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Prevalence of medication overuse headache in an interdisciplinary pain clinic 英文参考文献
WannerSchmidetal.TheJournalofHeadacheandPain2013,14:4
/content/14/1/4
RESEARCH ARTICLE
OpenAccess
Prevalenceofmedicationoveruseheadacheinan
interdisciplinarypainclinic
CorinneWannerSchmid1?,KonradMaurer1,2*?,DanielMSchmid3,EliAlon1,DonatRSpahn1,
AndreasRGantenbein4andPeterSSandor4
Abstract
Background:Medicationoveruseheadache(MOH)hasbeenrecognizedasanimportantprobleminheadache
patientsalthoughthepathophysiologicalmechanismsremainunclear.ThediagnosisofMOHisbasedonclinical
characteristicsdefinedbytheInternationalHeadacheSociety.Theaimwastheevaluationofthediagnosticcriteria
ofMOHinamixedpopulationofchronicpainpatientstogaininformationabouttheprevalenceandpossible
associationswithMOH.
Methods:DataofallpatientsreferredtotheinterdisciplinarypainclinicattheUniversityHospitalofZurich
betweenSeptember2005andDecember2007wereretrospectivelyanalyzed.Demographicdata(age,sex,history
ofmigration),aswellasdataaboutdurationofpaindisease,categoryofpaindisease(neurological,psychiatric,
rheumatologic,other),useofmedication,historyoftrauma,andcomorbidityofdepressionandanxietyhave
beencollected.
Results:Totally178of187consecutivechronicpainpatientswereincludedinthestudy.Atotalof138patients
(78%)usedanalgesicson15ormoredayspermonth.Chronicheadachewasmoreprevalentamongpatients
withanalgesicoveruse(39.8%)thanwithoutanalgesicoveruse(18%).TheprevalenceofMOHwas29%.Theodds
ratio(OR)forapatientwithmedicationoverusetohavechronicheadachewas13.1ifhehadahistoryofprimary
headache,comparedtoapatientwithoutaprimaryheadachesyndrome.Furthermore,historyofheadache
(OR2.5,CI[1.13;5.44]),historyofmigration(OR2.9,CI[1.31;6.32])andcomorbiddepression(OR3.5,CI[1.46;8.52])
wereassociatedwithoveruseofacutemedication,ingeneral.
Conclusions:Primaryheadacheshaveahighriskforchronificationinpatientsoverusinganalgesicsforotherpain
disorders.Whereashistoryofheadache,historyofmigrationandcomorbidityofdepressionareindependentely
associatedwithanalgesicoveruseinthisgroupofpatients.
Keywords:Medicationoveruse,Headache,Int
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