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Evers S, Dell'Agnello G, Novick D, Gonderten HS, Panni T, Pascual J. Acute Treatment Patterns, Migraine Burden, and Healthcare Resource Use in People With Migraine: Results From the OVERCOME (EU) Observational Study. Pain Ther 2024; 13:589-607. [PMID: 38625512 PMCID: PMC11111430 DOI: 10.1007/s40122-024-00589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/22/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION The ObserVational survey of the Epidemiology, tReatment and Care Of MigrainE (OVERCOME) European Union (EU) is part of an overarching population-based study program that also includes the United States and Japan. Here, we report data on the migraine/severe headache burden and the use of acute medication and healthcare resources in Spain and Germany. METHODS OVERCOME (EU) was an online, non-interventional, cross-sectional survey conducted in adults in Spain and Germany between October 2020 and February 2021. A total migraine cohort was established based on health survey participants who reported headache/migraine in the last 12 months AND identified as having migraine based on modified International Classification of Headache Disorders, third edition criteria OR self-reported physician diagnosis. Data were analyzed for the total migraine cohort and the subcohort with moderate to severe headache attacks, with average pain severity ≥ 5 points, pain duration ≥ 4 h, and at least moderate disability due to migraine [Migraine Disability Assessment (MIDAS) score ≥ 11] over the past 3 months. RESULTS Pain of moderate or severe intensity was the most frequent symptom in the total migraine cohort (n = 19,103/20,756; 92.0%). Proportions of participants reporting severe disability (MIDAS Grade IV), poorer quality of life (QoL; Migraine-Specific QoL Questionnaire), and higher interictal burden (Migraine Interictal Burden Scale-4), generally increased with number of headache days (HDs)/month. Most participants (92.5%) reported current acute migraine/severe headache medication use, although only 39.0% were using triptans. In the moderate to severe attacks subcohort (n = 5547), 48.4% were using triptans, with nonsteroidal anti-inflammatory drugs the most common acute medication. The moderate to severe attacks subcohort also reported poorer QoL and greater pain and disability with increasing HDs/month, although severe interictal burden was reported for ~ 60% of participants regardless of HDs/month. Treatment satisfaction (six-item migraine Treatment Optimization Questionnaire) in those using triptans was generally poor in both total and subcohorts. CONCLUSION High migraine-related burden levels were reported, despite use of acute medication. Although triptans are recommended for moderate to severe migraine attacks in Spanish and German guidelines, less than half of participants were using triptans; treatment satisfaction in those using triptans was generally poor. New tailored treatment options may help address unmet needs in current acute treatment.
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Affiliation(s)
- Stefan Evers
- University of Münster, Münster, Germany
- Lindenbrunn Hospital, Coppenbrügge, Germany
| | | | | | | | | | - Julio Pascual
- Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria and IDIVAL, Santander, Spain
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Müller B, Dresler T, Rimmele F, Jürgens T, Niederberger U, Schwarz C, Kropp P. [Interdisciplinary multimodal pain therapy in headache disorders]. Schmerz 2024; 38:80-88. [PMID: 37278838 DOI: 10.1007/s00482-023-00723-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 06/07/2023]
Abstract
Primary headaches are among the most common pain disorders. They include migraines (prevalence 15%), tension headaches (up to 80%), and others, including trigeminal autonomic headaches (about 0.2%). Migraine, in particular, leads to significant impairment of personal life and high societal costs. Therefore, the need for effective and sustainable therapeutic procedures is high. This article provides an overview of psychological procedures in headache therapy and critically summarizes the empirical evidence for the effectiveness of interdisciplinary multimodal pain therapy (IMST) consisting of psychotherapy and pharmacotherapy. It can be shown that psychoeducation, relaxation procedures, cognitive behavioral therapy, and biofeedback are psychological procedures from which headache patients can benefit. In the synopsis of multimodal approaches in the treatment of headache, consistently greater effects can be observed when both pharmacological treatment and psychotherapeutic procedures are used. This added value should be regularly taken into account in the treatment of headache disorders. This requires close cooperation between headache specialists and psychotherapists who specialize in the treatment of pain.
