Adherence Status and Influencing Factors of Acute and Preventive pharmacotherapy Among Migraine Patients in China

Objective: To investigate the current adherence status and associated factors for acute and preventive pharmacotherapy among migraine patients in China . Methods: Utilizing a prospective cohort design with retrospective identification, migraine patients first attending the Headache Clinic (Chinese PLA General Hospital, May–November 2024) were prospectively assessed for treatment adherence and influencing factors via structured telephone follow-ups.。 Results: Among 456 enrolled patients (75.88% female), migraine subtypes included: probable migraine (14.91%), migraine without aura (72.59%) , migraine with aura (4.17%), and chronic migraine (8.34%). Good adherence rates were 30.53% for acute and 53.25% for preventive pharmacotherapy. Key non-adherence behaviors for acute medication: acute headache medication abstinence (63.06%) and administration after pain progression to moderate/severe intensity (35.03%). Primay reasons: mild headache deemed non-requiring medication (43.31%) and fear of potential adverse effects (35.98%). Key non-adherence behaviors for proventive medication: incomplete treatment course duration (76.39%), failure to obtain prescribed medications (15.28%), and non-adherent to prescribed medication schedule (11.11%). Primay reasons given for nonadherence of proventiv medication included perceived prescription inappropriateness (43.06%) and adverse effects occurred (19.40%). Multivariate regression analysis revealed that adherence to acute pharmacotherapy increased with higher educational level, medical insurance coverage, satisfaction with pain relief, and enhanced patient valuation of pharmacotherapy. (all p < 0.05). For preventive medication, adherence was associated with adverse effects, satisfaction with treatment efficacy, and enhanced patient valuation of pharmacotherapy (all p < 0.05). Good adherence independently predicted fewer monthly headache days (MHD: 3.39 ± 3.85 days vs. 7.68 ± 6.14 days, p < 0.01). Conclusion: Suboptimal medication adherence persists among Chinese migraine patients with patient valuation of pharmacotherapy being the strongest modifiable factor. Interventions should prioritize patient education, personalized treatment plans, and tailored adherence strategies to improve outcomes.