Prevalence of medication overuse headache in an interdisciplinary pain clinic 英文参考文献.docVIP

Prevalence of medication overuse headache in an interdisciplinary pain clinic 英文参考文献.doc

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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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