Low Income and Education Levels May Cause Medication Overuse and Chronicity in Migraine Patients

Atasoy, H. Tuğrul; Ünal, Aysun; Atasoy, Nuray; Emre, Ufuk; Sümer, Murat

doi:10.1111/j.1526-4610.2005.05006.x

Cited by 39 publications

(35 citation statements)

References 38 publications

(83 reference statements)

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“…Still, the most likely reason is that primary headache disorders in general, and migraine in particular, are more common in women (8), and these are the principal risk factors for MOH since an antecedent headache is a necessary precondition. With regard to gender differences noted in this study, women had significantly lower incomes than men, and lower income has been noted as a risk factor for medication overuse and for headache chronicity (21). While relative poverty of a particular demographic group may affect health across populations, it seems unlikely to do so between genders, at least among those living within families who, presumably, share their income.…”

Section: Discussionmentioning

confidence: 85%

Medication-overuse headache in China: Clinical profile, and an evaluation of the ICHD-3 beta diagnostic criteria

et al. 2014

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Section: Discussionmentioning

confidence: 85%

Medication-overuse headache in China: Clinical profile, and an evaluation of the ICHD-3 beta diagnostic criteria

et al. 2014

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“…As for other frequent headaches, MOH patients tend to be of low socioeconomic status with low income and education, but it is uncertain whether this may be a cause of or an effect of headache 40,42,61,74,75. A high prevalence of smoking, elevated body mass index, and sleeping problems have also been found among MOH patients 42,44.…”

Section: Risk Factors For Mohmentioning

confidence: 99%

Medication-overuse headache: a review

Kristoffersen

Lundqvist²

2014

JPR

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Medication-overuse headache (MOH) is a worldwide health problem with a prevalence of 1%–2%. It is a severe form of headache where the patients often have a long history of headache and of unsuccessful treatments. MOH is characterized by chronic headache and overuse of different headache medications. Through the years, withdrawal of the overused medication has been recognized as the treatment of choice. However, currently, there is no clear consensus regarding the optimal strategy for management of MOH. Treatment approaches are based on expert opinion rather than scientific evidence. This review focuses on aspects of epidemiology, diagnosis, pathogenesis, prevention, and treatment of MOH. We suggest that information and education about the risk of MOH is important since the condition is preventable. Most patients experience reduction of headache days and intensity after successful treatment. The first step in the treatment of MOH should be carried out in primary care and focus primarily on withdrawal, leaving prophylactic medication to those who do not manage primary detoxification. For most patients, a general practitioner can perform the follow-up after detoxification. More complicated cases should be referred to neurologists and headache clinics. Patients suffering with MOH have much to gain by an earlier treatment-focused approach, since the condition is both preventable and treatable.

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“…Neither of these features have been correlated with migraine prevalence and consultation patterns [14,15], whereas they might represent risk factors for medication overuse and chronicity [16]. In this regard, Rasmussen showed that none of the sociodemographic variables: marital status, cohabitation, educational level, occupational category or employment status were significantly associated with migraine [13].…”

Section: Discussionmentioning

confidence: 96%

The effects of a sensitisation campaign on unrecognised migraine: the Casilino study

et al. 2007

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A striking feature of migraine is the difference between the estimated migraine prevalence and the actual number of migraineurs consulting their general practitioners (GPs). We investigated the impact of a sensitisation campaign on migraine in a large cohort of patients, living in a district of Rome. The study involved 10 GPs and a population of about 12 000 people, contacted by mail and posters located in GP clinics. Both the letter and poster stressed the impact of headache on quality of life and included the Italian version of the three-item Identification of Migraine (ID Migraine) screening test, consisting of questions on disability, nausea and photophobia. If the subjects suffered from headaches, they were invited to contact their GPs for a visit and a free consultation with a headache expert. By means of this sensitisation campaign, 195 headache patients consulted their GPs. Ninety-two percent of them (n=179) were migraineurs; 73% of them had never consulted a physician for headache. The ID Migraine test had a sensitivity of 0.92 (95% CI 0.86–0.95), a specificity of 0.75 (95% CI 0.47–0.91) and a positive predictive value (PPV) of 0.97 (95% CI 0.93–0.99) for a clinical diagnosis of migraine, according to the International Headache Society (IHS) criteria. This study confirms that a large number of migraine patients never see a doctor for their headache. This awareness campaign is likely to identify the severest cases of undiagnosed migraineurs. However, mailing campaigns do not seem to be so effective in bringing undiagnosed migraine patients into the primary care setting, and more efficient strategies have to be planned.

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Low Income and Education Levels May Cause Medication Overuse and Chronicity in Migraine Patients

Abstract: We report that migraineurs with low socioeconomic status may have risk of developing MOH. A better identification of patients at risk of drug-associated headache may contribute to improved health in a group of patients with MOH.

Cited by 39 publications

References 38 publications

Medication-overuse headache in China: Clinical profile, and an evaluation of the ICHD-3 beta diagnostic criteria

Medication-overuse headache in China: Clinical profile, and an evaluation of the ICHD-3 beta diagnostic criteria

Medication-overuse headache: a review

The effects of a sensitisation campaign on unrecognised migraine: the Casilino study

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