A 4-year follow-up of patients with medication-overuse headache previously included in a randomized multicentre study |
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Authors: | Knut Hagen Claus Albretsen Steinar T Vilming Rolf Salvesen Marit Grønning Grethe Helde Gøril Gravdahl John-Anker Zwart Lars Jacob Stovner |
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Institution: | 1.Department of Neuroscience, Faculty of Medicine,Norwegian University of Science and Technology,Trondheim,Norway;2.Department of Neurology, Faculty of Medicine, Norwegian National Headache Centre, St. Olavs Hospital,NTNU,Trondheim,Norway;3.Department of Neurology,Troms? University Hospital,Troms?,Norway;4.Department of Neurology, Oslo University Hospital, Ullevaal,University of Oslo,Oslo,Norway;5.Department of Neurology,Nordland Hospital,Bod?,Norway;6.Institute of Clinical Medicine,University of Troms?,Troms?,Norway;7.Department of Neurology,Haukeland University Hospital,Bergen,Norway |
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Abstract: | The aim of this study was to evaluate the long-term outcome in 61 patients with medication-overuse headache (MOH) who 4 years
previously had been included in a randomized open-label prospective multicentre study. Sixty patients still alive after 4 years
were invited to a follow-up investigation. Fifty patients (83%) participated. Sixteen visited a neurologist, 22 were interviewed
through telephone, 2 gave response by a letter, and 10 were evaluated through hospital records. The influence of baseline
characteristics on outcome 4 years later was evaluated by non-parametric tests. p values below 0.01 were considered significant. At follow-up, the 50 persons had a mean reduction of 6.5 headache days/month
(p < 0.001) and 9.5 acute headache medication days/month (p < 0.001) compared to baseline. Headache index/month was reduced from 449 to 321 (p < 0.001). Sixteen persons (32%) were considered as responders due to a ≥50% reduction in headache frequency from baseline,
whereas 17 (34%) persons met the criteria for MOH. None of the baseline characteristics consistently influenced all five outcome
measures. Total Hospital Anxiety and Depression Scale (HADS) score at baseline was predictors (p < 0.005) for being a responder after 4 years. At 4 years’ follow-up, one-third of the 50 MOH patients had ≥50% reduction
in headache frequency from baseline. A low total HADS score at baseline was associated with the most favorable outcome. |
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Keywords: | Medication-overuse headache Follow-up Outcome Predictors |
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