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Early management of patients with medication‐overuse headache: results from a multicentre clinical study.

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Title: Early management of patients with medication‐overuse headache: results from a multicentre clinical study.
Authors: Corbelli, I., Sarchielli, P., Eusebi, P., Cupini, L. M., Caproni, S., Calabresi, P., SAMOHA Study Group
Source: European Journal of Neurology. Aug2018, Vol. 25 Issue 8, p1027-1033. 7p. 1 Diagram, 2 Charts.
Subjects: Medication abuse, Headache treatment, Headache, Migraine, Drug overdose, Patients
Abstract: Background and purpose: Educational intervention has proved to be effective in reducing drug abuse in uncomplicated medication‐overuse headache (MOH). This ancillary of the SAMOHA multicentre study aimed to assess any differences in phenotypic characteristics, type and amount of drugs overused, and comorbidities between patients with MOH who responded to simple advice and those who did not. Methods: Demographic and clinical headache data of the last 3 months before enrollment of patients were collected and patients were then asked to fill out a daily headache diary for 4 weeks. Patients were then divided into two subgroups, i.e. those with confirmed MOH continued in the study [randomized (R) group], whereas those who did not still show any features of MOH dropped out of the study. Results: A total of 88 (67.7%) patients still met the inclusion criteria after the baseline 4 weeks (R group). Conversely, 42 (32.3%) patients dropped out of the study. A detailed analysis of those who dropped out revealed that only 34 were not randomized at visit 2 because they no longer satisfied the inclusion criteria for MOH [screening failures (SF) group]. The SF group was significantly younger and had fewer years of migraine history than the R group. Moreover, the SF group had a significantly shorter history of chronicity compared with the R group. Conclusions: Our findings suggest that in MOH trials, after an educational session, an observational period is needed in order to confirm the diagnosis of MOH and to avoid overestimation of the effect of other treatments used to manage MOH. Future research should focus mainly on those patients with MOH who do not respond to simple advice and with unsuccessful withdrawal. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Early management of patients with medication‐overuse headache: results from a multicentre clinical study.
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  Data: <searchLink fieldCode="AR" term="%22Corbelli%2C+I%2E%22">Corbelli, I.</searchLink><br /><searchLink fieldCode="AR" term="%22Sarchielli%2C+P%2E%22">Sarchielli, P.</searchLink><br /><searchLink fieldCode="AR" term="%22Eusebi%2C+P%2E%22">Eusebi, P.</searchLink><br /><searchLink fieldCode="AR" term="%22Cupini%2C+L%2E+M%2E%22">Cupini, L. M.</searchLink><br /><searchLink fieldCode="AR" term="%22Caproni%2C+S%2E%22">Caproni, S.</searchLink><br /><searchLink fieldCode="AR" term="%22Calabresi%2C+P%2E%22">Calabresi, P.</searchLink><br /><searchLink fieldCode="AR" term="%22SAMOHA+Study+Group%22">SAMOHA Study Group</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Aug2018, Vol. 25 Issue 8, p1027-1033. 7p. 1 Diagram, 2 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Medication+abuse%22">Medication abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Headache+treatment%22">Headache treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Headache%22">Headache</searchLink><br /><searchLink fieldCode="DE" term="%22Migraine%22">Migraine</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+overdose%22">Drug overdose</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink>
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  Label: Abstract
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  Data: Background and purpose: Educational intervention has proved to be effective in reducing drug abuse in uncomplicated medication‐overuse headache (MOH). This ancillary of the SAMOHA multicentre study aimed to assess any differences in phenotypic characteristics, type and amount of drugs overused, and comorbidities between patients with MOH who responded to simple advice and those who did not. Methods: Demographic and clinical headache data of the last 3 months before enrollment of patients were collected and patients were then asked to fill out a daily headache diary for 4 weeks. Patients were then divided into two subgroups, i.e. those with confirmed MOH continued in the study [randomized (R) group], whereas those who did not still show any features of MOH dropped out of the study. Results: A total of 88 (67.7%) patients still met the inclusion criteria after the baseline 4 weeks (R group). Conversely, 42 (32.3%) patients dropped out of the study. A detailed analysis of those who dropped out revealed that only 34 were not randomized at visit 2 because they no longer satisfied the inclusion criteria for MOH [screening failures (SF) group]. The SF group was significantly younger and had fewer years of migraine history than the R group. Moreover, the SF group had a significantly shorter history of chronicity compared with the R group. Conclusions: Our findings suggest that in MOH trials, after an educational session, an observational period is needed in order to confirm the diagnosis of MOH and to avoid overestimation of the effect of other treatments used to manage MOH. Future research should focus mainly on those patients with MOH who do not respond to simple advice and with unsuccessful withdrawal. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Aug2018
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