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Medication-overuse headache (MOH) is common in the general population. We investigated effectiveness of brief intervention (BI) for achieving drug withdrawal in primary care patients with MOH.
In this research
paper, gain from effective management of MOH
in primary care, thus benefiting patients and society and reduction in economic
costs has been mentioned.
General practitioners experience brief intervention as a practical approach
towards MOH.
Medication-overuse
headache (MOH) is common in the general population. We investigated
effectiveness of brief intervention (BI) for achieving drug withdrawal in
primary care patients with MOH.
The study was
double-blind, pragmatic and cluster-randomised controlled. A total of 25 486
patients (age 18–50) from 50 general practitioners (GPs) were screened for MOH.
GPs defined clusters and were randomised to receive BI training (23 GPs) or to
continue business as usual (BAU; 27 GPs). The Severity of Dependence Scale was
applied as a part of the BI. BI involved feedback about individual risk of MOH
and how to reduce overuse. Primary outcome measures were reduction in
medication and headache days/month 3 months after the intervention and were
assessed by a blinded clinical investigator.
42% responded to
the postal screening questionnaire, and 2.4% screened positive for MOH. A
random selection of up to three patients with MOH from each GP were invited
(104 patients), 75 patients were randomised and 60 patients included into the
study. BI was significantly better than BAU for the primary outcomes
(p<0.001). Headache and medication days were reduced by 7.3 and 7.9 (95% CI
3.2 to 11.3 and 3.2 to 12.5) days/month in the BI compared with the BAU group.
Chronic headache resolved in 50% of the BI and 6% of the BAU group.
The BI method
provides GPs with a simple and effective instrument that reduces
medication-overuse and headache frequency in patients with MOH.
J Neurol Neurosurg Psychiatry. 2015 May; 86(5): 505–512.
Brief intervention for medication-overuse headache in primary care. The BIMOH study: a double-blind pragmatic cluster randomized parallel controlled trial
Espen Saxhaug Kristoffersen et al.
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