Abstract
BackgroundMedication-overuse headache (MOH) is a common problem in primary care. Brief intervention (BI) has successfully been used for detoxification from overuse of alcohol and drugs. The aim of this pilot study was to develop and test methodology, acceptability and logistics for a BI for MOH in primary care.FindingsObservational feasibility study of an intervention in a Norwegian general practice population.Six general practitioners (GPs) were recruited. A screening questionnaire for MOH was sent to all 18–50 year old patients on these GPs` list. GPs were taught BI, which was applied to MOH patients as follows: Severity of dependence scale (SDS) scores were collected and individual feedback was given of the relationship between the SDS, medication overuse and headache. Finally, advice to reduce medication was given. Patients were invited to a headache interview three months after the BI. Main outcomes were feedback from GPs/patients about the feasibility and logistics of the study design, screening/recruitment process, BI and headache interviews. Efficacy and patient-related outcomes were not focused. The patients reported a high degree of acceptability of the methodology. The GPs reported the BI to be feasible to implement within a busy practice and to represent a new and improved instrument for communication with MOH patients. The BI requires further testing in a randomised controlled trial (RCT) in order to provide evidence of efficacy.ConclusionThis feasibility study will be used to improve the BI for MOH and the design of a cluster-RCT.Trial registrationClinicalTrials.gov: NCT01078012 (Initially registered as controlled efficacy trial but changed to observational study).
Highlights
Medication-overuse headache (MOH) is a common problem in primary care
Five out of six general practitioners (GPs) completed a Brief intervention (BI) for MOH
We have demonstrated that BI for MOH carried out by minimally trained GPs seems feasible and acceptable by both patients and GPs
Summary
BI for MOH seems feasible and acceptable by both patients and GPs. We intend to test the efficacy of BI for MOH in a double-blind pragmatic cluster-RCT since this is a simple intervention with a potential to reach many suffering patients at the lowest effective health care level (GP). Competing interests The authors declare that they have no competing interests. Authors’ contributions CL had the original idea for the study and together with JS, MBR and ESK planned the overall design. ESK prepared the initial draft and was the main author of the present manuscript. ESK and CL carried out the pilot study. MBR supported in the design of the study and with scientific input regarding headache. All authors have read, revised and approved the final manuscript
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