title: Low income and education levels may cause medication overuse and chronicity in migraine patients.
abstract: BACKGROUND
  Frequent analgesic drug intake, especially in migraine patients, may induce the risk of medication overuse headache (MOH). The various conditions that may affect the development and the features of MOH have not been determined yet.
  
  
  OBJECTIVE
  To compare MOH patients with migraine as pre-existing headache and episodic migraine patients according to socioeconomic and educational variables.
  
  
  METHODS
  Forty-six MOH patients with migraine as pre-existing headache and 61 migraine patients were included into study. The headache characteristics, socioeconomic and educational variables of MOH and migraine groups and subgroups divided according to the education (low/high education subgroups), and income (low/high income subgroups) levels were evaluated.
  
  
  RESULTS
  We found that mean duration of education was shorter in MOH patients than migraine patients. There was a negative correlation between duration of education and duration of MOH. The mean duration of MOH was longer and rate of low-income level was higher in patients with low-education level. The duration of education was lower in MOH patients with low income. The frequency of migraine attacks and low-income rate was also higher in low-educated migraine patients. The duration of education was shorter in migraine patients with low income.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurology, Zonguldak Karaelmas University Faculty of Medicine, Zonguldak, Turkey.
authors.forename: Huseyin Tugrul
authors.initials: HT
authors.lastname: Atasoy
authors.forename: Aysun Eroglu
authors.initials: AE
authors.lastname: Unal
authors.forename: Nuray
authors.initials: N
authors.lastname: Atasoy
authors.forename: Ufuk
authors.initials: U
authors.lastname: Emre
authors.forename: Murat
authors.initials: M
authors.lastname: Sumer
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000009:adverse effects; D002908:Chronic Disease; D004522:Educational Status; D005260:Female; D020773:Headache Disorders / Q000209:etiology*; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000700:Analgesics