Chronic Daily Headache with Medication Overuse: A Randomized Follow-Up by Neurologist or PCP
Several studies have shown the benefit of withdrawal therapy when medication overuse headache (MOH) is suspected. Our aim was to compare the effect of withdrawal therapy in patients followed by a neurologist (group A, n = 42) and a primary care physician (PCP) (group B, n = 38). Patients were random...
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| Veröffentlicht in: | Cephalalgia 2009-08, Vol.29 (8), p.855-863 |
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| description | Several studies have shown the benefit of withdrawal therapy when medication overuse headache (MOH) is suspected. Our aim was to compare the effect of withdrawal therapy in patients followed by a neurologist (group A, n = 42) and a primary care physician (PCP) (group B, n = 38). Patients were randomized to A or B, and follow-up was at 3, 6 and 12 months. Calculated mean headache (MH at 6 months + MH at 12 months)/2 (primary end-point) was similar; A 1.04 (0.87, 1.21) and B 1.02 (0.82, 1.21) (P = 0.87). The number of patients with 50% improvement of headache days was also similar; 14/42 in group A vs. 12/34 in B (P = 0.86) at 3 months, 15/42 vs. 11/33 (P = 0.83) at 6 months and 15/42 vs. 14/38 (P = 0.92) at 12 months. Days without headache during the last 9 months of follow-up were 123 (96, 150) in group A and 137 (112, 161) in B (P = 0.62). After 3 months one-third were classified as MOH. Patients with MOH improved similarly in group A and B, and so did patients without MOH. Within 1 year 7/42 in A and 9/38 in B had recurrent medication overuse (P = 0.43). In summary, there were no significant differences in follow-up results between the two groups. |
| doi_str_mv | 10.1111/j.1468-2982.2008.01810.x |
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Our aim was to compare the effect of withdrawal therapy in patients followed by a neurologist (group A, n = 42) and a primary care physician (PCP) (group B, n = 38). Patients were randomized to A or B, and follow-up was at 3, 6 and 12 months. Calculated mean headache (MH at 6 months + MH at 12 months)/2 (primary end-point) was similar; A 1.04 (0.87, 1.21) and B 1.02 (0.82, 1.21) (P = 0.87). The number of patients with 50% improvement of headache days was also similar; 14/42 in group A vs. 12/34 in B (P = 0.86) at 3 months, 15/42 vs. 11/33 (P = 0.83) at 6 months and 15/42 vs. 14/38 (P = 0.92) at 12 months. Days without headache during the last 9 months of follow-up were 123 (96, 150) in group A and 137 (112, 161) in B (P = 0.62). After 3 months one-third were classified as MOH. Patients with MOH improved similarly in group A and B, and so did patients without MOH. Within 1 year 7/42 in A and 9/38 in B had recurrent medication overuse (P = 0.43). 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Our aim was to compare the effect of withdrawal therapy in patients followed by a neurologist (group A, n = 42) and a primary care physician (PCP) (group B, n = 38). Patients were randomized to A or B, and follow-up was at 3, 6 and 12 months. Calculated mean headache (MH at 6 months + MH at 12 months)/2 (primary end-point) was similar; A 1.04 (0.87, 1.21) and B 1.02 (0.82, 1.21) (P = 0.87). The number of patients with 50% improvement of headache days was also similar; 14/42 in group A vs. 12/34 in B (P = 0.86) at 3 months, 15/42 vs. 11/33 (P = 0.83) at 6 months and 15/42 vs. 14/38 (P = 0.92) at 12 months. Days without headache during the last 9 months of follow-up were 123 (96, 150) in group A and 137 (112, 161) in B (P = 0.62). After 3 months one-third were classified as MOH. Patients with MOH improved similarly in group A and B, and so did patients without MOH. Within 1 year 7/42 in A and 9/38 in B had recurrent medication overuse (P = 0.43). 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| subjects | Adult Comorbidity Female Follow-Up Studies Headache Disorders - diagnosis Headache Disorders - epidemiology Headache Disorders - prevention & control Humans Male Medication overuse headache Middle Aged Neurology - statistics & numerical data Norway - epidemiology Pain Measurement - drug effects Pain Measurement - statistics & numerical data Patient Satisfaction - statistics & numerical data Physicians, Family - statistics & numerical data Prevalence primary care physician Substance-Related Disorders - epidemiology Substance-Related Disorders - prevention & control Treatment Outcome withdrawal Withholding Treatment - statistics & numerical data |
| title | Chronic Daily Headache with Medication Overuse: A Randomized Follow-Up by Neurologist or PCP |
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