The cost and the value of treatment of medication overuse headache in Italy: a longitudinal study based on patient‐derived data

Raggi, Alberto; Leonardi, Matilde; Sansone, Emanuela; Curone, Marcella; Grazzi, Licia; D’Amico, Domenico

doi:10.1111/ene.14034

Cited by 30 publications

(31 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Within the pediatric cohort, MOH is estimated at a prevalence around 0.5% with a higher rate among girls 19‐21 . The negative impact on quality of life (QoL) and the economic cost of MOH are substantial; with both high direct and indirect costs, total cost for nations run into billions of dollars per year 22,23 …”

Section: Introductionmentioning

confidence: 99%

The Many Faces of Medication‐Overuse Headache in Clinical Practice

2020

View full text Add to dashboard Cite

The management of medication-overuse headache (MOH) is multifaceted and headache experts have different views on the optimal strategy to tackle this type of secondary headache. The purpose of this review is to provide an overview of the literature on the management of MOH, and to highlight important considerations in the clinical evaluation of the MOH patient.Managing MOH in clinical practice starts by evaluating the headache patient with medication overuse, determining the overused drug(s), assessing the impact of headaches on the patient and assessing comorbid conditions and disorders. Withdrawal of the overused medication is the cornerstone of treatment. An inpatient or outpatient setting is chosen based on the clinical profile of the patient. There is evidence for abrupt withdrawal combined with headache preventive treatment.Bridging therapy to bring relief to withdrawal headaches and/or symptoms should be offered. Education and motivational work through multidisciplinary assessment show benefits in sustaining withdrawal and preventing relapse.Although the reversal of chronic headache after cessation of overused acute medication has been noticed worldwide, different aspects of the management of MOH, such as complete or gradual withdrawal, or preventive treatment with or without withdrawal are still debated.

show abstract

Section: Introductionmentioning

confidence: 99%

The Many Faces of Medication‐Overuse Headache in Clinical Practice

2020

View full text Add to dashboard Cite

show abstract

“…Second, the question concerning the number of days with 50% or more reduction of work performance does not quantify the days when the headache has a less than 50% impact on productivity. In fact, when specifically asked, most of the patients felt their reduction in productivity at work with migraine was lower than 50% . The requirement in MIDAS for ≥50% disability prevents a comprehensive appreciation of the different degrees of migraine interference with work‐related activities …”

Section: Brief Review Of Available Patient‐reported Outcome Measures mentioning

confidence: 99%

“…We reported in 2019 the cost of medication overuse headache for Italy, and we relied on the joint combination of full workdays lost and lost work with partial disability for the calculation of LPT . We asked respondents to describe their ability to work in days with headache, using a 1%‐99% , at baseline and after three months.…”

Section: Why Is a New Pro Needed?mentioning

confidence: 99%

“…Understanding the limitations that migraine entails with work duties is important because migraine is highly prevalent and peaks in the young adult age where higher work productivity is expected. This highlights the need to evaluate indirect costs, ie those associated with reduced productivity, over direct costs, which in the case of headache disorders correspond to measured healthcare cost …”

Section: Introductionmentioning

confidence: 99%

“…The reduction of work productivity may be assessed in terms of absenteeism, loss of paid work days, and presenteeism, hours or days in which patients worked less productively due to migraine. The costs associated with the latter are higher than those caused by absenteeism, given the tendency of patients suffering from different migraine forms to turn up at work despite the actual headache episode. In fact, for each lost workday, patients with EM and CM spend 3 to 5 days with reduced work productivity …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

HEADWORK Questionnaire: Why Do We Need a New Tool to Assess Work‐Related Disability in Patients With Migraine?

