Chronic use of symptomatic headache medications.
Chronic use of symptomatic headache medication is believed to be a risk factor for drug-induced chronic headache. This study reports the frequency of chronic use of symptomatic headache medications implicated in drug-induced chronic headache among primary-care headache (PCH) patients and identifies predictors of chronic/frequent use. The design uses a 2-year cohort study of a sample of PCH patients in Group Health Cooperative of Puget Sound, a large health maintenance organization in Seattle, WA. Among 779 PCH patients (aged 18-74 years) interviewed at baseline, 662 (85%) completed both 1- and 2-year follow-up interviews. This study estimates the percent of PCH patients reporting: (1) frequent use of over-the-counter, non-steroidal anti-inflammatory, opioid, sedative-hypnotic, and ergot medications (defined as 14 or more days of use for each class in the prior month), (2) chronic/frequent use of these medications, defined as surpassing criteria for frequent use on at least 2 of the 3 study interviews, and (3) chronic/frequent polypharmacy, defined as chronic/frequent use of 2 or more classes of headache medication. Twenty-one percent of PCH patients were chronic/frequent users of symptomatic headache medications, while 2.6% met study criteria for chronic/frequent polypharmacy. Chronic/frequent use of over-the-counter medications (15.9%) was twice as common as chronic/frequent use of prescription medications (7.7%). Headache days at baseline was the strongest predictor of chronic/frequent medication use. After controlling for baseline persistence and severity, older patients were more likely to be chronic/frequent users of headache medications. The age effect was explained by chronic/frequent use of over-the-counter medications.(ABSTRACT TRUNCATED AT 250 WORDS)
Korff
Michael Von
MV
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA 98101, USA University of Washington School of Medicine, Seattle, WA 98195, USA Division of Applied Health Care Research, Glaxo, Research Triangle Park, NC, USA.
Galer
Bradley S
BS
Stang
Paul
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D004878:Ergotamine / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000188:drug therapy*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013997:Time Factors
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006993:Hypnotics and Sedatives; D004878:Ergotamine