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Affiliation(s)
- Britta Müller
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Gehlsheimer Straße 20, 18147, Rostock, Deutschland
| | - Thomas Dresler
- Klinik für Psychiatrie und Psychotherapie, Tübingen Center for Mental Health, Universitätsklinikum Tübingen, Calwerstraße 14, 72076, Tübingen, Deutschland
- Graduiertenschule & Forschungsnetzwerk LEAD, Universität Tübingen, Europastraße 6, 72072, Tübingen, Deutschland
| | - Florian Rimmele
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Gehlsheimer Straße 20, 18147, Rostock, Deutschland
| | - Tim Jürgens
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Gehlsheimer Straße 20, 18147, Rostock, Deutschland
- Klinik für Neurologie, KMG Klinikum Güstrow, Güstrow, Deutschland
| | - Uwe Niederberger
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Preußerstraße 1-9, 24105, Kiel, Deutschland
| | - Christof Schwarz
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Gehlsheimer Straße 20, 18147, Rostock, Deutschland
| | - Peter Kropp
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Gehlsheimer Straße 20, 18147, Rostock, Deutschland.
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Starling AJ, Cady R, Buse DC, Buzby M, Spinale C, Steinberg K, Lenaburg K, Kymes S. Harris Poll Migraine Report Card: population-based examination of high-frequency headache/migraine and acute medication overuse. J Headache Pain 2024; 25:26. [PMID: 38408888 PMCID: PMC10895775 DOI: 10.1186/s10194-024-01725-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/22/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Migraine is a disabling neurologic disease that can fluctuate over time in severity, frequency, and acute medication use. Harris Poll Migraine Report Card was a US population-based survey to ascertain quantifiable distinctions amongst individuals with current versus previous high-frequency headache/migraine and acute medication overuse (HFM+AMO). The objective of this report is to compare self-reported experiences in the migraine journey of adults with HFM+AMO to those who previously experienced HFM+AMO but currently have a sustained reduction in headache/migraine frequency and acute medication use. METHODS An online survey was available to a general population panel of adults (≥18 years) with migraine per the ID Migraine™ screener. Respondents were classified into "current HFM+AMO" (within the last few months had ≥8 headache days/month and ≥10 days/month of acute medication use; n=440) or "previous HFM+AMO" (previously had HFM+AMO, but within the last few months had ≤7 headache days/month and ≤9 days/month of acute medication use; n=110). Survey questions pertained to demographics, diagnosis, living with migraine, healthcare provider (HCP) communication, and treatment. RESULTS Participants in the current HFM+AMO group had 15.2 monthly headache days and 17.4 days of monthly acute medication use in last few months compared to 4.2 and 4.1 days for the previous HFM+AMO group, respectively. Overall, current preventive pharmacologic treatment use was low (15-16%; P>0.1 for current vs previous) in both groups. Previous HFM+AMO respondents reported better current acute treatment optimization. More respondents with current (80%) than previous HFM+AMO (66%) expressed concern with their current health (P<0.05). More than one-third of both groups wished their HCP better understood their mental/emotional health (current 37%, previous 35%; P>0.1 for current vs previous) and 47% (current) to 54% (previous) of respondents worried about asking their HCP too many questions (P>0.1 for current vs previous). CONCLUSION Apart from optimization of acute medication, medical interventions did not significantly differentiate between the current and previous HFM+AMO groups. Use of preventive pharmacological medication was low in both groups. Adults with current HFM+AMO more often had health concerns, yet both groups expressed concerns of disease burden. Optimization of acute and preventive medication and addressing mental/emotional health concerns of patients are areas where migraine care may impact outcomes regardless of their disease burden.
