Analgesic abuse headache: risk factors and causes of poor adherence in the detox process
DOI:
https://doi.org/10.48208/HeadacheMed.2021.21Keywords:
medication overuse headache, risk factor, Comorbidities, Poor adherence, Dependence, Headache DisordersAbstract
Background
Medication overuse headache (MOH) is characterized by a pre-existing primary or secondary headache associated with medication overuse.
Aims
To identify the clinical, epidemiological, and therapeutic profiles associated with MOH and poor adherence to treatment.
Methods
A cross-sectional, comparative, descriptive, analytical study was carried out to assess the characteristics of patients with MOH treated at the Hospital Geral de Fortaleza (HGF).
Results
103 patients participated, 95 (92.2%) women and 8 (7.8%) men. Of these, 55 (53.4%) patients answered that had already been instructed about the MOH, however they continue to abuse medication for many reasons i.e.: difficulty in bearing pain, and fear of worsening the pain. When asked about what could be done to improve adherence to treatment, in a general way, 28 (27.2%) were unable to inform, 37 (35.9%) answered that most frequent consultations could help. Furthermore, 19 (18.4%) believe that psychological counseling wound bring benefits.
Conclusion
The lack of guidance or interest in the guidelines provided are real and important obstacles to treat MOH. Changes in the care model that include effective communication, more frequent return, family and psychotherapy support and close monitoring by the physician or nurses are factors that should be considered in headache clinics.
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References
Kristoffersen ES and Lundqvist C. Medication-overuse headache: a review. J Pain Res. 2014 Jun 26; 7:367-78. DOI: https://doi.org/10.2147/JPR.S46071
Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton RB, Scher AI, Steiner TJ, Zwart JA. The global burden of headache: a documentation of headache prevalence and disability worldwide. Review. Cephalalgia. 2007, 27, 193-210. DOI: https://doi.org/10.1111/j.1468-2982.2007.01288.x
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders ICHD-3, 3rd edition. Cephalalgia 2018; 38: 1–211. DOI: https://doi.org/10.1177/0333102417738202
Grazzi L, Andrasik F, Damico D, Leone M, Usai S, Kass SJ, Bussone G. Behavioral and pharmacologic treatment of transformed migraine with analgesic overuse: outcome at 3 years. Headache. 2002 jun;42(6):483-90. DOI: https://doi.org/10.1046/j.1526-4610.2002.02123.x
Vandenbussche M, Laterza D, Lisicki M, Lloyd J, Lupi C, Tischler H, Toom K, Vandervost F, Quintana S, Paemeleire K, Katsarava Z. Medication-overuse headache: a widely recognized entity amidst ongoing debate. The Journal of Headache and Pain volume 19, Article number: 50 (2018) DOI: https://doi.org/10.1186/s10194-018-0875-x
Diener HC, Antonaci F, Braschinsky M, Evers S, Jensen R, Lainez M, Kristoffersen ES, Tassorelli C, Ryliskiene K, Petersen JA. European Academy of Neurology guideline on the management of medication-overuse headache. European Journal of Neurology 2020, 27: 1102– 1116 DOI: https://doi.org/10.1111/ene.14268
Sousa LD. Cefaleias por abuso medicamentoso – aspectos clínicos. Sinapse. 2002 Maio (1) 22-26.
Straube A, Pfaffenrath V, Ladwig KH, Meisenger C, Hoffmann W, Fendrich K, Vennemann M, Berger K. Prevalence of chronic migraine and medication overuse in Germany-The DMKG headache study. Cephalalgia. 2010 Feb;30(2):207-13 DOI: https://doi.org/10.1111/j.1468-2982.2009.01906.x
Evers S. and Marziniak M. Clinical features, pathophysiology, and treatment of medication-overuse headache. Lancet Neurol 2010 Apr;9(4):391-401. DOI: https://doi.org/10.1016/S1474-4422(10)70008-9
Shand B, Goicochea MT, Valenzuela R, Fadic R, Jensen R, Tassorelli C, Nappi G and COMOESTAS CONSORTIUM. Clinical and Demographical Characteristcs of Patientes with Medication Overuse in Argentina and Chile: Analysis of the Latin American Section of COMOESTAS Project. The Journal of Headache and Pain (2015) 16:83 DOI 10.1186/s10194-015-0561-1. DOI: https://doi.org/10.1186/s10194-015-0561-1
Chen P-K and Wang S-J. Medication Overuse and Medication Overuse Headache: Risk Factors, Comorbidities, Associated Burdens and Nonpharmacologic and Pharmacologic Treatment Approaches. Current Pain and Headache Reports (2019) 23:60. DOI: https://doi.org/10.1007/s11916-019-0796-7
Diener HC, Dodick D, Evers S, Holle D, Jensen RH, Lipton RB, Porreca F, Silberstein S, Schwedt T. Pathophysiology, prevention, and treatment of medication overuse headache. Lancet Neurol 2019 Published Online June 4, 2019 http://dx.doi.org/10.1016/ S1474-4422(19)30146-2.
