Abstract
BackgroundMedication overuse headache (MOH) is a chronic headache disorder, caused by overuse of acute medication. To date, it remains unclear why some people overuse these medications. The aim of this qualitative study was to explore how individuals with MOH use medications and other strategies to manage headaches in their daily lives, and their thoughts about their own use of acute medication. Our intention was to develop a theoretical model about the development of MOH, from the perspective of those with MOH.MethodsData collection and analysis were conducted according to grounded theory methodology. The participants were recruited via newspaper advertisements. Fourteen persons with MOH were interviewed in individual qualitative interviews.ResultsThe basic process leading to medication overuse was holding on to the indispensable medication. The acute medication was indispensable to the participants because they perceived it as the only thing that could prevent headaches from ruining their lives. The participants perceived headaches as something that threatened to ruin their lives. As a result, they went to great lengths trying to find ways to manage it. They tried numerous strategies. However, the only strategy actually perceived as effective was the use of acute medication and they eventually became resigned to the idea that it was the only effective aid. The acute medication thus became indispensable. Their general intention was to use as little medication as possible but they found themselves compelled to medicate frequently to cope with their headaches. They did not like to think about their medication use and sometimes avoided keeping track of the amount used.ConclusionsThis qualitative study adds understanding to the process via which MOH develops from the perspective of those having MOH. Such knowledge may help bridge the gap between the perspectives of patients and health-care professionals.
Highlights
Medication overuse headache (MOH) is a chronic headache disorder, caused by overuse of acute medication
The method is suitable for the study of how thoughts about headache and medication use can lead to overuse and the development of MOH
Core category: Holding on to the indispensable medication The basic process leading to medication overuse was holding on to the indispensable medication, Figure 1
Summary
Medication overuse headache (MOH) is a chronic headache disorder, caused by overuse of acute medication. Medication use is the prevailing method for treating pain, excessive use of acute medication is usually not a successful strategy, in the case of headaches where it may lead to medication-overuse headache (MOH), a chronic headache disorder with daily or neardaily symptoms, caused by overuse of acute headache medication [1,2] This may, in turn, lead to negative consequences such as a higher disease burden [3], reduced quality of life [4,5] and potentially harmful physiological effects [6,7]. To date, it remains unclear why some persons with headaches overuse acute medications [6,8]. In the only study identified concerning decision-making in MOH, Lauwerier et al [8] used a functional coping perspective and found that patients who primarily focused on the problem of pain as one that had to be solved were at a higher risk of developing MOH than those who tried to disengage from the problem and focus on other areas of life in stead
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