et al. 2020

Self Cite

View full text Add to dashboard Cite

Objective.-This article reviews current headache disability measures and clinical need, as well as presenting the rationale for a new measure addressing work-related disability in migraine patients and the steps devoted to this aim.Background.-Episodic and chronic migraine (EM and CM) constitute an enormous economic burden to societies, and the vast majority of this burden is attributable to indirect costs, ie those associated with productivity loss. A measure of workrelated disability is therefore needed to quantify the impact of EM and CM on patients' ability to carry out work tasks.Methods.-We briefly present the advantages and disadvantages of the disability measures that have been most commonly used for this purpose and the rationale for developing a new measure.Results.-The entire process of development of HEADWORK, a questionnaire designed to assess work-related disability, is presented together with short-term sensitivity to change.Conclusions.-Current headache disability measures need improvement. HEADWORK is a valid, reliable, and sensitive questionnaire to address the amount and severity of workrelated difficulties and of the factors contributing to such difficulties. HEADWORK is suitable for daily clinical practice, epidemiological research and for clinical trials, and potentially to define work-related disability weights for the calculation of migraine indirect costs.

show abstract

Comparison of 3 Treatment Strategies for Medication Overuse Headache

et al. 2020

View full text Add to dashboard Cite

IMPORTANCE Medication overuse headache (MOH) is a disabling, globally prevalent disorder representing a well-known and debated clinical problem. Evidence for the most effective treatment strategy is needed.OBJECTIVE To compare 3 treatment strategies for MOH. DESIGN, SETTING, AND PARTICIPANTSThis open-label, randomized clinical trial with 6 months of follow-up was conducted in the tertiary sector at the Danish Headache Center, Glostrup, from October 25, 2016, to June 28, 2019. Of 483 patients with MOH referred during the inclusion period, 195 met the criteria consisting of migraine and/or tension-type headache, 18 years or older, eligibility for outpatient treatment, no severe physical or psychiatric disorder, no other addiction, and not pregnant or breastfeeding. Of these, 75 refused participation and 120 were included. Data were analyzed from July 3 to September 6, 2019.INTERVENTIONS Random assignment (1:1:1 allocation) to 1 of the 3 outpatient treatments consisting of (1) withdrawal plus preventive treatment, (2) preventive treatment without withdrawal, or (3) withdrawal with optional preventive treatment 2 months after withdrawal. MAIN OUTCOMES AND MEASURESThe primary outcome was change in headache days per month after 6 months. Predefined secondary outcomes were change in monthly migraine days, use of short-term medication, pain intensity, number of responders, patients with remission to episodic headache, and cured MOH. RESULTSOf 120 patients, 102 (mean [SD] age, 43.9 [11.8] years; 81 women [79.4%]) completed the 6-month follow-up. Headache days per month were reduced by 12.3 (95% CI, 9.3-15.3) in the withdrawal plus preventive group, by 9.9 (95% CI, 7.2-12.6) in the preventive group, and by 8.5 (95% CI, 5.6-11.5) in the withdrawal group (P = .20). No difference was found in reduction of migraine days per month, use of short-term medication, or headache intensity. In the withdrawal plus preventive group, 23 of 31 patients (74.2%) reverted to episodic headache, compared with 21 of 35 (60.0%) in the preventive group and 15 of 36 (41.7%) in the withdrawal group (P = .03). Moreover, 30 of 31 patients (96.8%) in the withdrawal plus preventive group were cured of MOH, compared with 26 of 35 (74.3%) in the preventive group and 32 of 36 (88.9%) in the withdrawal group (P = .03). These findings corresponded to a 30% (relative risk, 1.3; 95% CI, 1.1-1.6) increased chance of MOH cure in the withdrawal plus preventive group compared with the preventive group (P = .03).CONCLUSION AND RELEVANCE All 3 treatment strategies were effective, but based on these findings, withdrawal therapy combined with preventive medication from the start of withdrawal is recommended as treatment for MOH.

show abstract

The cost and the value of treatment of medication overuse headache in Italy: a longitudinal study based on patient‐derived data

Cited by 30 publications

References 25 publications

The Many Faces of Medication‐Overuse Headache in Clinical Practice

The Many Faces of Medication‐Overuse Headache in Clinical Practice

HEADWORK Questionnaire: Why Do We Need a New Tool to Assess Work‐Related Disability in Patients With Migraine?

Comparison of 3 Treatment Strategies for Medication Overuse Headache

Contact Info

Product

Resources

About