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Affiliation(s)
| | - Roger Cady
- RK Consults, Ozark, MO, USA
- Missouri State University, Springfield, MO, USA
- Axon-Therapeutics, San Diego, CA, USA
| | - Dawn C Buse
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Meghan Buzby
- Coalition for Headache and Migraine Patients (CHAMP), San Rafael, CA, USA
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Kebede YT, Mohammed BD, Tamene BA, Abebe AT, Dhugasa RW. Medication overuse headache: a review of current evidence and management strategies. FRONTIERS IN PAIN RESEARCH 2023; 4:1194134. [PMID: 37614243 PMCID: PMC10442656 DOI: 10.3389/fpain.2023.1194134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 07/18/2023] [Indexed: 08/25/2023] Open
Abstract
The third edition of the International Classification of Headache Disorders (ICHD-3) defines medication-overuse headache (MOH) as a headache that develops when a person regularly uses acute or symptomatic headache medications excessively (10 or more, or 15 or more days per month, depending on the medication) for a period of time longer than 3 months. Even though it may not be reported as frequently as it actually is, it affects about 5% of the general population on average. It typically happens following repeated anti-pain medication use for pre-existing headache disorders, such as migraines. Anti-pains can also be used frequently in patients with pre-existing headache disorders for reasons other than treating headaches, such as psychological drug attachment. MOH is linked to a number of illnesses, such as anxiety, depression, and obsessive compulsive disorder (OCD). Both simple and complex types are possible. Additionally, there is no universal consensus on how to treat MOH, but drug discontinuation is the best course of action. Using the medical subject headings "Medication Overuse Headache," "Migraine Headache," "Tension Headache," "Chronification of Headache," and "Antipains," an all-language literature search was done on PubMed, Google Scholar, and Medline up until March 2023. We looked into the epidemiology, risk factors, pathophysiology, clinical characteristics, comorbidities, diagnosis, management, and preventative measures of MOH in the literature. This article focuses on the MOH research themes.
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Affiliation(s)
- Yabets Tesfaye Kebede
- School of Medicine, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Bekri Delil Mohammed
- School of Medicine, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Beimnet Ayenew Tamene
- School of Medicine, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abel Tezera Abebe
- School of Medicine, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Kayar O, Altinoğlu Dikmeer İ, Güler Aksu G, Toros F, Özge A. The mediating role of early maladaptive schemas on the relationship between illness perception and pain coping strategies among adolescents diagnosed with migraine. Front Neurol 2023; 14:1128965. [PMID: 37056362 PMCID: PMC10086163 DOI: 10.3389/fneur.2023.1128965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/01/2023] [Indexed: 03/30/2023] Open
Abstract
ObjectiveThis study aimed to examine the mediating role of early maladaptive schemas on the relationship between illness-related perceptions and pain coping strategies among adolescents diagnosed with migraine.Material and methodsA total of 134 adolescents (aged 12–18 years) diagnosed with migraine with and without aura participated in the study. The Illness Perception Questionnaire, the Pain Coping Questionnaire, and the Early Maladaptive Schema Questionnaires Set for Children and Adolescents were used.ResultsThe intensity of using desperate ways of coping with pain was higher among adolescents who perceive migraine as a chronic disease (β = 0.199, p < 0.05) even if they have episodic attacks and who have higher levels of coherency in understanding the illness (β = 0.256, p < 0.01). First, full mediations of over-vigilance/inhibition and impaired autonomy/performance schema domains on these relations were observed. Second, the increases in negative cognitive (β = 0.199, p < 0.05) and emotional (β = 0.280, p < 0.01) representations related to the consequences of the illness lead to an increase in the uncontrolled and frequent use of analgesic drugs where the partial mediating role of over-vigilance/inhibition schema domain on this correlation is observed. The perceptions about the negative as well as serious consequences of migraine are related to both the self-active behaviors (β = 0.181, p < 0.05) and the conscious cognitive attempts (β = 0.207, p < 0.05) as effective coping strategies, which is an unexpected finding. The disconnection/rejection schema domain had a full mediation role on both relations.ConclusionThe results suggest that early maladaptive schemas are essential factors that affect the migraine coping processes of adolescents.
