Holding on to the indispensable medication –A grounded theory on medication use from the perspective of persons with medication overuse headache

Abstract

BackgroundMedication overuse headache (MOH) is a chronic headache disorder, caused by overuse of acute medication. To date, it remains unclear why some people overuse these medications. The aim of this qualitative study was to explore how individuals with MOH use medications and other strategies to manage headaches in their daily lives, and their thoughts about their own use of acute medication. Our intention was to develop a theoretical model about the development of MOH, from the perspective of those with MOH.MethodsData collection and analysis were conducted according to grounded theory methodology. The participants were recruited via newspaper advertisements. Fourteen persons with MOH were interviewed in individual qualitative interviews.ResultsThe basic process leading to medication overuse was holding on to the indispensable medication. The acute medication was indispensable to the participants because they perceived it as the only thing that could prevent headaches from ruining their lives. The participants perceived headaches as something that threatened to ruin their lives. As a result, they went to great lengths trying to find ways to manage it. They tried numerous strategies. However, the only strategy actually perceived as effective was the use of acute medication and they eventually became resigned to the idea that it was the only effective aid. The acute medication thus became indispensable. Their general intention was to use as little medication as possible but they found themselves compelled to medicate frequently to cope with their headaches. They did not like to think about their medication use and sometimes avoided keeping track of the amount used.ConclusionsThis qualitative study adds understanding to the process via which MOH develops from the perspective of those having MOH. Such knowledge may help bridge the gap between the perspectives of patients and health-care professionals.

The Many Faces of Medication‐Overuse Headache in Clinical Practice

“…Assessing the impact of medication overuse is important. Some patients overuse analgesics out of fear of the negative consequences of headache 72 . Others may simply add the daily and multiple use of acute medications in their routines to function through life.…”

Living with chronic migraine: a qualitative study on female patients' perspectives from a specialised headache clinic in Spain

“… 17–20 It has also been applied to the analysis of patients’ expectations of the healthcare system and different therapeutic resources, including alternative therapies, and control strategies adopted by the patients themselves. 21–27 However, no qualitative study to date has focused on CM, the most debilitating form of migraine. By using qualitative methods, we aimed to answer the following research question: ‘what is the lived experience of patients with CM?’.…”

Living With Cluster Headache: A Qualitative Study of Patients’ Perspectives

“…Headache experience and management is highly individual, and qualitative research (QR) can provide a more holistic picture that may be more meaningful to practitioners . QR has already been used to study the experiences of patients with migraine, general practitioners’ approach to the diagnosis of headache, and factors and behaviors related to acute headache medication . In contrast, there are no previous studies describing the experience of patients with CH, except for a letter published in Headache by Mr. Vaughan, an American lawyer afflicted by the disease, and a few patient histories published in books or on the internet…”

“…8,9 QR has already been used to study the experiences of patients with migraine, 10,11 general practitioners' approach to the diagnosis of headache, 12 and factors and behaviors related to acute headache medication. 13,14 In contrast, there are no previous studies describing the experience of patients with CH, except for a letter published in Headache by Mr. Vaughan, an American lawyer afflicted by the disease, 15 and a few patient histories published in books or on the internet. 16,17 The purpose of this study was to explore the experience and perspective of a group of Spanish men suffering from CH with qualitative methods.…”