Abstract
Objectives: Patients with chronic migraine (CM) display a considerable amount of comorbidities, particularly psychiatric and cardiovascular, and the presence of multiple comorbidities, that is, the so-called multimorbidity, is a risk factor for migraine chronification or maintenance of CM. Our aim was to address the rate and impact of multimorbidity in patients with CM and medication overuse headache (MOH). Materials & Methods: In a sample of patients with CM attending a structured withdrawal for coexisting MOH, we defined multimorbidity as the presence of two or more conditions in addition to CM-MOH. We compared patients with and without multimorbidity for demographic and clinical variables, quality of life, and disability; we also tested whether patients with multimorbidity had higher likelihood to attend emergency room, relapse into CM, and require further withdrawal treatments by 12 months. Results: One hundred and ninety-four patients were enrolled as follows: 61% had at least one comorbidity, the most common being mental (34%), circulatory (18%), and endocrine conditions (13%); 32% were multimorbidity cases. Patients with multimorbidity had higher headaches frequency, older age, lower education and lower employment rates, higher disability and lower QoL. They were more frequently opioids/barbiturates overusers and were more likely to attend ER (OR: 2.36), relapse into CM (OR: 2.19), and undergo another withdrawal (OR: 2.75) by 12 months after discharge, after controlling for age, gender, years of education, and headache frequency. Conclusions: Recognizing multimorbidity in patients with CM-MOH is important to enhance the management of these complex patients, who are at risk of polypharmacy and increased health care utilization.
| Original language | English |
|---|---|
| Pages (from-to) | 515-522 |
| Number of pages | 8 |
| Journal | Acta Neurologica Scandinavica |
| Volume | 138 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 1 2018 |
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Keywords
- comorbidity
- disability
- medication overuse headache
- multimorbidity
- quality of life
- relapse rate
- withdrawal
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
Cite this
Multimorbidity in patients with chronic migraine and medication overuse headache. / D'Amico, Domenico; Sansone, Emanuela; Grazzi, Licia; Giovannetti, Ambra M.; Leonardi, Matilde; Schiavolin, Silvia; Raggi, Alberto.
In: Acta Neurologica Scandinavica, Vol. 138, No. 6, 01.12.2018, p. 515-522.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Multimorbidity in patients with chronic migraine and medication overuse headache
AU - D'Amico, Domenico
AU - Sansone, Emanuela
AU - Grazzi, Licia
AU - Giovannetti, Ambra M.
AU - Leonardi, Matilde
AU - Schiavolin, Silvia
AU - Raggi, Alberto
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Objectives: Patients with chronic migraine (CM) display a considerable amount of comorbidities, particularly psychiatric and cardiovascular, and the presence of multiple comorbidities, that is, the so-called multimorbidity, is a risk factor for migraine chronification or maintenance of CM. Our aim was to address the rate and impact of multimorbidity in patients with CM and medication overuse headache (MOH). Materials & Methods: In a sample of patients with CM attending a structured withdrawal for coexisting MOH, we defined multimorbidity as the presence of two or more conditions in addition to CM-MOH. We compared patients with and without multimorbidity for demographic and clinical variables, quality of life, and disability; we also tested whether patients with multimorbidity had higher likelihood to attend emergency room, relapse into CM, and require further withdrawal treatments by 12 months. Results: One hundred and ninety-four patients were enrolled as follows: 61% had at least one comorbidity, the most common being mental (34%), circulatory (18%), and endocrine conditions (13%); 32% were multimorbidity cases. Patients with multimorbidity had higher headaches frequency, older age, lower education and lower employment rates, higher disability and lower QoL. They were more frequently opioids/barbiturates overusers and were more likely to attend ER (OR: 2.36), relapse into CM (OR: 2.19), and undergo another withdrawal (OR: 2.75) by 12 months after discharge, after controlling for age, gender, years of education, and headache frequency. Conclusions: Recognizing multimorbidity in patients with CM-MOH is important to enhance the management of these complex patients, who are at risk of polypharmacy and increased health care utilization.
AB - Objectives: Patients with chronic migraine (CM) display a considerable amount of comorbidities, particularly psychiatric and cardiovascular, and the presence of multiple comorbidities, that is, the so-called multimorbidity, is a risk factor for migraine chronification or maintenance of CM. Our aim was to address the rate and impact of multimorbidity in patients with CM and medication overuse headache (MOH). Materials & Methods: In a sample of patients with CM attending a structured withdrawal for coexisting MOH, we defined multimorbidity as the presence of two or more conditions in addition to CM-MOH. We compared patients with and without multimorbidity for demographic and clinical variables, quality of life, and disability; we also tested whether patients with multimorbidity had higher likelihood to attend emergency room, relapse into CM, and require further withdrawal treatments by 12 months. Results: One hundred and ninety-four patients were enrolled as follows: 61% had at least one comorbidity, the most common being mental (34%), circulatory (18%), and endocrine conditions (13%); 32% were multimorbidity cases. Patients with multimorbidity had higher headaches frequency, older age, lower education and lower employment rates, higher disability and lower QoL. They were more frequently opioids/barbiturates overusers and were more likely to attend ER (OR: 2.36), relapse into CM (OR: 2.19), and undergo another withdrawal (OR: 2.75) by 12 months after discharge, after controlling for age, gender, years of education, and headache frequency. Conclusions: Recognizing multimorbidity in patients with CM-MOH is important to enhance the management of these complex patients, who are at risk of polypharmacy and increased health care utilization.
KW - comorbidity
KW - disability
KW - medication overuse headache
KW - multimorbidity
KW - quality of life
KW - relapse rate
KW - withdrawal
UR - http://www.scopus.com/inward/record.url?scp=85052942614&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052942614&partnerID=8YFLogxK
U2 - 10.1111/ane.13014
DO - 10.1111/ane.13014
M3 - Article
C2 - 30107027
AN - SCOPUS:85052942614
VL - 138
SP - 515
EP - 522
JO - Acta Neurologica Scandinavica
JF - Acta Neurologica Scandinavica
SN - 0001-6314
IS - 6
ER -