Little research has examined optimal use of acute medications essential to manage disorders characterized by acute episodes, such as headache disorders. Social Cognitive Theory suggests that self-efficacy for optimal use of acute headache medication, or confidence in one's ability use acute medications optimally, is key to cultivating these behaviors. This project ained to identify the behaviors and barriers associated with optimal use of acute headache medication and develop a measure of Acute Medication Self-Efficacy for Headache (AMSE-H).
In Study 1, qualitative interviews [people with headache (n = 21) and health care providers (n = 15)] identified 8 behaviors required for optimal use of acute headache medication and 10 barriers to these behaviors. 14 preliminary AMSE-H items were developed.
In Study 2, 35 people with migraine completed the 14 preliminary items for the AMSE-H. The final 7 AMSE-H items were selected to ensure diversity of content and moderate relationships between each scale item overall self-efficacy for optimal use of acute headache medication, the total score, and other scale items.
In Study 3, 161 migraine sufferers were recruited after completing studies during which participants recorded acute headache medication use in a daily dairy and completed validity measures. Upon recruitment into the current study (1-15 months after completion of the previous studies), participants completed the AMSE-H and additional validity measures.
An exploratory principal components factor analysis identified two factors: cross-episode and episode-specific. The internal consistency was adequate (α = .80) but test-retest reliability was low (r = .66, p < .001). The AMSE-H demonstrated significant relationships in the expected directions with all validity measures administered concurrently with the AMSE-H (the Headache Management Self-Efficacy and measures of perceived access to medication and acute medication outcome expectancies), but failed to demonstrate significant relationships with validity measures administered prior to the AMSE-H (the Headache Specific Locus of Control and daily diary measures of acute medication use). Thus, the current study provided only limited evidence for the reliability and validity of the AMSE-H.