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Affiliation(s)
- Ozan Kayar
- Department of Psychology, Çankırı Karatekin University, Çankırı, Türkiye
- *Correspondence: Ozan Kayar
| | | | - Gülen Güler Aksu
- Department of Child and Adolescent Psychiatry, Mersin University, Mersin, Türkiye
| | - Fevziye Toros
- Department of Child and Adolescent Psychiatry, Mersin University, Mersin, Türkiye
| | - Aynur Özge
- Department of Neurology, Mersin University, Mersin, Türkiye
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Houben R. Reduced frequency of migraine attacks following coronavirus disease 2019: a case report. J Med Case Rep 2023; 17:62. [PMID: 36810289 PMCID: PMC9943734 DOI: 10.1186/s13256-023-03795-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 01/29/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 is a virus affecting different organs and causing a wide variety and severity of symptoms. Headache as well as loss of smell and taste are the most frequently reported neurological manifestations of coronavirus disease 2019 induced by severe acute respiratory syndrome coronavirus 2. Here we report on a patient with chronic migraine and medication overuse headache, who experienced remarkable mitigation of migraine following coronavirus disease 2019. CASE PRESENTATION For many years prior to the severe acute respiratory syndrome coronavirus 2 infection, a 57-year-old Caucasian male suffered from very frequent migraine attacks and for control of headaches he had been taking triptans almost daily. In the 16-month period before the outbreak of coronavirus disease 2019, triptan was taken 98% of the days with only a 21-day prednisolone-supported triptan holiday, which, however, had no longer-lasting consequences on migraine frequency. Upon severe acute respiratory syndrome coronavirus 2 infection, the patient developed only mild symptoms including fever, fatigue, and headache. Directly following recovery from coronavirus disease 2019, the patient surprisingly experienced a period with largely reduced frequency and severity of migraine attacks. Indeed, during 80 days following coronavirus disease 2019, migraine as well as triptan usage were restricted to only 25% of the days, no longer fulfilling criteria of a chronic migraine and medication overuse headache. CONCLUSION Severe acute respiratory syndrome coronavirus 2 infection might be capable of triggering mitigation of migraine.
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Affiliation(s)
- Roland Houben
- Department of Dermatology, Venereology Und Allergology, University Hospital Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.
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Comparative Impact of Pharmacological Therapies on Cluster Headache Management: A Systematic Review and Network Meta-Analysis. J Clin Med 2022; 11:jcm11051411. [PMID: 35268502 PMCID: PMC8911224 DOI: 10.3390/jcm11051411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 12/10/2022] Open
Abstract
It is important to find effective and safe pharmacological options for managing cluster headache (CH) because there is limited evidence from studies supporting the general efficacy and safety of pharmacological therapies. This systematic review and network meta-analysis (NMA) analyzed published randomized controlled trials (RCTs) to evaluate the efficacy and safety of pharmacological treatments in patients with CH. The PubMed and Embase databases were searched to identify RCTs that evaluated the efficacy and safety of pharmacological treatments for CH. Efficacy outcomes included frequency and duration of attacks, pain-free rate, and the use of rescue agents. Safety outcomes were evaluated based on the number of patients who experienced adverse events. A total of 23 studies were included in the analysis. The frequency of attacks was reduced (mean difference (MD) = −1.05, 95% confidence interval (CI) = −1.62 to −0.47; p = 0.0004), and the pain-free rate was increased (odds ratio (OR) = 3.89, 95% CI = 2.76−5.48; p < 0.00001) in the pharmacological treatment group, with a lower frequency of rescue agent use than the placebo group. Preventive, acute, and triptan or non-triptan therapies did not show significant differences in efficacy (p > 0.05). In the NMA, different results were shown among the interventions; for example, zolmitriptan 5 mg was more effective than zolmitriptan 10 mg in the pain-free outcome (OR = 0.40, 95% CI = 0.19−0.82; p < 0.05). Pharmacological treatment was shown to be more effective than placebo to manage CH with differences among types of therapies and individual interventions, and it was consistently shown to be associated with the development of adverse events. Thus, individualized therapy approaches should be applied to treat CH in real-world practice.
