Department of Neurology, University Medical Center Rostock, University of Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany.
Headache Center North-East, University Medical Center Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany.
Sci Rep. 2023 Mar 20;13(1):4546. doi: 10.1038/s41598-023-30854-y.
To examine factors for adherent and non-adherent behavior in patients with cluster headache and migraine. Adults with cluster headache or migraine were included in this anonymous online survey using a questionnaire accessed via homepages of headache support groups. Medication adherence in preventive treatment was measured with the Medication Adherence Report Scale (MARS-D). Factors for non-adherent behavior were examined (subjective socioeconomic status, psychological comorbidities, self-efficacy, coping, side effects, expectations of treatment, information on medical treatment, and trust in the physician/treatment concept). 200 participants (n = 58 with cluster headache, n = 142 with migraine) were included. The rate of medication adherence in preventive treatment was 32.8% for participants with cluster headache and 20.4% for migraine. The most common reasons for low adherence in participants with cluster headache were altering the prescribed medication dose (34%) or taking less than instructed (14%), which was mostly due to insufficient benefit from the medication or side effects. Positive expectations of medical treatment (p ≤ 0.05) correlated significantly with adherent behavior in cluster headache. Furthermore, the adherence-promoting factors coping and self-efficacy were more pronounced in patients with cluster headache than in those with migraine (p < 0.05). This study is the first to comprehensively investigate medication adherence and factors influencing adherent/non-adherent behavior in patients with cluster headache. Patients with cluster headache had similar adherence levels to patients with migraine, but had higher resources of adherence-promoting factors.
为了研究丛集性头痛和偏头痛患者坚持和不坚持治疗行为的因素。本匿名在线调查纳入了成年丛集性头痛或偏头痛患者，他们通过头痛支持小组的主页访问来填写问卷。预防性治疗的药物依从性使用药物依从报告量表（MARS-D）进行测量。研究检查了不依从行为的因素（主观社会经济状况、心理共病、自我效能、应对方式、副作用、治疗期望、医疗信息和对医生/治疗概念的信任）。共有 200 名参与者（58 名丛集性头痛，142 名偏头痛）纳入研究。丛集性头痛患者预防性治疗的药物依从率为 32.8%，偏头痛患者为 20.4%。丛集性头痛患者药物低依从的最常见原因是改变处方剂量（34%）或未按规定服药（14%），这主要是因为药物的获益不足或副作用。对治疗的积极期望（p≤0.05）与丛集性头痛患者的坚持治疗行为显著相关。此外，应对和自我效能等促进依从性的因素在丛集性头痛患者中比偏头痛患者更为明显（p<0.05）。这项研究首次全面调查了丛集性头痛患者的药物依从性和影响坚持/不坚持治疗行为的因素。丛集性头痛患者的依从水平与偏头痛患者相似，但具有更高的促进依从性的因素。
