• R B Grande, K Aaseth, J Š Benth, C Lundqvist, and M B Russell.
• Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog Faculty Division Akershus University Hospital, University of Oslo, Norway.
• Eur. J. Neurol. 2011 Jan 1; 18 (1): 129-37.

Objectiveour aim was to investigate the course of medication-overuse headache in the general population and the effect of simple advice regarding medication overuse.Designprospective cohort study. Participants were identified in a cross-sectional epidemiological sample of 30000 persons aged 30-44 from the general Norwegian population. People with chronic headache (≥ 15 days per month for at least 3 months) and medication overuse received short information about the possible role of medication overuse in headache chronification. A cohort was followed up 1½ years later. The diagnostic criteria of the International Classification of Headache Disorders and data splitting methodology were used.SettingAkershus University Hospital, Oslo, Norway.Participantsa total of 109 participants with chronic primary headache and medication overuse were available for follow-up (85% participation rate).Main Outcome Measure  Change in medication days and headache days per month.Resultsat baseline chronic tension-type headache was found in 92% of participants; 8% had chronic migraine or new daily persistent headache. Migraine co-occurrence was found in 53%. The mean duration of chronic headaches were 8-18 years, the mean duration of medication overuse between 5 and 10 years prior to intervention. At follow up, the mean medication days were significantly reduced from 22 days to 6 days per month, and 76% no longer had medication overuse. Forty-two percent no longer had chronic headache and the headache index was reduced by 24%.Conclusionour examination and short information served as a modified brief intervention which can improve chronic headache and medication overuse in the general population.

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