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Reduction in medication-overuse headache after short information. The Akershus study of chronic headache

Authors

  • R. B. Grande,

    1. Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog
    2. Faculty Division Akershus University Hospital, University of Oslo, Nordbyhagen
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  • K. Aaseth,

    1. Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog
    2. Faculty Division Akershus University Hospital, University of Oslo, Nordbyhagen
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  • J. Š. Benth,

    1. Faculty Division Akershus University Hospital, University of Oslo, Nordbyhagen
    2. HØKH, Research Centre, Akershus University Hospital, Lørenskog
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  • C. Lundqvist,

    1. Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog
    2. HØKH, Research Centre, Akershus University Hospital, Lørenskog
    3. Department of Neurology, Ullevål University Hospital, Oslo, Norway
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  • M. B. Russell

    1. Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog
    2. Faculty Division Akershus University Hospital, University of Oslo, Nordbyhagen
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Christofer Lundqvist, MD, PhD, HØKH, Research Centre, Akershus University Hospital, 1478 Lørenskog, Oslo, Norway (tel.: +47 47278881; fax: +47 67968860; e-mail: a.c.lundqvist@medisin.uio.no).

Abstract

Objective:  Our aim was to investigate the course of medication-overuse headache in the general population and the effect of simple advice regarding medication overuse.

Design:  Prospective cohort study. Participants were identified in a cross-sectional epidemiological sample of 30 000 persons aged 30–44 from the general Norwegian population. People with chronic headache (≥15 days per month for at least 3 months) and medication overuse received short information about the possible role of medication overuse in headache chronification. A cohort was followed up 1½ years later. The diagnostic criteria of the International Classification of Headache Disorders and data splitting methodology were used.

Setting:  Akershus University Hospital, Oslo, Norway.

Participants:  A total of 109 participants with chronic primary headache and medication overuse were available for follow-up (85% participation rate).

Main outcome measure:  Change in medication days and headache days per month.

Results:  At baseline chronic tension-type headache was found in 92% of participants; 8% had chronic migraine or new daily persistent headache. Migraine co-occurrence was found in 53%. The mean duration of chronic headaches were 8–18 years, the mean duration of medication overuse between 5 and 10 years prior to intervention. At follow up, the mean medication days were significantly reduced from 22 days to 6 days per month, and 76% no longer had medication overuse. Forty-two percent no longer had chronic headache and the headache index was reduced by 24%.

Conclusion:  Our examination and short information served as a modified brief intervention which can improve chronic headache and medication overuse in the general population.

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