Kristoffersen ES and Lundqvist C. Medication-overuse headache: epidemiology, diagnosis and treatment. Ther Adv Drug Saf 2014, Vol. 5(2) 87–99 DOI: https://doi.org/10.1177/2042098614522683
Sances G, Ghiotto N, Galli F, Guaschino E, Rezzani C, Guidetti V, Nappi G. Risk factors in medication-overuse headache: a 1-year follow-up study (care II protocol). Cephalalgia. 2010 Mar;30(3):329-36. DOI: https://doi.org/10.1111/j.1468-2982.2009.01934.x
Nagel V, Cavanagh S, Olivier M, Larripa N, Gutierrez MT, Calvo D, Salvat F, Bonamico L, Goicochea MT. Frequency of diagnoses in a specialized headache clinic in Buenos Aires, 2019. Headache Medicine, v.10, n.3, p.66-69. DOI: https://doi.org/10.48208/HeadacheMed.2019.19
Diener HC, Holle D, Solbach K, Gaul C. Medication-overuse headache: risk factors, pathophysiology and management. Nat Rev Neurol 2016; 12: 575–83 DOI: https://doi.org/10.1038/nrneurol.2016.124
Alstadhaug KB, Ofte HK, Kristoffersen ES. Preventing and treating medication overuse headache. Pain Rep 2017 Jul 26;2(4): e612 DOI: https://doi.org/10.1097/PR9.0000000000000612
Find NL, Terlizzi R, Munksgaard SB, Bentsen L, Tassorelli C, Nappi G, Katsarava Z, Lainez M, Goicochea MT, Shand B, Fadic R, Spadafora S, Pagani M and Jensen R. Medication overuse headache in Europe and Latin America: general demographic and clinical characteristics, referral pathways and national distribution of painkillers in a descriptive, multinational, multicenter study. The Journal of Headache and Pain (2016) 17:20 DOI: https://doi.org/10.1186/s10194-016-0612-2
Bottiroli S, Allena M, Sances G, De Icco R, Avenali M, Fadic R, Katsarava Z, Lainez MJ, Goicochea MT, Jensen RH, Nappi G, Tassorelli C and COMOESTAS CONSORTIUM. Changes in anxiety and depression symptoms associated to the outcome of MOH: A post-hoc analysis of the Comoestas Project. Cephalalgia. 2018 Apr;38(4):646-654 DOI: https://doi.org/10.1177/0333102417704415
Jonsson P, Linde M, Hensing G, Hederund T. Sociodemographic differences in medication use, health-care contacts and sickness absence among individuals with medication-overuse headache. J Headache Pain2012 Jun;13(4):281-90. DOI: https://doi.org/10.1007/s10194-012-0432-y
Lai JT, Dereix JD, Ganepola RP, Nightingale PG, Markey KA, Aveyard PN, Sinclair AJ. Should we educate about the risks of medication overuse headache? J Headache Pain. 2014 Feb 13;15(1):10. DOI: https://doi.org/10.1186/1129-2377-15-10
Bekkelund SI and Salvesen R. Drug-associated headache is unrecognized in patients treated at a neurological centre. Acta Neurol Scand. 2002 Feb;105(2):120-3. doi: 10.1034/j.1600-0404.2002.1o193.x.PMID: 11903122 DOI: https://doi.org/10.1034/j.1600-0404.2002.1o193.x
Carlsen LN, Munksgaard SB, Jensen RH, Bentsen L. Complete detoxification is the most effective treatment of medication-overuse headache: a randomized controlled open-label trial. Cephalalgia 38:225–236 (2018). DOI: https://doi.org/10.1177/0333102417737779
Munksgaard SB, Madsen SK, Wienecke T. Treatment of medication overuse headache – A review 2018. ACTA NEURO ESCAND. DOI: https://doi.org/10.1111/ane.13074
Andrasik F, Grazzi L, Kass S, Bussone G. Disability in chronic migraine with medication overuse: treatment effects through 5 years. Cephalalgia. 2010 May;30(5):610-4. DOI: https://doi.org/10.1111/j.1468-2982.2009.01932.x
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