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Takeshima T, Nakai M, Shibasaki Y, Ishida M, Kim BK, Ning X, Koga N. Early onset of efficacy with fremanezumab in patients with episodic and chronic migraine: subanalysis of two phase 2b/3 trials in Japanese and Korean patients. J Headache Pain 2022; 23:24. [PMID: 35139816 PMCID: PMC8903536 DOI: 10.1186/s10194-022-01393-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Early onset of action has become recognized as an important efficacy feature of preventive migraine treatment, which can help overcome adherence issues commonly associated with older medications. Preventive treatments that target the calcitonin gene-related peptide (CGRP) or the CGRP receptor have been previously shown to provide early onset of action. Methods This subanalysis of primary endpoints of two separate phase 2b/3 studies sought to determine the onset of action of fremanezumab in Japanese and Korean patients with episodic migraine (EM) and chronic migraine (CM). Results In EM patients (n = 357), both fremanezumab quarterly and fremanezumab monthly led to greater reductions in weekly migraine days (days/week) than placebo from the first week after the initial injection and thereafter during the remainder of the study period. Similarly, CM patients (n = 571) had a greater reduction in headache days of at least moderate severity (days/week) with fremanezumab (total) than placebo. The percentage of patients with a migraine day (EM) or headache day at least moderate severity (CM) was lower in those treated with fremanezumab than placebo and this effect was apparent from as early as Day 2 (1 day after first injection). Conclusions These results suggest that fremanezumab has an early onset of action, as noted in previous post hoc analyses of anti-CGRP monoclonal antibodies. Trial registration ClinicalTrials.gov. NCT03303092, Registered 5 October 2017, NCT03303079, Registered 5 October 2017.
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Affiliation(s)
- Takao Takeshima
- Headache Center, Department of Neurology, Tominaga Hospital, 1-4-48 Minatomachi Naniwa-ku, Osaka-shi, Osaka, 556-0017, Japan
| | - Masami Nakai
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., 3-2-27 Otedori, Chuo-ku, Osaka, 540-0021, Japan.
| | - Yoshiyuki Shibasaki
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo, 108-8242, Japan
| | - Miki Ishida
- Headquarters of Clinical Development, Otsuka Pharmaceutical Co., Ltd., 3-2-27 Otedori, Chuo-ku, Osaka, 540-0021, Japan
| | - Byung-Kun Kim
- Nowon Eulji Medical Center, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul, 01830, Republic of Korea
| | - Xiaoping Ning
- Speciality Clinical Development, Teva Branded Pharmaceutical Products R&D, Inc., 145 Brandywine Pkwy, West Chester, PA, 19380, USA
| | - Nobuyuki Koga
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., 463-10 Kagasuno, Kawauchi-cho, Tokushima, 771-0192, Japan
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Rauschert C, Seitz NN, Olderbak S, Pogarell O, Dreischulte T, Kraus L. Abuse of Non-opioid Analgesics in Germany: Prevalence and Associations Among Self-Medicated Users. Front Psychiatry 2022; 13:864389. [PMID: 35546935 PMCID: PMC9081647 DOI: 10.3389/fpsyt.2022.864389] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Abuse of non-opioid analgesics (NOA) is associated with serious health consequences. However, due to inconsistent definitions of NOA abuse, prevalence estimates for the German population are unclear. OBJECTIVES This study aimed to estimate the 12-month prevalence of NOA abuse among self-medicated users of these drugs in the general German population and to identify risk factors. METHODS Data are from the 2015 Epidemiological Survey of Substance Abuse, a nationally representative sample with 9,204 individuals aged 18-64 years. Classification of NOA abuse was based on self-reported information according to the definition of the ICD-10-GM diagnosis F55.2 abuse of non-dependence producing substances. Multiple logistic regression was performed to examine associations between NOA abuse and sociodemographic, behavioral, and health-related variables. RESULTS The weighted 12-month prevalence of NOA abuse was 14.6% (95%-CI [13.2- 16.0]) among self-medicated users of these drugs. Extrapolation of the proportion of individuals abusing NOA to the German population aged 18 to 64 is 3,243,396 individuals or 6.4% (95%-CI [5.7- 7.1]). Inexplicable physical pain, being underweight, depression, hazardous alcohol use, daily smoking, illegal drug use, and frequent use of NOA (one or more times per week and daily use) were associated with an increased probability of NOA abuse. The use of cannabis was associated with a lower probability of NOA abuse. CONCLUSION Abuse of NOA is highly prevalent in the German population. Against the background of increasing self-medication of NOA, healthcare providers need to be aware of potential risk factors of abuse to better identify and prevent this problem.
