Economic burden of medication-overuse headache in Iran: direct and indirect costs

Togha, Mansoureh; Nadjafi-Semnani, Fatemeh; Martami, Fahimeh; Mohammadshirazi, Zahra; Vahidpour, Niusha; Amini, Ali; Daroudi, Rajabali

doi:10.1007/s10072-020-04716-8

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…Although overall this was only 1.1%, what is of concern is the strong association with age, with AOR = 5.0 in adolescents (prevalence 1.9%) compared with children (prevalence 0.4%) (Table 2). Thus is the pattern set for MOH in adults, a significant and costly cause of disability in Iran (16). MOH is an acquired disorder, attributable to a behaviour that, when it occurs in children, is most probably taught to them by their parents.…”

Section: Discussionmentioning

confidence: 99%

“…It is the first such study from the Eastern Mediterranean Region, adding to those from European (8,9), Western Pacific (10) and African Regions (11,12). While there is published evidence of headache-attributed burden among adults in Iran, the data are not population-based (14 –16). Iran is the second-largest country in the Middle East after Saudi Arabia, although much of it is mountainous and uninhabitable.…”

Section: Introductionmentioning

confidence: 99%

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The prevalence of headache disorders in children and adolescents in Iran: a schools-based study

et al. 2022

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Background While the Global Burden of Disease study reports headache disorders as the third-highest cause of disability worldwide, the headache data in this study largely come from adults. This national study in Iran, the first of its type in the Eastern Mediterranean Region, was part of a global schools-based programme within the Global Campaign against Headache contributing data from children (6–11 years) and adolescents (12–17 years). Methods We followed the generic protocol for the global study. In a cross-sectional survey, self-completed structured questionnaires were administered to pupils within their classes in 121 schools selected from across the country to be representative of its diversities. Headache diagnostic questions were based on ICHD-3 criteria but for the inclusion of undifferentiated headache. Results Of 3,357 potential participants, 3,244 (children 1,308 [40.3%], adolescents 1,936 [59.7%]; males 1,531 [47.2%], females 1,713 [52.8%]) satisfactorily completed the questionnaire. Children and males were therefore somewhat under-represented, with a participating proportion of 96.6%. Gender- and age-adjusted 1-year prevalence of any headache was 65.4%, of migraine 25.2%, of tension-type headache 12.7%, of undifferentiated headache 22.1%, of all headache on ≥15 days/month 4.1%, and of probable medication-overuse headache 1.1%. All headache types except undifferentiated headache were more prevalent among adolescents than children; probable medication-overuse headache increased five-fold between childhood and adolescence. Conclusions Headache disorders are common in children and adolescents in Iran, with undifferentiated headache accounting for over one third of cases. The increasing prevalence of probable medication-overuse headache with age is concerning. These findings are of importance to health and educational policies in Iran.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The prevalence of headache disorders in children and adolescents in Iran: a schools-based study

et al. 2022

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“…The 3-month cost per patient with MOH fell from EUR 2989 to EUR 1160 in Italy [95]. Moreover, the total cost for MOH patients is USD 10,179,000,000 annually in Iran [96]. A high economic burden for MOH was shown in other countries in the world as well [46,[97][98][99].…”

Section: Discussionmentioning

confidence: 99%

Candidate Genes and Proteomic Biomarkers of Serum and Urine in Medication-Overuse Headache

Shnayder

Sharavii

Петрова

et al. 2021

IJMS

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Chronic headache is a topical problem of neurology, psychiatry and general practice. The medication-overuse headache (MOH) is one of the leading pathologies in the structure of chronic headache. However, early diagnosis of the MOH is challenging. We analyzed potential proteomic biomarkers of serum and urine in patients with MOH. Methods: We searched PubMed, Springer, Scopus, Web of Science, ClinicalKey, and Google Scholar databases for English publications over the past 10 years using keywords and their combinations. Results: We found and analyzed seven studies that met the search criteria for the purpose of the review, including 24 serum proteomic biomarkers and 25 urine proteomic biomarkers of MOH. Moreover, the candidate genes and locus of the studied serum (vitamin D-binding protein, lipocalin-type prostaglandin D2 synthase, apolipoprotein E, etc.) and urine proteomic biomarkers (uromodulin, alpha-1-microglobulin, zinc-alpha-2-glycoprotein, etc.) of MOH are presented in this review. Conclusions: The serum and urine proteomic biomarkers of MOH can potentially help with the identification of patients with MOH development. Due to the relevance of the problem, the authors believe that further investigation of the MOH proteomic biomarkers in different ethnic and racial groups of patients with primary headache is necessary. In addition, it is important to investigate whether medications of different drug classes influence the levels of serum and urine proteomic biomarkers.

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“…In this research, each dollar was considered equal to currency exchange rate at the time of payments as 42 000 Rials. 19 Inclusion/Exclusion Criteria All data of the survivors exposed to SM were included. Only the HCU of survivors was examined and the data of their families were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

Healthcare Utilization and Expenditures among Iranian Chemical Warfare Survivors Exposed to Sulfur Mustard

et al. 2022

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Background: This study aims to explore the healthcare utilization (HCU) and expenditures from complementary health insurance among Iranian people who survived sulfur mustard (SM) exposure during the Iran-Iraq war. Methods: This study was conducted between March 21, 2018 and March 21, 2019 using secondary data. Data on the HCU and expenditure of war survivors after their exposure to SM were obtained from the Iran Veterans and Martyr Affair Foundation (VMAF) database and the national complementary insurance organization that covers their medical expenses. Multiple linear and zero-inflated poison regression (ZIP) models were used to estimate the costs and HCU. Analyses were performed in R software version 3.6.3. Results: Among 58880 survivors who were included in study, 36383 (61.7%) used at least one service during a year. The total frequency of HCU was 15.6 services per person per year. The annual mean medical cost of each survivor was US$807.6 (±2901.2). The highest number of utilizations was related to medicine and physician visits. The highest median cost was related to rehabilitation (US$151.7), medical equipment (US$84.5), medicine (US$83.3) and inpatient services (US$ 48.8). With increasing age, disability, weight, severity of injury in lung or eye injuries, the rate of health service utilization rose significantly. Conclusion: Over 30 years after the Iran-Iraq war, Iranian people who were exposed to SM and survived still suffer from injuries and pose a significant drain on healthcare resources.

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Economic burden of medication-overuse headache in Iran: direct and indirect costs

Cited by 14 publications

References 21 publications

The prevalence of headache disorders in children and adolescents in Iran: a schools-based study

The prevalence of headache disorders in children and adolescents in Iran: a schools-based study

Candidate Genes and Proteomic Biomarkers of Serum and Urine in Medication-Overuse Headache

Healthcare Utilization and Expenditures among Iranian Chemical Warfare Survivors Exposed to Sulfur Mustard

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