title: A CARE: pathway in medication-overuse headache: the experience of the Headache Centre in Pavia.
abstract: Medication-overuse headache (MOH) is one of the headache forms that most frequently prompts patients to consult a specialist headache centre. The prevalence of this form in the general population is approximately 1-2%. Around 40% of patients seen at headache centres present with a chronic form of headache and 80% of this chronic headache patients make excessive use of symptomatic drugs. MOH shows a clinical improvement, accompanied by a reduction in the consumption of analgesic drugs, if patients are submitted to detoxification therapy. But detoxification is only the first stage in a long and complex course of care and global approach demands adequate follow-up visit to prevent early relapses. At the Headache Centre of the C. Mondino Institute of Neurology in Pavia, a course of care (CARE: ) has been developed for the complete management of patients with MOH both during Hospitalization and during the subsequent follow-up period. CARE: IS designed to trace the clinical, psychopathological and pharmacological profile of MOH in the short-, medium- and long-term; to look for factors possibility predictive of relapse; to assess the direct costs linked to overuse-headache in the year leading up to and following detoxification; and to evaluate disability, in terms of working days lost, before and after detoxification.
authors.affiliation: Headache Unit, IRCCS, Institute of Neurology C. Mondino Foundation, Via Mondino 2, I-27100, Pavia, Italy. gracia.sances@mondino.it
authors.forename: Grazia
authors.initials: G
authors.lastname: Sances
authors.forename: Natascia
authors.initials: N
authors.lastname: Ghiotto
authors.forename: Marianna
authors.initials: M
authors.lastname: Loi
authors.forename: Elena
authors.initials: E
authors.lastname: Guaschino
authors.forename: Enrico
authors.initials: E
authors.lastname: Marchioni
authors.forename: Teresa
authors.initials: T
authors.lastname: Catarci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nappi
mesh_terms: D000328:Adult; D000700:Analgesics / Q000009:adverse effects*; D005260:Female; D006261:Headache / Q000139:chemically induced* / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009462:Neurology / Q000458:organization & administration*; D010349:Patient Compliance; D015397:Program Evaluation
chemical_list: D000700:Analgesics