Department of Neurology and Neuroscience, Stanford University School of Medicine, Stanford, Los Angeles, CA, USA.
Teva Pharmaceuticals, Frazer, Philadelphia, PA, USA.
J Headache Pain. 2019 May 9;20(1):50. doi: 10.1186/s10194-019-0998-8.
Adherence to a therapy, though a key factor for successful treatment, is low among patients with chronic conditions such as migraine. Dose frequency plays a major role in adherence. This study evaluated the impact of having flexible dosing options on acceptance of and adherence to a new migraine preventive therapy class among adults with migraine.
In this observational study, two 20-min online surveys were completed: one by physicians currently treating adult patients with migraine and the other by adults with migraine. Both surveys presented the participants with three scenarios: 1) only monthly, 2) only quarterly, and 3) both dosing options of the new medication are available. Physicians estimated the proportion of their migraine patients who would receive the new medication in each scenario. Patients were asked about their dosing preference when either or both options are available. Respondents were asked to rate the likelihood of their acceptance of and adherence to the therapy.
400 physicians and 417 US adults with migraine completed the surveys. The availability of both dosing options yielded a significant increase in the proportion of patients expected to receive the new medication. The overall proportion of patients favoring monthly dosing (35%) was similar to the proportion favoring quarterly dosing (40%). Among those who preferred monthly dosing (n = 147), a greater proportion indicated they are more likely to fill the prescription (77% vs 56%, P < 0.05) and remain adherent (80% vs 57%, P < 0.05) when only monthly is available versus when only quarterly is available. Similarly, among those who preferred quarterly dosing (n = 166), a greater proportion indicated they are likely to fill (63% vs 55%, P < 0.05) and remain adherent (62% vs 54%, P < 0.05) when only quarterly is available compared with when only monthly is available.
Physicians anticipated that the proportion of patients to receive the new medication would increase when both dosing options are available. Patients stated that they are more likely to fill the prescription and adhere to the new therapy when their preferred dosing regimen is available.
尽管坚持治疗是慢性疾病（如偏头痛）成功治疗的关键因素，但患者的治疗依从性仍然很低。剂量频率在治疗依从性中起着重要作用。本研究评估了新的偏头痛预防治疗方案具有灵活的给药选择对接受和坚持使用新治疗方案的影响。
在这项观察性研究中，完成了两项 20 分钟的在线调查：一项是由目前治疗偏头痛成年患者的医生完成的，另一项是由偏头痛成年患者完成的。两项调查都向参与者展示了三种情况：1）仅每月一次，2）仅每季度一次，3）新药物的两种给药方案都可用。医生估计在每种情况下，他们的偏头痛患者中有多少人会接受新药物。当一种或两种方案都可用时，患者被问到他们的剂量偏好。受访者被要求对他们对治疗的接受度和依从性的可能性进行评分。
400 名医生和 417 名美国偏头痛成年患者完成了调查。提供两种剂量方案显著增加了预计接受新药物的患者比例。每月一次给药的患者总体比例（35%）与每季度一次给药的比例（40%）相似。在那些喜欢每月一次给药的患者中（n=147），与仅每季度一次给药相比，更多的人表示他们更有可能（77% vs 56%，P<0.05）和坚持（80% vs 57%，P<0.05）开处方。同样，在那些更喜欢每季度一次给药的患者中（n=166），与仅每月一次给药相比，更多的人表示他们更有可能（63% vs 55%，P<0.05）和坚持（62% vs 54%，P<0.05）开处方。
医生预计当两种剂量方案都可用时，接受新药物的患者比例将会增加。当患者首选的给药方案可用时，他们表示更有可能开处方并坚持使用新疗法。