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Affiliation(s)
- Christian Rauschert
- Department of Epidemiology and Diagnostics, IFT Institut für Therapieforschung, Munich, Germany
| | - Nicki-Nils Seitz
- Department of Epidemiology and Diagnostics, IFT Institut für Therapieforschung, Munich, Germany
| | - Sally Olderbak
- Department of Epidemiology and Diagnostics, IFT Institut für Therapieforschung, Munich, Germany.,Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Tobias Dreischulte
- Department of General Practice and Family Medicine, Ludwig-Maximilians-Universität, Munich, Germany
| | - Ludwig Kraus
- Department of Epidemiology and Diagnostics, IFT Institut für Therapieforschung, Munich, Germany.,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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Koval'chuk NA, Shagbazian AE, Tabeeva GR. Abuse of medications for the treatment of migraines: results of an online survey. CONSILIUM MEDICUM 2021. [DOI: 10.26442/20751753.2021.11.201146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background. The abuse of headache medications is an important factor in the formation of drug-induced headache.
Aim. To determine the prevalence and nature of drug use among patients with migraine and chronic cephalgic syndrome.
Materials and methods. An Internet survey was conducted among 1598 Internet users, as well as through social networks (Instagram, Facebook, VK) using Google Forms.
Results. 60% of respondents with chronic headache and migraine symptoms did not have a reliable diagnosis. More than 70% of patients choose a drug for pain relief on their own and 62.7% take the drug in every headache attack.
Conclusion. Among patients with chronic headaches and migraines, there is a high percentage of people abusing symptomatic drugs, which indicates a high risk of drug-induced headache formation.
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Association between Arthritis and Migraine: A US Nationally Representative Study Including 2649 Adults. J Clin Med 2021; 10:jcm10020342. [PMID: 33477560 PMCID: PMC7831134 DOI: 10.3390/jcm10020342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/14/2020] [Accepted: 01/15/2021] [Indexed: 12/13/2022] Open
Abstract
This study aimed to investigate the cross-sectional association between arthritis and migraine in a large representative sample of the US adult population. The study used data from adults who participated in the RAND American Life Panel (ALP). Arthritis (excluding rheumatoid arthritis) and migraine were self-reported. Control variables included sex, age, ethnicity, marital status, education, employment, annual family income, stroke, epilepsy, coronary artery disease, asthma, depression, anxiety, bipolar disorder, and alcohol dependence. The association between arthritis and migraine was investigated using multivariable logistic regression models, while sex and age interaction analyses were also conducted. This study included 2649 adults (51.7% women; mean (SD) age 50.6 (15.9 years). The prevalence of migraine was 10.7% in the sample. After adjusting for several potential confounders, there was a significant association between arthritis and migraine (OR = 1.83, 95% CI = 1.20-2.81). Further sensitivity analyses revealed that the association was significant in women, adults aged ≤45 years, and those aged >65 years. The mere fact that arthritis and migraine may coexist is problematic, as this could lead to an important medical and economic burden. Therefore, strategies should be implemented to reduce the cooccurrence of these two chronic conditions.
