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- Title
Predictors of 12-Months Relapse After Withdrawal Treatment in Hospitalized Patients With Chronic Migraine Associated With Medication Overuse: A Longitudinal Observational Study.
- Authors
Raggi, Alberto; Giovannetti, Ambra M.; Leonardi, Matilde; Sansone, Emanuela; Schiavolin, Silvia; Curone, Marcella; Grazzi, Licia; Usai, Susanna; D'Amico, Domenico
- 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.
- Subjects
ITALY; 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
- Publication
Headache: The Journal of Head & Face Pain, 2017, Vol 57, Issue 1, p60
- ISSN
0017-8748
- Publication type
Article
- DOI
10.1111/head.12979