• Ninett Louise Find, Rossana Terlizzi, Signe Bruun Munksgaard, Lars Bendtsen, Cristina Tassorelli, Giuseppe Nappi, Zaza Katsarava, Miguel Lainez, Maria Teresa Goicochea, Beatriz Shand, Ricardo Fadic, Santiago Spadafora, Marco Pagani, Rigmor Jensen, and COMOESTAS Consortium.
• Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark.
• J Headache Pain. 2015 Jan 1; 17: 2020.

BackgroundMedication overuse headache (MOH) is a very disabling and costly disorder due to indirect costs, medication and healthcare utilization. The aim of the study was to describe general demographic and clinical characteristics of MOH, along with the national referral pathways and national painkillers distribution in several European and Latin American (LA) Countries.MethodsThis descriptive cross-sectional observational study included 669 patients with MOH referred to headache-centers in Europe and LA as a part of the COMOESTAS project. Information about acute medication and healthcare utilization were collected by extensive questionnaires, supplemented with structured patient interviews.ResultsTriptans were overused by 31 % European patients and by 6 % in LA (p < 0.001), whereas ergotamines were overused by 4 % in Europe and 72 % in LA (p < 0.001). Simple analgesics were overused by 54 % in Europe and by 33 % in LA (p < 0.001), while combination-analgesics were more equally overused (24 % in Europe and 29 % in LA). More European patients (57 %) compared with LA patients (27 %) visited general practitioners (p < 0.001), and 83 % of European patients compared to 38 % in LA consulted headache specialists (p < 0.001). A total of 20 % in Europe and 30 % in LA visited emergency rooms (p = 0.007).ConclusionThere are marked variations between LA and Europe in healthcare pathways and in acute medication overuse regarding patients with MOH. This should be considered when planning prevention campaigns against MOH.

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