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Pozo-Rosich P, Layos-Romero A, Martin-Delgado J, Pascual J, Bailón C, Tentor A, Santiago A, Ignacio E, Torrés A, Mira JJ. Low-value care practice in headache: a Spanish mixed methods research study. J Headache Pain 2020; 21:74. [PMID: 32522142 PMCID: PMC7288523 DOI: 10.1186/s10194-020-01147-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Headache is one of the most prevalent diseases. The Global Burden of Disease Study ranks it as the seventh most common disease overall and the second largest neurological cause of disability in the world. The "Do Not Do" recommendations are a strategy for increasing the quality of care and reducing the cost of care for headache. This study aimed to identify specific low-value practices in headache care, determine their frequency, and estimate the cost overrun that they represent, in order to establish "Do not Do" recommendations specifically for headache by consensus and according to scientific evidence. METHODS This was a mixed methods research study that combined qualitative consensus-building techniques, involving a multidisciplinary panel of experts to define the "Do Not Do" recommendations in headache care, and a retrospective observational study with review of a randomized set of patient records from the past 6 months in four hospitals, to quantify the frequency of these "Do Not Do" practices. We calculated the sum of direct costs of medical consultations, medicines, and unnecessary diagnostic tests. RESULTS Seven "Do Not Do" recommendations were established for headache. In total, 3507 medical records were randomly reviewed. Low-value practices had a highly variable occurrence, depending on the hospital and type of headache. Overall, 34.1% of low-value practices were related to treatment, 21% were related to overuse of imaging in consultation, and 19% were related to emergency care. The estimated cost of low-value practices in the four hospitals was 203,520.47 euros per 1000 patients. CONCLUSIONS This study identified low-value headache practices that need to be eradicated and provided data on their frequency and cost overruns.
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Affiliation(s)
- Patricia Pozo-Rosich
- Headache Unit, Neurology Department, Vall d'Hebron Hospital, Barcelona, Spain
- Headache and Neurological Pain Research Group, VHIR, Universitat Autonoma of Barcelona, Barcelona, Spain
| | | | - Jimmy Martin-Delgado
- ATENEA research group, Foundation for the Promotion of Health and Biomedical Research, Sant Joan d'Alacant, Spain.
| | - Julio Pascual
- University Hospital Marqués de Valdecilla, Santander, Spain
- University of Cantabria and IDIVAL, Santander, Spain
| | | | - Ana Tentor
- Barrio del Pilar Health Center, Madrid, Spain
| | | | | | - Antonio Torrés
- Patient Safety Observatory, Andalusian Healthcare Quality Agency, Seville, Spain
| | - José Joaquín Mira
- Health Department Sant Joan d'Alicante, Alicante, Spain
- Miguel Hernández University of Elche, Elche, Spain
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A Chinese Prescription Chuanxiong Chatiao San for Migraine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2301680. [PMID: 31467571 PMCID: PMC6699287 DOI: 10.1155/2019/2301680] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/13/2019] [Indexed: 11/24/2022]
Abstract
Backgrounds Chuanxiong Chatiao san (CXCT) is a famous Chinese classical prescription. It has a favorable effect in treating migraine. It is reported that CXCT combined with Western conventional medicine (WCM) could increase the therapeutic efficacy on migraine. The purpose of this paper is to systematically assess the clinical efficacy, safety, and some indexes of CXCT for migraine. Methods PubMed, Embase Database, China National Knowledge Infrastructure (CNKI), Wanfang Database, the Cochrane Library, and the CBM were searched from January 2000 to February 2019. We made a detailed record of outcome measurements. Meta-analysis was performed using RevMan 5.3 software. Results A total of 3307 patients were included in the 37 articles. Meta-analysis showed that CXCT significantly increased the total efficiency rate (TER), compared with Western medicine treatment (WMC) (P < 0.00001). When CXCT is combined with WMC, the result showed that P < 0.00001. CXCT was significantly reduced the adverse events (AEs) compared with WMC (P < 0.00001). The levels of VAS, number of migraine episodes (NE), and time of headache duration (TD) were significantly reduced (P < 0.00001). Platelet function and blood rheology level were improved via a significantly decrease in 5-HT and β-EP (P < 0.00001). Other indicators such as substance P, CGRP high-cut viscosity, low-cut viscosity, plasma viscosity, and fibrinogen were significantly reduced (P < 0.00001). Conclusion Our findings provide evidence that CXCT and CXCT combined with WMC have higher efficacy in the treatment of migraine compared with WCM alone. Methodological quality was generally low, so the conclusion of this paper has some limitations and it has to be carefully evaluated.
