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Disability, anxiety and depression in patients with medication‐overuse headache in primary care – the BIMOH study
Author(s) -
Kristoffersen E. S.,
Straand J.,
Russell M. B.,
Lundqvist C.
Publication year - 2016
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12850
Subject(s) - medicine , anxiety , depression (economics) , hospital anxiety and depression scale , population , randomized controlled trial , physical therapy , psychiatry , pediatrics , environmental health , economics , macroeconomics
Background and purpose Medication‐overuse headache ( MOH ) is common in the general population. Detoxification is the general treatment principle for MOH . The present paper is based on a study of a brief intervention ( BI ) for MOH in primary care. New data on headache disability and the Hospital Anxiety and Depression Scale ( HADS ) for MOH patients compared to population controls with and without chronic headache are presented and compared to previously published main outcome data. Methods This was a double‐blind pragmatic cluster randomized controlled trial carried out amongst 50 general practitioners in Norway. The BI was compared to business as usual ( BAU ) and population controls, and patients were followed up after 3 months. Primary outcomes were headache and medication days per month after 3 months. Headache disability and HADS were also measured as secondary outcomes. Results Sixty MOH patients and 40 population controls were included. BI was significantly better than BAU after 3 months regarding primary outcomes. Non‐intervention population controls did not change. The MOH patients had significantly higher headache disability and anxiety scores than the population controls. Conclusions Patients with MOH are a highly disabled group where anxiety and depression are important comorbidities. Detoxification of MOH by a BI in primary care is effective and has potential for saving resources for more treatment‐resistant cases in neurologist care.