Race differences in adherence to headache treatment appointments in persons with headache disorders.
OBJECTIVE
This research characterized patterns and predictors of adherence to headache treatment appointments in patients presenting at headache specialty treatment clinics throughout Ohio.


METHODS
Participants were 186 patients (118 white, 68 African Americans, 89% female) in headache treatment clinics in Cincinnati, Cleveland, Columbus and Toledo, OH. The study used a naturalistic longitudinal cohort design and assessed patients during four treatment visits (pretreatment, one-month follow-up, two-month follow-up and six-month follow-up). During the 30 days prior to initiating new headache treatments, patients used a daily diary to record data on headache severity, frequency and disability; headache treatment locus of control and headache management self-efficacy; social support; and demographic characteristics. The Primary Care Evaluation for Mental Disorders interview was administered to all patients at pretreatment to screen for psychiatric diagnoses. Patient attendance at the four treatment appointments was used to create a dichotomous measure of treatment appointment adherence (i.e., 0 = completed treatment; 1 = terminated treatment prematurely).


RESULTS
African Americans were more likely to be diagnosed with depression than whites and were more likely to prematurely terminate their headache treatment appointments regardless of their socioeconomic status (SES). White patients with SES values above the median reported the lowest rate of premature treatment termination.


CONCLUSIONS
Higher SES enables whites (but not African Americans) to attend all headache treatment appointments. Interventions that enable African-American headache patients to complete their prescribed headache treatments are urgently needed.
Heckman
Bernadette Davantes
BD
Department of Psychology, Ohio University, Athens, OH 45701, USA. heckmanb@ohiou.edu
Holroyd
Kenneth A
KA
O'Donnell
Francis J
FJ
Tietjen
Gretchen
G
Utley
Christine
C
Stillman
Mark
M
Ellis
Gary
G
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D001294:Attitude to Health; D003863:Depression; D005260:Female; D006261:Headache / Q000188:drug therapy* / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009820:Ohio; D010349:Patient Compliance / Q000523:psychology*; D011446:Prospective Studies; D011581:Psychological Tests; D011594:Psychometrics; D044469:Racial Groups; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014481:United States; D044465:White People
D000700:Analgesics