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Patterns of medication use by chronic and episodic headache sufferers in the general population: results from the frequent headache epidemiology study.
Cephalalgia. 2010 Mar; 30(3):321-8.C

Abstract

Though symptomatic medication overuse is believed to play a role in progression from episodic headaches (EH) to chronic daily headaches (CDH), population-based data on this topic are limited. Our objective was to describe patterns of medication use among CDH and EH sufferers in a general population sample. We compared medications used to treat headache in CDH cases and EH controls identified from a large population-based computer-assisted telephone interview survey. CDH began within 5 years of the computer-assisted telephone interview. Questions on medication use focused on treatment prior to the onset of CDH for cases and on an equivalent period in the past for controls. We asked about the likelihood of treating, time waiting to treat, number of different medications used, first, second and third most frequently used headache pain medication, and total treatment days. Questions were also asked about the use of medication for non-headache pain. Current treatment patterns and past treatment patterns were assessed. Likelihood of use of specific medications was compared between CDH cases and EH controls after adjusting for age, sex, primary headache type and number of medications taken to treat pain. Our sample consists of 206 CDH cases and 507 EH controls. CDH subjects were more likely than EH controls to use over-the-counter/caffeine combination products, triptans, opioid compounds and 'other' prescription pain medications. Use of aspirin was protective. After adjustment, aspirin and ibuprofen were (negatively) associated with CDH [OR = 0.5 (0.3-0.9), OR = 0.7 (0.5-1.0)] and opioids remained positively associated with CDH [OR = 2.3 (1.3-3.9)]. For past use, CDH was positively associated with over-the-counter/caffeine combination products and opioid compounds and was negatively associated with use of aspirin. Only ibuprofen remained (negatively) associated with CDH after adjustment [OR = 0.6 (0.4-0.9)]. After adjusting for demographic factors, primary headache type and number of medications taken, CDH sufferers are more likely to use opioid-combination analgesics, and less likely to use aspirin or ibuprofen, than EH sufferers.

Authors+Show Affiliations

Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, MD 20814, USA. ascher@usuhs.milNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19614708

Citation

Scher, A I., et al. "Patterns of Medication Use By Chronic and Episodic Headache Sufferers in the General Population: Results From the Frequent Headache Epidemiology Study." Cephalalgia : an International Journal of Headache, vol. 30, no. 3, 2010, pp. 321-8.
Scher AI, Lipton RB, Stewart WF, et al. Patterns of medication use by chronic and episodic headache sufferers in the general population: results from the frequent headache epidemiology study. Cephalalgia. 2010;30(3):321-8.
Scher, A. I., Lipton, R. B., Stewart, W. F., & Bigal, M. (2010). Patterns of medication use by chronic and episodic headache sufferers in the general population: results from the frequent headache epidemiology study. Cephalalgia : an International Journal of Headache, 30(3), 321-8. https://doi.org/10.1111/j.1468-2982.2009.01913.x
Scher AI, et al. Patterns of Medication Use By Chronic and Episodic Headache Sufferers in the General Population: Results From the Frequent Headache Epidemiology Study. Cephalalgia. 2010;30(3):321-8. PubMed PMID: 19614708.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns of medication use by chronic and episodic headache sufferers in the general population: results from the frequent headache epidemiology study. AU - Scher,A I, AU - Lipton,R B, AU - Stewart,W F, AU - Bigal,M, Y1 - 2010/02/01/ PY - 2009/7/21/entrez PY - 2009/7/21/pubmed PY - 2011/1/21/medline SP - 321 EP - 8 JF - Cephalalgia : an international journal of headache JO - Cephalalgia VL - 30 IS - 3 N2 - Though symptomatic medication overuse is believed to play a role in progression from episodic headaches (EH) to chronic daily headaches (CDH), population-based data on this topic are limited. Our objective was to describe patterns of medication use among CDH and EH sufferers in a general population sample. We compared medications used to treat headache in CDH cases and EH controls identified from a large population-based computer-assisted telephone interview survey. CDH began within 5 years of the computer-assisted telephone interview. Questions on medication use focused on treatment prior to the onset of CDH for cases and on an equivalent period in the past for controls. We asked about the likelihood of treating, time waiting to treat, number of different medications used, first, second and third most frequently used headache pain medication, and total treatment days. Questions were also asked about the use of medication for non-headache pain. Current treatment patterns and past treatment patterns were assessed. Likelihood of use of specific medications was compared between CDH cases and EH controls after adjusting for age, sex, primary headache type and number of medications taken to treat pain. Our sample consists of 206 CDH cases and 507 EH controls. CDH subjects were more likely than EH controls to use over-the-counter/caffeine combination products, triptans, opioid compounds and 'other' prescription pain medications. Use of aspirin was protective. After adjustment, aspirin and ibuprofen were (negatively) associated with CDH [OR = 0.5 (0.3-0.9), OR = 0.7 (0.5-1.0)] and opioids remained positively associated with CDH [OR = 2.3 (1.3-3.9)]. For past use, CDH was positively associated with over-the-counter/caffeine combination products and opioid compounds and was negatively associated with use of aspirin. Only ibuprofen remained (negatively) associated with CDH after adjustment [OR = 0.6 (0.4-0.9)]. After adjusting for demographic factors, primary headache type and number of medications taken, CDH sufferers are more likely to use opioid-combination analgesics, and less likely to use aspirin or ibuprofen, than EH sufferers. SN - 1468-2982 UR - https://www.unboundmedicine.com/medline/citation/19614708/Patterns_of_medication_use_by_chronic_and_episodic_headache_sufferers_in_the_general_population:_results_from_the_frequent_headache_epidemiology_study_ L2 - http://journals.sagepub.com/doi/full/10.1111/j.1468-2982.2009.01913.x?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -