title: Treatment adherence in patients with headache: a systematic review.
abstract: OBJECTIVE
  To review and critically evaluate the extant research literature pertaining to adherence in youth and adults with headache and to provide recommendations for future research.
  
  
  BACKGROUND
  This article provides the first systematic review of pediatric headache adherence and updates a previous review of treatment adherence in adults with headache.
  
  
  METHODS
  Systematic review of empirical literature.
  
  
  METHODS
  A literature search with no date restriction was conducted using PubMed and PsycINFO electronic databases and bibliographies of relevant articles.
  
  
  RESULTS
  Adherence rates in adults with headache range considerably from 25% to 94% across treatment, assessment method, and definition of adherence utilized. Methods to assess adherence included retrospective prescription claims data, paper or electronic diaries, follow-up appointment attendance, written and verbal self-report of general adherence, verbal self-report of adherence over a specific amount of time via in person interview or telephone, validated adherence measures, adherence questionnaires without validation, and counselor ratings of homework. Each methodology and assessment tool demonstrated strengths and weaknesses. No studies have systematically examined medication adherence in children with headache, and the few available studies examining adherence to behavioral treatment have documented adherence rates ranging from 52% to 86%.
  
  
  CONCLUSIONS
  Adherence research in adults with headache is growing, but studies demonstrate a number of methodological shortcomings. Adherence research in children with headache, and adherence intervention research in both adults and children, is scant. Future research should use objective measures of adherence, consider over-the-counter medications and medication overuse, examine demographic, psychological, and behavioral correlates of adherence, assess adherence to botulinum toxin type A, and examine the efficacy of adherence interventions in individuals with headache.
authors.affiliation: Department of Psychology, Oklahoma State University, Stillwater, OK, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Rachelle R
authors.initials: RR
authors.lastname: Ramsey
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Ryan
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hershey
authors.forename: Scott W
authors.initials: SW
authors.lastname: Powers
authors.forename: Brandon S
authors.initials: BS
authors.lastname: Aylward
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Hommel
mesh_terms: D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D006261:Headache / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D055118:Medication Adherence; D010349:Patient Compliance
keywords: adherence; headache; migraine; patient compliance; pediatric; self-management
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