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Predictors of 12-Months Relapse After Withdrawal Treatment in Hospitalized Patients With Chronic Migraine Associated With Medication Overuse: A Longitudinal Observational Study.
- Source :
- Headache: The Journal of Head & Face Pain; Jan2017, Vol. 57 Issue 1, p60-70, 11p
- Publication Year :
- 2017
-
Abstract
- Background Studies addressing relapse rates conflate relapse into chronic migraine (CM) and medication overuse (MO), and the consequent need to repeat withdrawal. We aim to identify 12-months predictors of relapse into CM (based on headaches frequency) separately from occurrence of another structured withdrawal. Methods Hospitalized patients with CM-MO under withdrawal were enrolled. Candidate predictors included demographic, disability, quality of life, depression scores, general self-efficacy, social support, headaches frequency and intensity, class of overused medications, history of withdrawal treatment in the three years prior to enrollment, attendance to emergency room (ER) between enrollment and follow-up, nonattendance to outpatient neurological examinations. Logistic regressions was used to address the significant predictors for the two outcomes. Results Complete data were available for 177 patients: 60 (33.9%) relapsed into CM, 38 (21.5%) underwent another withdrawal treatment. Recent history of withdrawal treatments, ER admission after discharge and high baseline BDI-II scores were significant predictors in both models. In addition to this, high baseline headache frequency predicted relapse into another withdrawal treatment. Conclusions Predictors or relapse into CM and of occurrence of another withdrawal by 12-months are somehow similar. It is important to assess presence of recent previous withdrawal treatments and to plan regular follow-up afterwards, in particular for patients with high headache frequency and relevant mood disturbances: in this way, it will be more likely that situations requiring further structured withdrawal treatments can be identified before patients have to refer to ER. [ABSTRACT FROM AUTHOR]
- Subjects :
- DISEASE relapse
HOSPITALS
ANALGESICS
CHI-squared test
CONFIDENCE intervals
LONGITUDINAL method
MIGRAINE
SCIENTIFIC observation
PROBABILITY theory
PSYCHOLOGICAL tests
QUESTIONNAIRES
REGRESSION analysis
RESEARCH funding
STATISTICS
SUBSTANCE abuse
SUBSTANCE abuse treatment
TREATMENT programs
RECEIVER operating characteristic curves
DATA analysis software
DESCRIPTIVE statistics
ODDS ratio
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 00178748
- Volume :
- 57
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Headache: The Journal of Head & Face Pain
- Publication Type :
- Academic Journal
- Accession number :
- 120504735
- Full Text :
- https://doi.org/10.1111/head.12979