Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates: A systematic review

Westergaard, M.; Hansen, Ebba Holme; Glümer, Charlotte; Olesen, Jes; Jensen, Rigmor Højland

doi:10.1177/0333102413512033

Cited by 136 publications

(123 citation statements)

References 101 publications

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“…TTH, despite being the second most prevalent disorder in the world (behind dental caries) [7], adds much less to population disability estimates because a low disability weight of 0.036 (on a scale of 0–1) is accorded to the headache of TTH compared with 0.434 for the ictal state of migraine [17]. MOH is recognised as far more disabling at an individual level but, with its prevalence still very poorly estimated in many regions [18, 19], it stays ranked as 18 th cause of YLDs in GBD 2015 [15]. …”

Section: How Much Headache Is There In the World?mentioning

confidence: 99%

GBD 2015: migraine is the third cause of disability in under 50s

2016

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Section: How Much Headache Is There In the World?mentioning

confidence: 99%

GBD 2015: migraine is the third cause of disability in under 50s

2016

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“…However, a recent review concludes that this varies in different parts of the world depending on the definitions used. The review reported a wide range of prevalence, ie, 0.5%–7.2% 45. The incidence of MOH was 0.72 per 1,000 person-years in a large prospective cohort study from Norway 46…”

Section: Epidemiologymentioning

confidence: 99%

Medication-overuse headache: a review

Kristoffersen

Lundqvist²

2014

JPR

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Medication-overuse headache (MOH) is a worldwide health problem with a prevalence of 1%–2%. It is a severe form of headache where the patients often have a long history of headache and of unsuccessful treatments. MOH is characterized by chronic headache and overuse of different headache medications. Through the years, withdrawal of the overused medication has been recognized as the treatment of choice. However, currently, there is no clear consensus regarding the optimal strategy for management of MOH. Treatment approaches are based on expert opinion rather than scientific evidence. This review focuses on aspects of epidemiology, diagnosis, pathogenesis, prevention, and treatment of MOH. We suggest that information and education about the risk of MOH is important since the condition is preventable. Most patients experience reduction of headache days and intensity after successful treatment. The first step in the treatment of MOH should be carried out in primary care and focus primarily on withdrawal, leaving prophylactic medication to those who do not manage primary detoxification. For most patients, a general practitioner can perform the follow-up after detoxification. More complicated cases should be referred to neurologists and headache clinics. Patients suffering with MOH have much to gain by an earlier treatment-focused approach, since the condition is both preventable and treatable.

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“…MOH, highly burdensome at individual level [2], may be seen in almost all cases as a complication of either migraine or TTH [6]. It has yet to be recognized in global surveys such as GBD [8-10] because of lack of epidemiological data, itself in part due to difficulties over case definition and ascertainment in population surveys [11,12]. …”

Section: Introductionmentioning

confidence: 99%

Estimating prevalence and burden of major disorders of the brain in Nepal: cultural, geographic, logistic and philosophical issues of methodology

et al. 2014

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BackgroundHeadache, anxiety and depression are major disorders of the brain in terms of their prevalence and the burdens and costs they impose on society. Nationwide population-based studies of these disorders are necessary to inform health policy but, in research-naïve and resource-poor countries such as Nepal, a host of methodological problems are encountered: cultural, geographic, logistic and philosophical.MethodsExpert consensus was sought among researchers from different professional and cultural backgrounds in planning and conceptualizing an epidemiological study and adapting established methods to the special situation and circumstances of Nepal.ResultsThe methodological problems were sorted into different themes: study design; climate; geography, access and transport; sociocultural issues; safety of interviewers. Each of these was dealt with separately, and their inter-relationships explored, in finding solutions that were sometimes pragmatic. A cross-sectional questionnaire-based study, with teams of interviewers visiting households across the three physiographic divisions (with extremes in altitude) in each of the five development regions of the country, would enable national sampling with sociocultural representativeness. However, the study instruments and interviews would be in Nepali only. Transport and access challenges were considerable, and their solutions combined travel by air, bus, river and foot, with allowances for rain-damaged roads, collapsed bridges and cancelled scheduled flights. The monsoon would render many routes impassable, and therefore set an absolute time limitation. Engaging participants willingly in the enquiry would be the key to success, and several tactics would be employed to enhance the success of this, most importantly enlisting the support of local community volunteers in each study site.ConclusionAnticipating problems in advance of investing substantial resources in a large nationwide epidemiological study in Nepal was a sensible precaution. The difficulties could be resolved or circumvented without expected compromise in scientific quality. Expert consensus was an effective means of achieving this outcome.

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Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates: A systematic review

Cited by 136 publications

References 101 publications

GBD 2015: migraine is the third cause of disability in under 50s

GBD 2015: migraine is the third cause of disability in under 50s

Medication-overuse headache: a review

Estimating prevalence and burden of major disorders of the brain in Nepal: cultural, geographic, logistic and philosophical issues of methodology

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