Hedenrud Tove, Jonsson Pernilla, Linde Mattias
Department of Social Medicine, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Ann Pharmacother. 2008 Jan;42(1):39-45. doi: 10.1345/aph.1K354. Epub 2007 Dec 11.
The problem of low adherence to drug therapy is as prevalent in migraine as in any other disorder, with important consequences for the patient, such as impaired quality of life and absence from work. Beliefs about medicines have been identified as one of the most significant factors for adherence.
To analyze whether beliefs about medicines and medication-related factors are associated with adherence to prophylactic drug therapy among migraineurs at a Swedish tertiary care clinic.
A questionnaire was distributed to migraineurs visiting a tertiary care clinic in Sweden. All participants had recently been prescribed prophylactic medicine. The questionnaire was comprised of background questions, questions about disease characteristics, perceived effects, and adverse effects of migraine medications used, the Beliefs about Medicines questionnaire, and the Medication Adherence Report Scale. Medication-related variables, collected from patients' records with consent, were also included. Logistic regression analysis was performed to analyze the association between beliefs about medicines, medication-related variables, and adherence to prophylactic drugs.
Of the 174 participants in the study, 64% were considered to be adherent to their prescribed prophylactic medicine. Users of beta-blockers were significantly more adherent compared with patients using other drugs (eg, tricyclic antidepressants [TCAs] or antiepileptics); the reverse was true for patients taking TCAs. Respondents with the lowest level of education (<or=9 y) expressed less concern about drugs and had a higher necessity-concerns differential compared with respondents with a higher educational level. In the final regression model, no variable was significantly associated with adherence.
About one-third of the migraineurs did not adhere to their prophylactic drugs. Beliefs about medicines and medication-related factors could not predict nonadherence. We recommend further research on medication-related variables in relation to adherence among migraineurs.
药物治疗依从性低的问题在偏头痛患者中与在其他任何疾病中一样普遍，这对患者会产生重要影响，如生活质量受损和旷工。对药物的认知已被确定为依从性的最重要因素之一。
分析在瑞典一家三级医疗诊所中，偏头痛患者对药物的认知和与药物治疗相关的因素是否与预防性药物治疗的依从性相关。
向在瑞典一家三级医疗诊所就诊的偏头痛患者发放问卷。所有参与者最近都被开了预防性药物。问卷包括背景问题、关于疾病特征的问题、所使用的偏头痛药物的感知效果和不良反应、药物认知问卷以及药物治疗依从性报告量表。还纳入了经患者同意从其病历中收集的与药物治疗相关的变量。进行逻辑回归分析以分析对药物的认知、与药物治疗相关的变量和预防性药物治疗依从性之间的关联。
在该研究的174名参与者中，64%的人被认为对其开具的预防性药物治疗依从。与使用其他药物（如三环类抗抑郁药 [TCA] 或抗癫痫药）的患者相比，β受体阻滞剂使用者的依从性明显更高；而服用TCA的患者则相反。教育程度最低（≤9年）的受访者对药物的担忧较少，与教育程度较高的受访者相比，必要性 - 担忧差异更大。在最终的回归模型中，没有变量与依从性显著相关。
约三分之一的偏头痛患者未坚持预防性药物治疗。对药物的认知和与药物治疗相关的因素无法预测不依从情况。我们建议进一步研究与偏头痛患者依从性相关的药物治疗变量。