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Dresler T, Caratozzolo S, Guldolf K, Huhn JI, Loiacono C, Niiberg-Pikksööt T, Puma M, Sforza G, Tobia A, Ornello R, Serafini G. Understanding the nature of psychiatric comorbidity in migraine: a systematic review focused on interactions and treatment implications. J Headache Pain 2019; 20:51. [PMID: 31072313 PMCID: PMC6734261 DOI: 10.1186/s10194-019-0988-x] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/27/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Migraine is a highly prevalent and disabling neurological disorder which is commonly linked with a broad range of psychiatric comorbidities, especially among subjects with migraine with aura or chronic migraine. Defining the exact nature of the association between migraine and psychiatric disorders and bringing out the pathophysiological mechanisms underlying the comorbidity with psychiatric conditions are relevant issues in the clinical practice. METHODS A systematic review of the most relevant studies about migraine and psychiatric comorbidity was performed using "PubMed", "Scopus", and "ScienceDirect" electronic databases from 1 January 1998 to 15 July 2018. Overall, 178 studies met our inclusion criteria and were included in the current review. RESULTS According to the most relevant findings of our overview, the associations with psychiatric comorbidities are complex, with a bidirectional association of major depression and panic disorder with migraine. Importantly, optimizing the pharmacological and non-pharmacological treatment of either migraine or its psychiatric comorbidities might help clinicians to attenuate the burden of both these conditions. CONCLUSIONS The available data highlight the need for a comprehensive evaluation of psychiatric disorders in migraine in order to promote an integrated model of care and carefully address the burden and psychosocial impairment related to psychiatric comorbidities in migraine.
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Affiliation(s)
- Thomas Dresler
- Department of Psychiatry & Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
| | - Salvatore Caratozzolo
- Neurology Unit - Neurological and Vision Sciences Department, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Kaat Guldolf
- Department of Neurology, University Hospital Brussels, Jette, Belgium
| | - Jana-Isabel Huhn
- Praxis Gendolla, Specialized care for Psychiatry, Neurology, Psychotherapy and Pain Therapy, Essen, Germany
| | - Carmela Loiacono
- Child Neuropsychiatry school, University of Palermo, Palermo, Italy
| | | | - Marta Puma
- Headache Centre & Neurocritical Care Unit, Department of Human Neurosciences, Sapienza - University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Giorgia Sforza
- Child Neurology Unit, Department of Neuroscience and Neurorehabilitation, Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Anna Tobia
- Child Neuropsychiatry Unit, ASL 3, Turin, Italy
| | - Raffaele Ornello
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy. .,IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
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Diener HC. In Reply. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:638. [PMID: 30373714 PMCID: PMC6218710 DOI: 10.3238/arztebl.2018.0638b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Hans-Christoph Diener
- *Seniorprofessur für Klinische Neurowissenschaften Universitätsklinik für Neurologie und Westdeutsches Kopfschmerzzentrum, Essen
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Gorzny F. Causes Need to Be Comprehensively Investigated. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:638. [PMID: 30373713 PMCID: PMC6218705 DOI: 10.3238/arztebl.2018.0638a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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