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NEUROLOGY

Beliefs About Medicines and Adherence Among Swedish Migraineurs

Assistant Professor, Department of Social Medicine, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden

Pernilla Jonsson, MSc(Pharm)

Research Assistant, Department of Social Medicine, The Sahlgrenska Academy at Göteborg University

Mattias Linde, PhD

Director and Consultant Neurologist, Cephalea Headache Centre, Göteborg, and Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Göteborg University

Reprints: Dr. Hedenrud, Department of Social Medicine, The Sahlgrenska Academy at Göteborg University, Box 453, 405 30, Göteborg, Sweden, fax 46-31-162847, tove.hedenrud{at}socmed.gu.se

BACKGROUND: The problem of low adherence to drug therapy is as prevalent in migraine as in any other disorder, with important consequences for the patient, such as impaired quality of life and absence from work. Beliefs about medicines have been identified as one of the most significant factors for adherence.

OBJECTIVE: To analyze whether beliefs about medicines and medication-related factors are associated with adherence to prophylactic drug therapy among migraineurs at a Swedish tertiary care clinic.

METHODS: A questionnaire was distributed to migraineurs visiting a tertiary care clinic in Sweden. All participants had recently been prescribed prophylactic medicine. The questionnaire was comprised of background questions, questions about disease characteristics, perceived effects, and adverse effects of migraine medications used, the Beliefs about Medicines questionnaire, and the Medication Adherence Report Scale. Medication-related variables, collected from patients' records with consent, were also included. Logistic regression analysis was performed to analyze the association between beliefs about medicines, medication-related variables, and adherence to prophylactic drugs.

RESULTS: Of the 174 participants in the study, 64% were considered to be adherent to their prescribed prophylactic medicine. Users of β-blockers were significantly more adherent compared with patients using other drugs (eg, tricyclic antidepressants [TCAs] or antiepileptics); the reverse was true for patients taking TCAs. Respondents with the lowest level of education (9 y) expressed less concern about drugs and had a higher necessity-concerns differential compared with respondents with a higher educational level. In the final regression model, no variable was significantly associated with adherence.

CONCLUSIONS: About one-third of the migraineurs did not adhere to their prophylactic drugs. Beliefs about medicines and medication-related factors could not predict nonadherence. We recommend further research on medication-related variables in relation to adherence among migraineurs.

Key Words: adherence, migraine, Sweden

Published Online, December 11, 2007. www.theannals.com, DOI 10.1345/aph.1K354

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