title: Chronic migraine with medication overuse: association between disability and quality of life measures, and impact of disease on patients' lives.
abstract: Patients with chronic migraine with medication overuse (CM-MO) have decreased quality of life (QoL) and increased disability: the degree to which these outcomes are connected to disease severity and the pattern of MO towards disease severity are unclear. Patients under withdrawal were administered the Migraine Disability Assessment (MIDAS), the WHO Disability Assessment Schedule (WHODAS), and the Migraine-Specific Quality of Life Questionnaire (MSQ). They overused NSAIDs, triptans, NSAIDs and triptans, and other drugs (ergotamine, caffeine, opioids/barbiturates). We calculated the correlations between MIDAS, WHODAS, and MSQ; compared WHODAS to normative scores; compared MIDAS, WHODAS, and MSQ in patients with different CM-MO severity; and run a logistic regression to predict CM-MO severity based on overused drugs. One hundred ninety-four patients were enrolled: correlations between WHODAS, MSQ, and MIDAS were moderate; wide differences on WHODAS against normative were found; and no trend was found across severity groups. Compared to triptans overusers, patients overusing NSAID and other drugs had higher odds of severe CM-MO. Coupling different disability measures with QoL assessment offered different insights on the lived experience of CM-MO. Future studies are needed to clarify the relationship between overused drugs and CM-MO severity: we added evidence that NSAIDs do not have protective effect in high-frequency CM-MO.
authors.affiliation: Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy. Electronic address: araggi@istituto-besta.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Raggi
authors.affiliation: Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Schiavolin
authors.affiliation: Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
authors.affiliation: Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
authors.forename: Ambra Mara
authors.initials: AM
authors.lastname: Giovannetti
authors.affiliation: Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Bussone
authors.affiliation: Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
authors.forename: Marcella
authors.initials: M
authors.lastname: Curone
authors.affiliation: Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Di Fiore
authors.affiliation: Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
authors.forename: Licia
authors.initials: L
authors.lastname: Grazzi
authors.affiliation: Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Usai
authors.affiliation: Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: D'Amico
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000139:chemically induced / Q000175:diagnosis*; D000067490:Prescription Drug Overuse / Q000009:adverse effects*; D011788:Quality of Life; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Chronic migraine; Detoxification; Disability; Health-related quality of life; Medication overuse; Withdrawal