Lasting improvement of medication‐overuse headache after brief intervention – a long‐term follow‐up in primary care. (23rd May 2017)

• Record Type: Journal Article
• Authors: Kristoffersen, E. S.; Straand, J.; Russell, M. B.; Lundqvist, C.
• Is Part Of: European journal of neurology. Volume 24:Number 7(2017:Jul.)
• Page Start: 883
• Page End: 891
• Publication Date: 2017-05-23
• Subjects: chronic headache -- general practice -- medication‐overuse headache -- migraine -- RCT; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.13318
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract : Background and purpose: Withdrawal therapy improves the headache situation for many patients with medication‐overuse headache (MOH), but relapses are common. The objective was to assess the long‐term effectiveness of a general practitioner conducted brief intervention (BI) for MOH. Methods: Sixty MOH patients initially participating in a blinded cluster‐randomized controlled trial evaluating BI versus business as usual (BAU) were followed up for 16 months. Follow‐up was open after 6 months. Headache and medication days per month were evaluated in three groups: BI early (BI throughout the study, n = 24), BI late (initial BAU, then cross‐over to BI, n = 22) and BAU throughout the study ( n = 14). Results: Fifty‐five of 60 initially included patients completed the follow‐up. The mean change over 16 months' observation in the BI early group was a reduction of 8.4 (5.4–11.4) headache and 13.5 (9.6–17.3) medication days per month. The relapse rate into medication overuse was 8.3%. Patients in the BI late group also improved significantly after a BI. BAU showed no significant improvement. Conclusions: Treatment for MOH in primary care through a BI is a simple intervention with lasting effects and low relapse rate. This approach may be a logical first step in MOH treatment, and referral should generally be reserved for primary care non‐responders. Abstract : Clickhere for the corresponding questions to this CME article.