title: GPs' experiences with brief intervention for medication-overuse headache: a qualitative study in general practice.
abstract: BACKGROUND
  Medication-overuse headache (MOH) is common in the general population, and most patients are managed in primary health care. Brief Intervention (BI) has been used as a motivational technique for patients with drug and alcohol overuse, and may a have role in the treatment of MOH.
  
  
  OBJECTIVE
  To explore GPs' experiences using BI in the management of patients with MOH.
  
  
  METHODS
  Qualitative study in Norwegian general practice.
  
  
  METHODS
  Data were collected through four focus group interviews with 22 GPs who participated in an intervention study on BI for MOH. Systematic text condensation was used to analyse transcripts from the focus group interviews.
  
  
  RESULTS
  The GPs experienced challenges when trying to convince patients that the medication they used to treat and prevent headache could cause headache, but labelling MOH as a diagnosis opened up a space for change. GPs were able to use BI within the scope of a regular consultation, and they thought that the structured approach had a potential to change patients' views about their condition and medication use. Being diagnosed with medication overuse could bring about feelings of guilt in patients, and GPs emphasised that a good alliance with the patient was necessary for successful change using BI to manage MOH.
  
  
  CONCLUSIONS
  GPs experience BI as a feasible strategy to treat MOH, and the technique relies on a good alliance between the doctor and patient. When using BI, GPs must be prepared to counter patients' misconceptions about medication used for headache.
authors.affiliation: Institute of Health and Society, University of Oslo, Oslo, Norway.
authors.forename: Jan C
authors.initials: JC
authors.lastname: Frich
authors.affiliation: Department of General Practice, Institute of Health and Society, University of Oslo, Oslo; HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Espen Saxhaug
authors.initials: ES
authors.lastname: Kristoffersen
authors.affiliation: HØKH, Research Centre, Akershus University Hospital, Lørenskog; Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen; Department of Neurology, Akershus University Hospital, Nordbyhagen, Norway.
authors.forename: Christofer
authors.initials: C
authors.lastname: Lundqvist
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D017144:Focus Groups; D058006:General Practice / Q000379:methods; D051271:Headache Disorders, Secondary / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010353:Patient Education as Topic; D036301:Qualitative Research
keywords: analgesic/adverse effects; headache disorder, secondary; primary care, qualitative study