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Behavioral Facilitation of Medical Treatment for Headache—Part II: Theoretical Models and Behavioral Strategies for Improving Adherence

Authors

  • Jeanetta C. Rains PhD,

  • Donald B. Penzien PhD,

  • Gay L. Lipchik PhD


  • From the Center for Sleep Evaluation, Elliot Hospital, Manchester, NH (Dr. Rains); Head Pain Center, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS (Dr. Penzien); and St. Vincent Health Psychology Services, Erie, PA (Dr. Lipchik).

Address all correspondence to Dr. Jeanetta C. Rains, Center for Sleep Evaluation, Elliot Hospital, One Elliot Way, Manchester, NH 03103.

Abstract

This is the second of 2 articles addressing the problem of noncompliance in medical practice and, more specifically, compliance with headache treatment. The companion paper describes the problem of noncompliance in medical practice and reviews literature addressing compliance in headache care (Behavioral Facilitation of Medical Treatment for Headache—Part I: Review of Headache Treatment Compliance). The present paper first summarizes relevant health behavior theory to help account for the myriad biopsychosocial determinants of adherence, as well as patient's shifting responsiveness or “readiness for change” over time. Appreciation of health behavior models may assist in optimally tailoring interventions to patient needs through instructional, motivational, and behavioral treatment strategies. A wide range of specific cognitive and behavioral compliance-enhancing interventions are described, which may facilitate treatment adherence among headache patients. Strategies address patient education, patient/provider interaction, dosing regimens, psychiatric comorbidities, self-efficacy enhancement, and other behavioral interventions.

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