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Multimorbidity in patients with chronic migraine and medication overuse headache
Author(s) -
D'Amico Domenico,
Sansone Emanuela,
Grazzi Licia,
Giovannetti Ambra M.,
Leonardi Matilde,
Schiavolin Silvia,
Raggi Alberto
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13014
Subject(s) - migraine , medicine , chronic migraine , pediatrics , physical therapy
Objectives Patients with chronic migraine ( CM ) display a considerable amount of comorbidities, particularly psychiatric and cardiovascular, and the presence of multiple comorbidities, that is, the so‐called multimorbidity, is a risk factor for migraine chronification or maintenance of CM . Our aim was to address the rate and impact of multimorbidity in patients with CM and medication overuse headache ( MOH ). Materials & Methods In a sample of patients with CM attending a structured withdrawal for coexisting MOH , we defined multimorbidity as the presence of two or more conditions in addition to CM ‐ MOH . We compared patients with and without multimorbidity for demographic and clinical variables, quality of life, and disability; we also tested whether patients with multimorbidity had higher likelihood to attend emergency room, relapse into CM , and require further withdrawal treatments by 12 months. Results One hundred and ninety‐four patients were enrolled as follows: 61% had at least one comorbidity, the most common being mental (34%), circulatory (18%), and endocrine conditions (13%); 32% were multimorbidity cases. Patients with multimorbidity had higher headaches frequency, older age, lower education and lower employment rates, higher disability and lower QoL. They were more frequently opioids/barbiturates overusers and were more likely to attend ER ( OR : 2.36), relapse into CM ( OR : 2.19), and undergo another withdrawal ( OR : 2.75) by 12 months after discharge, after controlling for age, gender, years of education, and headache frequency. Conclusions Recognizing multimorbidity in patients with CM ‐ MOH is important to enhance the management of these complex patients, who are at risk of polypharmacy and increased health care utilization.