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Brief intervention for
MOH patients could be considered in primary care before referral as the
frequency of headache, and medication use were the only identified predictors.
According to a recent study published in a peer-reviewed medical journal, Acta Neurologica Scandinavica, the frequency of headache and medication use are the predictors that can estimate treatment accomplishment in a medication-overuse headache (MOH).
A medication-overuse headache is a chronic headache condition among people who overuse a different kind of analgesics. This is a common condition in people with primary headache conditions such as cluster or tension-type headaches and migraines. This problem can limit the action of migraine or severe headache medication. Therefore, there is a challenge in managing this condition which can be done by discontinuing the overuse of medication and also by detoxifying medication's effects. Further, with its treatment, one more question is raised that how to diagnose the treatment effects over MOH.
A pragmatic cluster-randomized controlled trial was conducted to predict the successful treatment outcomes after the brief intervention (BI) for MOH. In this study, a total, 46 patients received BI. The trial was conducted with a single crossover. Further, the BI (early or after crossover) compared to business as usual (BAU) for the treatment of MOH. The patients were then followed up for three months after BI.
The analyses evaluated 6.9 and 10.9 mean reduction in headache and medication days/month from baseline for the BI. Further, the mean percentage reduction in headache and medication days were measured up to 30.5% and 50.4%, respectively. Out of 46 patients, only 5 patients started prophylactic medications. However, the main type of overused drug, the co-occurrence of migraine, age, gender and dependence scale score severity at baseline could not predict the successful withdrawal in the prespecified analyses. Only the headache days/month and medication use at baseline was the significant predictor in the analysis.
All the evaluated data reflected that BI for MOH is a simple and
effective intervention in primary care. The predictors that can estimate
treatment accomplishment were the frequency of headache and medication use.
These predictors evaluated that the treatment for all MOH patients should be
attempted in primary care before referral. Further, an awareness regarding MOH
is needed as the problem is highly preventable and treatable.
Acta Neurologica Scandinavica
Predictors of successful primary care detoxification treatment for a medication-overuse headache
E. S. Kristoffersen et al.
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