Todd J Schwedt1, Joseph G Hentz1, Soma Sahai-Srivastava2, Nicole M Spare3, Vincent T Martin4, Christina Treppendahl5, Kathleen Digre6, Nathan L Bennett7, Marius Birlea8, David Watson9, Natalia Murinova10, Teri Robert11, David W Dodick1. 1. Department of Neurology, Mayo Clinic, Phoenix, AZ, USA. 2. Department of Neurology, University of Southern California, Los Angeles, CA, USA. 3. Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. 4. Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA. 5. The Headache Center, Ridgeland, MS, USA. 6. Department of Neurology, University of Utah, Salt Lake City, UT, USA. 7. Preferred Primary Care Physicians, Pittsburgh, PA, USA. 8. Department of Neurology, University of Colorado, Denver, CO, USA. 9. Department of Neurology, West Virginia University, Morgantown, WV, USA. 10. Department of Neurology, University of Washington, Seattle, WA, USA. 11. Patient Advocate and Educator, Washington, WV, USA.
Abstract
OBJECTIVE: To describe headache characteristics, medication use, disability, and quality of life in a large patient cohort from the United States who have chronic migraine (CM) and medication overuse headache (MOH). METHODS: In all, 610 adult patients were enrolled into the Medication Overuse Treatment Strategy trial from 34 healthcare clinics, including headache specialty, general neurology, and primary care clinics. Descriptive statistics characterize baseline demographics, headache characteristics, medication use, disability (Headache Impact Test 6 [HIT-6] and Migraine Functional Impact Questionnaire [MFIQ]), pain interference (PROMIS Pain Interference), and quality of life (EQ-5D-5L). Relationships with headache frequency were assessed. RESULTS: Mean age was 45 years (SD 13) and 531/608 (87.3%) were females. Mean headache days per 30 was 24.3 (SD 5.5), including 13.6 (SD 7.1) with moderate to severe headache. Daily headaches were reported by 36.1% (219/607) of patients. Acute headache medications were used on 21.5 (SD 7.5) per 30 days. The most commonly overused medications were simple analgesics (378/607, 62% of patients), combination analgesics (246/607, 41%), and triptans (128/607, 21%). HIT-6, MFIQ, PROMIS Pain Interference, and EQ-5D-5L scores demonstrated substantial negative impact from CM with MOH on patient functioning and quality of life. Higher headache frequency was associated with more moderate-severe headache days, more frequent acute headache medication use, greater headache-related disability, and lower quality of life. Only 272/606 (44.9%) were taking migraine preventive medication. CONCLUSIONS: CM with MOH is associated with a large burden on patients in the United States. Higher headache frequency is associated with greater impact on functioning, pain interference, and quality of life.
OBJECTIVE: To describe headache characteristics, medication use, disability, and quality of life in a large patient cohort from the United States who have chronic migraine (CM) and medication overuse headache (MOH). METHODS: In all, 610 adult patients were enrolled into the Medication Overuse Treatment Strategy trial from 34 healthcare clinics, including headache specialty, general neurology, and primary care clinics. Descriptive statistics characterize baseline demographics, headache characteristics, medication use, disability (Headache Impact Test 6 [HIT-6] and Migraine Functional Impact Questionnaire [MFIQ]), pain interference (PROMIS Pain Interference), and quality of life (EQ-5D-5L). Relationships with headache frequency were assessed. RESULTS: Mean age was 45 years (SD 13) and 531/608 (87.3%) were females. Mean headache days per 30 was 24.3 (SD 5.5), including 13.6 (SD 7.1) with moderate to severe headache. Daily headaches were reported by 36.1% (219/607) of patients. Acute headache medications were used on 21.5 (SD 7.5) per 30 days. The most commonly overused medications were simple analgesics (378/607, 62% of patients), combination analgesics (246/607, 41%), and triptans (128/607, 21%). HIT-6, MFIQ, PROMIS Pain Interference, and EQ-5D-5L scores demonstrated substantial negative impact from CM with MOH on patient functioning and quality of life. Higher headache frequency was associated with more moderate-severe headache days, more frequent acute headache medication use, greater headache-related disability, and lower quality of life. Only 272/606 (44.9%) were taking migraine preventive medication. CONCLUSIONS: CM with MOH is associated with a large burden on patients in the United States. Higher headache frequency is associated with greater impact on functioning, pain interference, and quality of life.
Authors: Lynda J Krasenbaum; Vasantha L Pedarla; Stephen F Thompson; Krishna Tangirala; Joshua M Cohen; Maurice T Driessen Journal: J Headache Pain Date: 2022-05-04 Impact factor: 8.588
Authors: Robert P Cowan; Michael J Marmura; Hans-Christoph Diener; Amaal J Starling; Jack Schim; Joe Hirman; Thomas Brevig; Roger Cady Journal: J Headache Pain Date: 2022-09-06 Impact factor: 8.588