title: The added value of an electronic monitoring and alerting system in the management of medication-overuse headache: A controlled multicentre study.
abstract: Background Medication-overuse headache (MOH) is a chronic disabling condition associated with a high rate of relapse. Methods We evaluated whether the adoption of electronic-assisted monitoring, advice and communication would improve the outcome over a follow-up of 6 months in a controlled, multicentre, multinational study conducted in six headache centres located in Europe and Latin America. A total of 663 MOH subjects were enrolled and divided into two groups: the Comoestas group was monitored with an electronic diary associated with an alert system and a facilitated communication option, and the Classic group with a paper headache diary. Results We observed a significantly higher percentage of overuse-free subjects in the Comoestas group compared with the Classic group: 73.1 vs 64.1% (odds ratio 1.45, 95% confidence interval 1.07-2.09, p = 0.046). The Comoestas group performed better also regarding the number of days/month with intake of acute drugs and the level of disability [Migraine Disability Assessment Score: Comoestas group - 42.5 ± 53.6 (35.5-49.3) and Classic group - 27.5 ± 56.1 (20.6-34.3) ( p < 0.003)]. Conclusion The adoption of the electronic tool improved the outcome of patients suffering from MOH after withdrawal from overused drugs. Information and communication technology represents a valid aid for optimizing the management of chronic conditions at risk of worsening or of relapsing. Trial registration The trial was registered at ClinicalTrials.gov (no. NCT02435056).
authors.affiliation: 1 Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy.|2 Department of Brain and Behavioral Sciences, University of Pavia, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Tassorelli
authors.affiliation: 3 Danish Headache Centre, Department of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Denmark.
authors.forename: Rigmor
authors.initials: R
authors.lastname: Jensen
authors.affiliation: 1 Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Allena
authors.affiliation: 1 Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy.|2 Department of Brain and Behavioral Sciences, University of Pavia, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: De Icco
authors.affiliation: 4 Department of Neurology, University of Essen, Germany.
authors.forename: Zaza
authors.initials: Z
authors.lastname: Katsarava
authors.affiliation: 5 Foundation of the Valencian Community, University Clinical Hospital, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Miguel Lainez
authors.affiliation: 6 Foundation for Combatting Neurological Diseases of Childhood, Buenos Aires, Argentina.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Leston
authors.affiliation: 7 Department of Neurology, Pontificia Catolica University of Chile, Santiago, Chile.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Fadic
authors.affiliation: 8 ISalud University, Buenos Aires, Argentina.
authors.forename: Santiago
authors.initials: S
authors.lastname: Spadafora
authors.affiliation: 9 Bioengeneering and Medical Informatics Consortium (CBIM), Pavia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pagani
authors.affiliation: 1 Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nappi
mesh_terms: D000328:Adult; D005260:Female; D051271:Headache Disorders, Secondary / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008499:Medical Records; D063731:Mobile Applications; D017060:Patient Satisfaction; D012008:Recurrence; D019114:Remote Consultation / Q000379:methods*
keywords: Electronic diary; information and communication technology; outcome; relapses