Patient-Reported Adherence, Knowledge and Perceived Outcomes After Specialist Nursing Education in a...

Background/Objectives: Migraine is a leading cause of disability worldwide. Despite advances such as calcitonin gene-related peptide (CGRP)-targeted therapies, suboptimal treatment adherence, limited health literacy, and weak self-management remain common, and patient-reported data on the contribution of specialist headache nurses within European tertiary units are scarce. This study describes patient-reported adherence to acute treatment and to lifestyle recommendations, self-perceived knowledge, and perceived quality of life in adults with migraine who had attended a structured, nurse-led educational consultation in a tertiary multidisciplinary headache unit. Methods: This cross-sectional descriptive study included 90 adults (≥18 years) with migraine diagnosed according to the International Classification of Headache Disorders, third edition (ICHD-3), who were starting treatment with an anti-CGRP monoclonal antibody and consecutively attended a specialist nursing consultation; patients with documented cognitive impairment or without written informed consent were excluded. Between January and December 2021, participants completed, on a single occasion after the consultation, an electronic, structured, piloted ad hoc survey covering knowledge (with pre-consultation knowledge rated retrospectively), adherence to pharmacological and lifestyle recommendations, perceived changes in attack frequency and intensity, and self-reported quality of life. Data were analysed descriptively, with 95% confidence intervals (CIs) for proportions and without formal hypothesis testing. Results: Participants were mostly women (67.8%), with a mean age of 43.1 ± 10.7 years. Overall, 74.4% (95% CI 64.6-82.3) reported always following acute-treatment instructions and 66.7% (56.4-75.5) always following lifestyle recommendations; 68.9% (58.7-77.5) felt the education had improved their understanding of migraine and their quality of life, and 67.8% (57.6-76.5) perceived fewer attacks. Self-rated adequate knowledge was higher at the time of the survey than retrospectively recalled for the pre-consultation period in all five domains. The main barriers were limited prior knowledge and difficulty maintaining a headache diary. Conclusions: Most patients who had received structured nurse-led education reported good adherence and perceived benefits in their understanding of migraine and quality of life. Given the cross-sectional design, the retrospective assessment of prior knowledge, the use of a non-validated questionnaire, and the absence of a control group, these findings cannot be attributed to the consultation itself, and perceived changes in attack frequency cannot be separated from the effect of the newly started anti-CGRP treatment; prospective, controlled studies using validated outcome measures are needed. This study was not registered.