Abstract
BackgroundThe type of medical care received (self-medication and/or medical care provided by a general practitioner or a neurologist) may be associated with differences in the frequency of medication overuse headaches.MethodThis cross-sectional analytical study included 222 records of patients with chronic daily headaches seen at the National Institute of Neurological Sciences Outpatient Unit in Lima, Peru. A pre-designed questionnaire was used to assess and categorize patients with frequent and chronic headaches.ResultsNinety-four patients (42.34% of those with chronic daily headaches) met the criteria for medication overuse headache. Of these, 19 (28%) self-medicated, 22 (36%) consulted with the general practitioner, and the highest proportion of subjects, 53 (58%), consulted with a neurologist. On bivariate analysis, subjects who had received care from a general practitioner and self-medicated were 38% and 51% less likely to have MOH than the subjects whoreceived medical care from the neurologist (p=0.012; 95% CI 0.42-0.90 and p=0.001; 95% CI 0.32-0.74). On multivariate analysis adjusting by sociodemographic and clinical factors, the association remained significant in regards to self-medication, but became marginal (p=0.055) in regard to being seen by a general practitioner.ConclusionIn this study, the frequency of the headache due to overuse of medication was higher in patients attending a neurologist than those attending a general practitioner or self-medicated. This cross-sectional design cannot assess whether this reflects more severe cases looking for specialized care or more medication overuse headaches as a result of inappropriate management.
Highlights
MethodsHeadache is a symptom associated with many medical conditions (ICHD-3), and migraine and tension-type headache (TTH) are the most prevalent types of headaches
When migraine or TTH are categorized as episodic migraine (EM) and episodic TTH (ETTH) if attacks occur less than 15 days a month
This study evaluated whether there is a relationship between Medication overuse headache (MOH) and the type of medical care received in new patients who attended a neurological referral center
Summary
MethodsHeadache is a symptom associated with many medical conditions (ICHD-3), and migraine and tension-type headache (TTH) are the most prevalent types of headaches. There is no clear evidence regarding the association of MOH with the type of medical care received. This study evaluated whether there is a relationship between MOH and the type of medical care received (selfmedication, general practitioner or neurologist) in new patients who attended a neurological referral center.
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