Reduction in medication-overuse headache after short information. The Akershus study of chronic headache.
OBJECTIVE
our aim was to investigate the course of medication-overuse headache in the general population and the effect of simple advice regarding medication overuse.


METHODS
prospective cohort study. Participants were identified in a cross-sectional epidemiological sample of 30000 persons aged 30-44 from the general Norwegian population. People with chronic headache (≥ 15 days per month for at least 3 months) and medication overuse received short information about the possible role of medication overuse in headache chronification. A cohort was followed up 1½ years later. The diagnostic criteria of the International Classification of Headache Disorders and data splitting methodology were used.


METHODS
Akershus University Hospital, Oslo, Norway.


METHODS
a total of 109 participants with chronic primary headache and medication overuse were available for follow-up (85% participation rate).


METHODS
Change in medication days and headache days per month.


RESULTS
at baseline chronic tension-type headache was found in 92% of participants; 8% had chronic migraine or new daily persistent headache. Migraine co-occurrence was found in 53%. The mean duration of chronic headaches were 8-18 years, the mean duration of medication overuse between 5 and 10 years prior to intervention. At follow up, the mean medication days were significantly reduced from 22 days to 6 days per month, and 76% no longer had medication overuse. Forty-two percent no longer had chronic headache and the headache index was reduced by 24%.


CONCLUSIONS
our examination and short information served as a modified brief intervention which can improve chronic headache and medication overuse in the general population.
Grande
R B
RB
Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog Faculty Division Akershus University Hospital, University of Oslo, Norway.
Aaseth
K
K
Benth
J Š
JŠ
Lundqvist
C
C
Russell
M B
MB
D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D051271:Headache Disorders, Secondary / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D009664:Norway / Q000453:epidemiology; D010353:Patient Education as Topic; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D018781:Tension-Type Headache / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*