Pain medication beliefs in individuals with headache

Abstract Objective To evaluate pain medication beliefs in a community sample of individuals with headache. Background Previous studies of medication adherence for individuals with headache have identified a high rate of prescription nonfulfillment, frequent medication discontinuation, and widely varying levels of medication‐related satisfaction. Still, there is a limited understanding of how these individuals view their medications and their relationships with health‐care providers. Insight into these perceptions could prove useful in explaining medication adherence behaviors. Methods In this secondary analysis of a cross‐sectional study, data from N = 215 adults with headache were analyzed. Participants completed the Pain Medication Attitudes Questionnaire (PMAQ), Center for Epidemiologic Studies Depression Scale (CES‐D), State–Trait Anxiety Inventory Form Y‐2, Weekly Stress Inventory Short Form, and Migraine Disability Scale. These participants also provided a list of their current pain medications. Results Using the PMAQ, participants could be characterized as having medication beliefs that were “trusting and unconcerned” ( n = 83/215 38.6%), “skeptical and somewhat worried” ( n = 99/215 46.0%), or “skeptical and concerned” ( n = 33/215 15.3%). Individuals with skeptical and concerned beliefs expressed elevated concerns ( z > 1.15) about side effects, scrutiny, perceived need, tolerance, withdrawal, and addiction. Individuals who were trusting and unconcerned expressed low levels ( z < −0.40) of these beliefs. Increasing levels of mistrust and medication concerns were correlated with higher depression scores on the CES‐D, with values ranging from r = 0.23 to r = 0.38. Conclusions Subgroups of pain medication beliefs were identified, including two groups of patients with at least some concerns about their medical providers. Beliefs ranged from a lack of concern about using pain medications to worries about scrutiny and harm. It is unclear if poor experiences with pain medications cause these beliefs or if they prevent individuals from effectively utilizing medications. Additionally, more negative beliefs about pain medications were associated with more depressive symptoms.