Behavioral facilitation of medical treatment for headache - Part I: Review of headache treatment compliance
Behavioral facilitation of medical treatment for headache - Part I: Review of headache treatment compliance
复制标题
DOI：
10.1111/j.1526-4610.2006.00581.x
复制
发表时间：
2006-10-01
期刊：
影响因子：
5
通讯作者：
Penzien, Donald B.
中科院分区：
文献类型：
--
作者：
Rains, Jeanetta C.;Lipchik, Gay L.;Penzien, Donald B.
不依从或不遵守医疗方案代表了对包括头痛治疗在内的医学实践的主要挑战。事实上，药物使用模式与头痛特别相关，因为头痛治疗可能会引起药物过度使用头痛。先前的研究表明，对各种慢性疾病的长期药物治疗的坚持率平均只有50%左右。头痛患者的依从性也同样很差。对症药物的滥用或过度使用已被证明会导致治疗失败，四分之一到一半的患者不依从预防性头痛药物治疗，至少40%的患者不依从药物治疗。依从性随着更频繁和复杂的给药方案、副作用和成本而下降，并且受到广泛的心理社会影响。主观的依从性报告不仅可能高估，而且与更客观的测量结果不一致。作为2篇文章中的第一篇，本文介绍了医疗实践中的不依从性问题，并对头痛管理的依从性进行了文献回顾。一个配套文件（行为促进头痛的医疗第二部分：理论模型和行为策略，提高依从性）总结了社会学习模型提出的多个决定因素的特点，坚持和指导行为的依从性增强干预措施，然后提出认知和行为策略，可能有助于头痛患者的治疗依从性。
Noncompliance or nonadherence with medical regimens represents a major challenge to the practice of medicine including the treatment of headache. Indeed, medication use patterns are particularly relevant to headache because of the potential for headache therapies to induce medication-overuse headache. Previous research has demonstrated that adherence to long-term medication therapy for various chronic illnesses averages only about 50%. The rate of adherence among headache patients has been found to be similarly poor. Misuse or overuse of symptomatic medication has been demonstrated to contribute to treatment failure, and one-fourth to one-half of patients are noncompliant with prophylactic headache medications and at least 40% nonadherent with appointment-keeping. Adherence declines with more frequent and complex dosing regimens, side effects, and costs, and is subject to a wide range of psychosocial influences. Subjective reports of adherence are likely not only to overestimate but also to be discordant with more objective measurements. As the first of 2 articles, this paper describes the problem of noncompliance in medical practice and reviews literature addressing compliance specific to headache management. A companion paper (Behavioral Facilitation of Medical Treatment for Headache-Part II: Theoretical Models and Behavioral Strategies for Improving Adherence) summarizes social learning models proposed to characterize the multiple determinants of adherence and guide behavioral adherence-enhancing interventions, and then presents cognitive and behavioral strategies that may facilitate treatment adherence with headache patients.