Lifetime history of an anxiety or depression disorder and adherence to medications used for the acute treatment of migraine.
Lifetime history of an anxiety or depression disorder and adherence to medications used for the acute treatment of migraine.
复制标题
一生有焦虑症或抑郁症病史，并且坚持服用用于急性偏头痛治疗的药物。
DOI：
10.1111/head.14477
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发表时间：
2023
期刊：
影响因子：
5
通讯作者：
Seng,ElizabethK
中科院分区：
文献类型：
--
作者：
Butler,Nicole;Snyder,IvyC;Korn,TaliaG;Nicholson,RobertA;Robbins,MatthewS;Seng,ElizabethK
目的：通过对移动健康头痛日记数据的二次分析，我们评估了偏头痛急性治疗药物依从性与焦虑或抑郁障碍的终生病史之间的关系。背景：药物不依从性可导致临床疗效差，并可能与药物过度使用有关。药物过度使用的定义是服用偏头痛特异性药物(MSM)≥10天/月，阿片类药物或巴比妥类药物≥10天/月，或非甾体类抗炎药物≥15天/月，头痛≥15天/月。现有文献主要评估固定时间表药物依从性。对于如用于偏头痛急性治疗的药物依从性的预测因素知之甚少。方法：先前诊断为偏头痛且每月头痛天数至少4天的成年人完成了评估抑郁或焦虑障碍诊断终生史的基线问卷，并被要求记录90天的每日一次的电子头痛日记，包括：头痛发生；症状;为治疗偏头痛而服用的药物（如有）；以及他们服药时的疼痛程度（轻度、中度、重度）。193名完成≥30天头痛日记的参与者被纳入该次要分析。结果45.7%（2825/6176）的头痛天数以男同性恋者为主。近四分之一的样本（45/193,23.3%）过度使用药物治疗急性偏头痛。药物过度使用在有焦虑病史的患者中更为常见，比值比（OR） 2.01(95%可信区间[CI] 1.01-3.69)，但当考虑头痛天数时，这种关系不显著，比值比为2.02 （95% CI 0.83-4.91）。抑郁症病史（OR 1.40 (95% CI 0.90-2.16)）和焦虑症（OR 1.11 (95% CI 0.71-1.72)）均与早期服药无关；然而，自我监测的持续时间与早期服用MSM相关，OR为1.006 （95% CI 1.004-1.009）。结论终生抑郁、焦虑史与早期MSM行为无关。药物过度使用在同时患有偏头痛和焦虑症的患者中更为常见。对所有参与者来说，早期服用男男性接触者随着时间的推移都有所改善，即使是在调整了焦虑和/或抑郁障碍的历史之后。
ObjectiveIn this secondary analysis of mobile health headache diary data, we evaluated the relationship between adherence to medication used for the acute treatment of migraine and lifetime history of an anxiety or depression disorder.BackgroundMedication non‐adherence can produce poor clinical efficacy and may be associated with medication overuse. Medication overuse was defined by taking a migraine‐specific medication (MSM) for ≥10 days/month, an opioid or barbiturate for ≥10 days/month, or a nonsteroidal anti‐inflammatory drug for ≥15 days/month and having ≥15 headache days/month. Extant literature predominantly evaluates fixed‐schedule medication adherence. Little is known about predictors of adherence to as‐needed medication such as those used for the acute treatment of migraine.MethodsAdults with prior migraine diagnosis and at least 4 headache days/month completed baseline questionnaires assessing lifetime history of depression or anxiety disorder diagnoses and were asked to record 90 days of once‐daily electronic headache diaries soliciting: Headache occurrence; symptoms; medication taken, if any, for the acute treatment of migraine; and their pain level (mild, moderate, severe) when the medication was taken. The 193 participants who completed ≥30 days of headache diary were included in this secondary analysis.ResultsA MSM was used as the first medication taken on 45.7% (2825/6176) of headache days. Nearly a quarter of the sample (45/193, 23.3%) overused medications for acute treatment of migraine. Medication overuse was more common in patients with a history of an anxiety disorder, odds ratio (OR) 2.01 (95% confidence interval [CI] 1.01–3.69), but this relationship was not significant when headache days were accounted for, OR 2.02 (95% CI 0.83–4.91). Neither a history of a depression disorder, OR 1.40 (95% CI 0.90–2.16), nor an anxiety disorder, OR 1.11 (95% CI 0.71–1.72), was associated with taking medications early; however, duration of self‐monitoring was associated with taking MSM early, OR 1.006 (95% CI 1.004–1.009).ConclusionLifetime history of depression and anxiety were not associated with taking a MSM early. Medication overuse may be more common in patients who have both migraine and anxiety. Taking a MSM early improved over time for all participants, even when adjusting for a history of an anxiety and or a depression disorder.