title: The heterogeneity of headache patients who self-medicate: a cluster analysis approach.
abstract: Patients with headache often self-treat their condition with over-the-counter analgesics. However, overuse of analgesics can cause medication-overuse headache. The present study aimed to identify subgroups of individuals with headache who self-medicate, as this could be helpful to tailor intervention strategies for prevention of medication-overuse headache. Patients (n = 1021) were recruited from 202 community pharmacies and completed a self-administered questionnaire. A hierarchical cluster analysis was used to group patients as a function of sociodemographics, pain, disability, and medication use for pain. Three patient clusters were identified. Cluster 1 (n = 498, 48.8%) consisted of relatively young individuals, and most of them suffered from migraine. They reported the least number of other pain complaints and the lowest prevalence of medication overuse (MO; 16%). Cluster 2 (n = 301, 29.5%) included older persons with mainly non-migraine headache, a low disability, and on average pain in 2 other locations. Prevalence of MO was 40%. Cluster 3 (n = 222, 21.7%) mostly consisted of patients with migraine who also report pain in many other locations. These patients reported a high disability and a severe limitation of activities. They also showed the highest rates of MO (73%).
authors.affiliation: Pharmaceutical Care Unit, Ghent University, Ghent, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Mehuys
authors.affiliation: Department of Neurology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Paemeleire
authors.affiliation: Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
authors.forename: Geert
authors.initials: G
authors.lastname: Crombez
authors.affiliation: Pharmaceutical Care Unit, Ghent University, Ghent, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Adriaens
authors.affiliation: CIRM, Clinical Pharmacy Unit, University of Liege, Liege, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Van Hees
authors.affiliation: CIRM, Clinical Pharmacy Unit, University of Liege, Liege, Belgium.
authors.forename: Sophie
authors.initials: S
authors.lastname: Demarche
authors.affiliation: Department of Family Medicine and Primary Health Care and Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Christiaens
authors.affiliation: Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Van Bortel
authors.affiliation: Pharmaceutical Care Unit, Ghent University, Ghent, Belgium.
authors.forename: Inge
authors.initials: I
authors.lastname: Van Tongelen
authors.affiliation: Pharmaceutical Care Unit, Ghent University, Ghent, Belgium.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Remon
authors.affiliation: Pharmaceutical Care Unit, Ghent University, Ghent, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Boussery
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000009:adverse effects* / Q000627:therapeutic use; D016000:Cluster Analysis; D006233:Persons with Disabilities; D005260:Female; D006261:Headache / Q000188:drug therapy*; D051271:Headache Disorders, Secondary / Q000139:chemically induced / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D015995:Prevalence; D012651:Self Medication; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics