Remission of chronic headache: Rates, potential predictors and the role of medication, follow-up results of the German Headache Consortium (GHC) Study. (March 2018)

• Record Type: Journal Article
• Authors: Henning, Verena; Katsarava, Zaza; Obermann, Mark; Moebus, Susanne; Schramm, Sara
• Is Part Of: Cephalalgia. Volume 38:Number 3(2018)
• Page Start: 551
• Page End: 560
• Publication Date: 2018-03
• Subjects: Migraine -- tension type headache -- cohort study -- medication overuse -- headache frequency -- longitudinal population-based study; Headache -- Periodicals; 616.8491
• DOI: 10.1177/0333102417699180
• Languages: English
• ISSNs: 0333-1024

Abstract

Objectives: To estimate remission rates of chronic headache (CH), focusing on potential predictors of headache remission and medication. Methods: We used data from the longitudinal population-based German Headache Consortium (GHC) Study (n = 9, 944, 18–65 years). Validated questionnaires were used at baseline (t0, 2003–2007, response rate: 55.2%), first follow-up after 1.87 ± 0.39 years (t1, 37.2%) and second follow-up after 3.26 ± 0.60 years (t2, 38.8%) to assess headache type and frequency, use of analgesics and anti-migraine drugs, medication overuse, education, BMI, smoking and alcohol consumption. CH was defined as ≥ 15 headache days/month at t0 over three months. Outcomes were: CH remission (<15 headache days/month at both follow-ups), CH persistence (≥ 15 headache days/month at both follow-ups); all others were considered as partially remitted. To estimate predictors of remission, univariate and multiple logistic regression were calculated. Results: At baseline, 255 (2.6%) participants were identified with CH. Of these, 158 (62.0%) participants responded at both follow-ups. Remission was observed in 58.2% of participants, partial remission in 17.7% and persistence in 24.1%. Remission was associated with female sex (adjusted odds ratio: 3.10, 95% confidence interval: 1.06–9.08) and no medication overuse (4.16, 1.45–11.94) compared to participants with persistent CH; participants with higher headache frequency at t0 were less likely to remit (0.90, 0.84–0.97). Medication, age, education, BMI, smoking and drinking showed no effects on remission. Similar results were observed for partial remission. Conclusion: The majority of CH participants remitted from CH. Female sex, no overuse of pain medication and lower headache frequency were associated with remission.