and Caucasian headache patients respond equally well to contemporary preventive pharmacotherapies, highlighting the importance of maximizing medication adherence in both racial groups 31 …”

“…Patients were then scheduled to participate in 2‐ and 6‐month follow‐up visits. The study's experimental design and procedures are described in greater detail elsewhere 31 …”