Study Objectives: To examine predictors of medication non-adherence in a racially diverse sample of patients receiving specialty treatment for headache disorders.
Methods: Using a longitudinal naturalistic study design, data from 33 African American and 79 Caucasian headache patients were collected to characterize patterns and predictors of non-adherence to daily headache preventive medication. Patients completed 30-day headache diaries that assessed daily preventive medication use, headache frequency, and headache severity during the 30-days following their six month follow-up medical visit with their physician at headache specialty clinics in four major cities in Ohio. At pre-treatment and 6-month follow-up, patients provided data on headache-specific quality of life and headache disability.
Results: African Americans (73%) and Caucasians (83%) were equally adherent to their preventive headache medication. A within-group examination of predictors of non-adherence to preventive medication revealed that greater headache severity and poorer quality of life at baseline predicted lower levels of non-adherence at 6-month follow-up for African Americans. Among Caucasians, the presence of a comorbid psychiatric disorder at baseline predicted greater non-adherence at 6-month follow-up.
Conclusions: Adherence to preventive medications in headache patients in specialty care clinics appears to be good. Poorer quality of life and greater headache severity predicted non-adherence in African Americans while psychiatric comorbidity predicted non-adherence in Caucasians. Racial differences in predictors of adherence suggest that adherence-improvement interventions in this clinical population should consider racial- and culturally-specific factors.