Abstract
Medication adherence is integral to successful treatment of migraine and other headache. The existing literature examining medication adherence in migraine is small, and the methodologies used to assess adherence are limited. However, these studies broadly suggest poor adherence to both acute and preventive migraine medications, with studies using more objective monitoring reporting lower adherence rates. Methods for improving medication adherence are described, including organizational strategies, provider-monitoring and self-monitoring of adherence, regimen strategies, patient education, self-management skills training (e.g., stimulus control, behavioral contracts), and cognitive–behavioral therapy techniques. The article concludes by discussing the future of research regarding adherence to medications for migraine and other headaches.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Katic BJ, Krause SJ, Tepper SJ, Hu HX, Bigal ME. Adherence to acute migraine medication: what does it mean, why does it matter? Headache. 2010;50(1):117–29.
Reed ML, Fanning KM, Serrano D, Buse DC, Lipton RB. Persistent frequent nausea is associated with progression to chronic migraine: AMPP study results. Headache. 2015;55(1):76–87.
Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68(5):343–9.
Bigal ME, Serrano D, Buse D, Scher A, Stewart WF, Lipton RB. Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population-based study. Headache. 2008;48(8):1157–68.
Lipton RB, Fanning KM, Serrano D, Reed ML, Cady R, Buse DC. Ineffective acute treatment of episodic migraine is associated with new-onset chronic migraine. Neurology. 2015;84(7):688–95. This large epidemiologic study provides evidence that patient perception of medication efficacy is associated with migraine chronification.
Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78(17):1337–45.
Holland S, Silberstein SD, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78(17):1346–53.
Rains JC, Lipchik GL, Penzien DB. Behavioral facilitation of medical treatment for headache—part I: review of headache treatment compliance. Headache. 2006;46(9):1387–94.
Ramsey RR, Ryan JL, Hershey AD, Powers SW, Aylward BS, Hommel KA. Treatment adherence in patients with headache: a systematic review. Headache J Head Face Pain. 2014;54(5):795–816. This is a thorough review of the treatment adherence literature across patients with headache, which highlights the paucity of research on acute medication adherence, adherence with lifestyle recommendations, and adherence with children and adolescents.
Nicholson RA, Smith TR. Likelihood of patients adhering to acute medication during migraine attacks. Submitted for presentation at the annual scientific meeting of the American Headache Society, Washington, DC.
Nicholson RA, Chibnall JT, Ng-Mak D, Banks JW, Smith TR. Why wait? Reasons that patients delay taking a triptan during individual migraine attacks. Headache. 2011;51(S1):S6–7.
Sattler EL, Lee JS, Perri 3rd M. Medication (re)fill adherence measures derived from pharmacy claims data in older Americans: a review of the literature. Drugs Aging. 2013;30(6):383–99.
Nau DP. Proportion of days covered (PDC) as a preferred method of measuring medication adherence http://www.pqaalliance.org/images/uploads/files/PQA%20PDC%20vs%20%20MPR.pdf: Pharmacy Quality Alliance; [cited 2014 December 4].
Hepp Z, Dodick DW, Varon SF, Gillard P, Hansen RN, Devine EB. Adherence to oral migraine-preventive medications among patients with chronic migraine. Cephalalgia. 2014;27:2014.
Hepp Z, Bloudek LM, Varon SF. Systematic review of migraine prophylaxis adherence and persistence. J Manag Care Pharm. 2014;20(1):22–33.
Mulleners WM, Whitmarsh TE, Steiner TJ. Noncompliance may render migraine prophylaxis useless, but once-daily regimens are better. Cephalalgia. 1998;18(1):52–6.
Steiner TJ, Catarci T, Hering R, Whitmarsh T, Couturier EG. If migraine prophylaxis does not work, think about compliance. Cephalalgia. 1994;14(6):463–4.
Matchar D, Harpole L, Samsa G, Jurgelski A, Lipton R, Silberstein S, et al. The headache management trial: a randomized study of coordinated care. Headache. 2008;48(9):1294–310.
Oberje EJ, de Kinderen RJ, Evers SM, van Woerkum CM, de Bruin M. Cost effectiveness of medication adherence-enhancing interventions: a systematic review of trial-based economic evaluations. Pharmacoeconomics. 2013;31(12):1155–68.
Messali AJ, Yang M, Gillard P, Tsai K, Tepper SJ, Bloudek LM, et al. Treatment persistence and switching in triptan users: a systematic literature review. Headache. 2014;54(7):1120–30.
Blumenfeld AM, Bloudek LM, Becker WJ, Buse DC, Varon SF, Maglinte GA, et al. Patterns of use and reasons for discontinuation of prophylactic medications for episodic migraine and chronic migraine: results from the second international burden of migraine study (IBMS-II). Headache. 2013;53(4):644–55.
