prevalence of medication overuse headache in an interdisciplinary pain clinic流行药物过度使用头痛的一个跨学科的疼痛诊所.pdfVIP

Wanner Schmid et al. The Journal of Headache and Pain 2013, 14:4 /content/14/1/4 RESEARCH ARTICLE Open Access Prevalence of medication overuse headache in an interdisciplinary pain clinic 1† 1,2*† 3 1 1 Corinne Wanner Schmid , Konrad Maurer , Daniel M Schmid , Eli Alon , Donat R Spahn , Andreas R Gantenbein4 and Peter S Sandor4 Abstract Background: Medication overuse headache (MOH) has been recognized as an important problem in headache patients although the pathophysiological mechanisms remain unclear. The diagnosis of MOH is based on clinical characteristics defined by the International Headache Society. The aim was the evaluation of the diagnostic criteria of MOH in a mixed population of chronic pain patients to gain information about the prevalence and possible associations with MOH. Methods: Data of all patients referred to the interdisciplinary pain clinic at the University Hospital of Zurich between September 2005 and December 2007 were retrospectively analyzed. Demographic data (age, sex, history of migration), as well as data about duration of pain disease, category of pain disease (neurological, psychiatric, rheumatologic, other), use of medication, history of trauma, and comorbidity of depression and anxiety have been collected. Results: Totally 178 of 187 consecutive chronic pain patients were included in the study. A total of 138 patients (78%) used analgesics on 15 or more days per month. Chronic headache was more prevalent among patients with analgesic overuse (39.8%) than without analgesic overuse (18%). The prevalence of MOH was 29%. The odds ratio (OR) for a patient with medication overuse to have chronic headache was 13.1 if he had a history of primary headache, com