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Pragmatic Clinical Trial
Disability, anxiety and depression in patients with medication-overuse headache in primary care - the BIMOH study.
- E S Kristoffersen, J Straand, M B Russell, and C Lundqvist.
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
- Eur. J. Neurol. 2016 Jan 1; 23 Suppl 1: 28-35.
Background And PurposeMedication-overuse headache (MOH) is common in the general population. Detoxification is the general treatment principle for MOH. The present paper is based on a study of a brief intervention (BI) for MOH in primary care. New data on headache disability and the Hospital Anxiety and Depression Scale (HADS) for MOH patients compared to population controls with and without chronic headache are presented and compared to previously published main outcome data.MethodsThis was a double-blind pragmatic cluster randomized controlled trial carried out amongst 50 general practitioners in Norway. The BI was compared to business as usual (BAU) and population controls, and patients were followed up after 3 months. Primary outcomes were headache and medication days per month after 3 months. Headache disability and HADS were also measured as secondary outcomes.ResultsSixty MOH patients and 40 population controls were included. BI was significantly better than BAU after 3 months regarding primary outcomes. Non-intervention population controls did not change. The MOH patients had significantly higher headache disability and anxiety scores than the population controls.ConclusionsPatients with MOH are a highly disabled group where anxiety and depression are important comorbidities. Detoxification of MOH by a BI in primary care is effective and has potential for saving resources for more treatment-resistant cases in neurologist care.© 2015 EAN.
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