Seng EK, Holroyd KA. Optimal use of acute headache medication: a qualitative examination of behaviors and barriers to their performance. Headache. 2013;53(9):1438–50. This qualitative study describes patient and provider perceptions about the medication-taking behaviors necessary for optimal use of acute headache medications, highlighting the barriers patients experience in their daily lives as they attempt to adhere with acute headache medication.
Gaul C, van Doorn C, Webering N, Dlugaj M, Katsarava Z, Diener HC, et al. Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: an observational study. J Headache Pain. 2011;12(4):475–83.
Wu YP, Pai AL. Health care provider-delivered adherence promotion interventions: a meta-analysis. Pediatrics. 2014;133(6):e1698–707.
Haynes RB, Yao X, Degani A, Kripalani S, Garg A, McDonald HP. Interventions to enhance medication adherence. Cochrane Database Syst Rev. 2005;4, CD000011.
Holroyd K, Cottrell C, O’Donnell F, Cordingley G, Carson B, Himiwan L. Effect of preventive (B blocker) treatment, behavioral migraine management or their combination on outcomes of optimized acute therapy in frequent migraine: randomized trial. BMJ. 2010;341:c4871.
Rains J, Penzien D, Lipchik G. Behavioral facilitation of medical treatment for headache part II: theoretical models and behavioral strategies for improving adherence. Headache. 2006;46(9):1395–403.
Spierings EL, Miree LF. Non-compliance with follow-up and improvement after treatment at a headache center. Headache. 1993;33(4):205–9.
Garber MC, Nau DP, Erickson SR, Aikens JE, Lawrence JB. The concordance of self-report with other measures of medication adherence: a summary of the literature. Med Care. 2004;42(7):649–52.
Wells RE, Markowitz SY, Baron EP, Hentz JG, Kalidas K, Mathew PG, et al. Identifying the factors underlying discontinuation of triptans. Headache. 2014;54(2):278–89. This study describes correlates of triptan discontinuation, highlighting the roles of treatment efficacy, migraine-related disability, psychiatric symptoms and triptan-related beliefs.
Hahn S, Lipton R, Sheftell F. Healthcare provider-patient communication and migraine assessment: results of the American Migraine Communication Study (AMCS) phase II. Curr Med Res Opin. 2006;24:1711–8.
Saper JR, Lake 3rd AE. Borderline personality disorder and the chronic headache patient: review and management recommendations. Headache. 2002;42(7):663–74.
Lash SJ, Stephens RS, Burden JL, Grambow SC, DeMarce JM, Jones ME, et al. Contracting, prompting, and reinforcing substance use disorder continuing care: a randomized clinical trial. Psychol Addict Behav J Soc Psychol Addict Behav. 2007;21(3):387–97.
Bandura A. Self-efficacy: the exercise of control. New York: W.H. Freeman; 1997.
Seng EK, Holroyd KA. Dynamics of changes in self-efficacy and locus of control expectancies in the behavioral and drug treatment of severe migraine. Ann Behav Med. 2010;40(3):235–47.
Beck AT. Cognitive therapy and the emotional disorders. New York: International Universities Press; 1976.
Compliance with Ethics Guidelines
Conflict of Interest
Elizabeth K. Seng is a consultant for Mercy Hospital Systems, received honoraria from Headache Cooperative of New England, and had travel/accommodations expenses covered or reimbursed by International Headache Academy (2014).
Jeanetta A. Rains reports National Institute of Health R21, Sleep Regulation and Circadian Phase in Chronic Migraine Position: Consultant. (Principal investigator: Jason Ong, PhD, Rush University) (2013–2015).
Robert A. Nicholson has no disclosures at this time.
Richard B. Lipton receives research support from the NIH: PO1 AG003949 (Program Director), PO1AG027734 (Project Leader), RO1AG025119 (Investigator), RO1AG022374-06A2 (Investigator), RO1AG034119 (Investigator), RO1AG12101 (Investigator), K23AG030857 (Mentor), K23NS05140901A1 (Mentor), and K23NS47256 (Mentor), the National Headache Foundation, and the Migraine Research Fund; serves on the editorial boards of Neurology and Cephalalgia and as senior advisor to Headache, has reviewed for the NIA and NINDS, holds stock options in eNeura Therapeutics (a company without commercial products); serves as consultant, advisory board member, or has received honoraria from: Alder, Allergan, American Headache Society, Autonomic Technologies, Avanir, Boston Scientific, Bristol Myers Squibb, Colucid, Dr. Reddy’s, Electrocore, Eli Lilly, Endo, eNeura Therapeutics, Informa, Labrys, Merck, Novartis, Teva, Vedanta.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is part of the Topical Collection on Psychological and Behavioral Aspects of Headache and Pain
Rights and permissions
About this article
Cite this article
Seng, E.K., Rains, J.A., Nicholson, R.A. et al. Improving Medication Adherence in Migraine Treatment. Curr Pain Headache Rep 19, 24 (2015). https://doi.org/10.1007/s11916-015-0498-8
Published:
DOI: https://doi.org/10.1007/s11916-015-0498-8