Behavioral facilitation of medical treatment of headache: implications of noncompliance and strategies for improving adherence.
Clinical recommendations were gleaned from a review of treatment adherence published in the regular issue of Headache (released in tandem with this supplement). The recommendations include: (1) Nonadherence is prevalent among headache patients, undermines treatment efficacy, and should be considered as a treatment variable; (2) Calling patients to remind them of appointments and recalling those who miss a scheduled appointment are fundamentally the most cost-effective adherence-enhancing strategies, insofar as failed appointment-keeping acts as a ceiling on all future treatment and adherence efforts; (3) Simplified and tailored medication regimens improve adherence (eg, minimized number of medications and dosings, fixed-dose combinations, cue-dose training, stimulus control); (4) Screening and management of psychiatric comorbidities, especially depression and anxiety, is encouraged; (5) The concept of self-efficacy as a modifiable psychological process often can be employed to predict and improve adherence.
Rains
Jeanetta C
JC
Center for Sleep Evaluation, Elliot Hospital, Manchester, NH 03103, USA.
Penzien
Donald B
DB
Lipchik
Gay L
GL
D001071:Appointments and Schedules; D001521:Behavior Therapy; D006261:Headache / Q000188:drug therapy* / Q000523:psychology* / Q000628:therapy; D006801:Humans; D010349:Patient Compliance; D017010:Reminder Systems; D020377:Self Efficacy; D016896:Treatment Outcome